Publications by authors named "Sanjay Raghav"

Introduction: Abnormal reactive saccade, with reduced saccadic gain, impaired smooth pursuit, and unwarranted reactions are clinically used to assess people with Parkinson's disease (PwPD). However, there are inconsistent findings related to other saccade parameters such as latency and transition times. This study aimed to identify differences in the reflexive saccade parameters of early stage PwPD and aged-matched control (AMC).

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Objective: A change in handwriting is an early sign of Parkinson's disease (PD). However, significant inter-person differences in handwriting make it difficult to identify pathological handwriting, especially in the early stages. This paper reports the testing of NeuroDiag, a software-based medical device, for the automated detection of PD using handwriting patterns.

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Background: Several validated clinical scales measure the severity of essential tremor (ET). Their assessments are subjective and can depend on familiarity and training with scoring systems.

Method: We propose a multi-modal sensing using a wearable inertial measurement unit for estimating scores on the Fahn-Tolosa-Marin tremor rating scale (FTM) and determine the classification accuracy within the tremor type.

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Commonly used methods to assess the severity of essential tremor (ET) are based on clinical observation and lack objectivity. This study proposes the use of wearable accelerometer sensors for the quantitative assessment of ET. Acceleration data was recorded by inertial measurement unit (IMU) sensors during sketching of Archimedes spirals in 17 ET participants and 18 healthy controls.

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We investigated whether computerised analysis of writing and drawing could discriminate essential tremor (ET) phenotypes according to the 2018 Consensus Statement on the Classification of Tremors. The Consensus scheme emphasises soft additional findings, mainly motor, that do not suffice to diagnose another tremor syndrome. Ten men and nine women were classified by blinded assessors according to Consensus Axis 1 definitions of ET and ET plus.

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Introduction: Some people with Parkinson's disease (PD) frequently have an unsteady gait with shuffling, reduced strength, and increased rigidity. This study has investigated the difference in the neuromuscular strategies of people with early-stage PD, healthy older adults (HOA) and healthy young adult (HYA) during short-distance walking.

Method: Surface electromyogram (sEMG) was recorded from tibialis anterior (TA) and medial gastrocnemius (MG) muscles along with the acceleration data from the lower leg from 72 subjects-24 people with early-stage PD, 24 HOA and 24 HYA during short-distance walking on a level surface using wearable sensors.

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Micrographia, one element of the dysgraphia of Parkinson's disease (PD), may be classified according to the presence or absence of a decremental pattern. The decremental form, progressive micrographia, is an expression of the sequence effect seen generally in bradykinesia. Its responsiveness to levodopa has not been evaluated kinematically.

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Context: Movement disorders represent a common presentation in pediatrics and are often a source of clinical and diagnostic dilemmas. In this review, we provide an overview of common causes along with simplified clinical approach and management options for major movement disorders.

Sources: This narrative review is based on contemporary evidence and personal experience.

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This study has investigated the efficiency of voice features in estimating the motor Unified Parkinson's Disease Rating Scale (UPDRS) score in Parkinson's disease (PD) patients. A total of 26 PD patients (mean age = 72) and 22 control subjects (mean age = 66.91) were recruited for the study.

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Surface electromyography (sEMG) of the lower limb muscles has been proposed to evaluate motor dysfunctions in Parkinson's disease (PD) patients. Variability in the sEMG could be used as an indicator of poor muscle coordination, but previous studies have reported conflicting results. This study has examined the variability of muscle using the coefficients of variance of Tibialis anterior (TA) and Medial gastrocnemius (MG) lower limb muscles for 24 PD, 24 age matched controls (CO), and 24 young controls (YC), during different phases of the gait cycle.

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In this paper, we have investigated the differences in the voices of Parkinson's disease (PD) and age-matched control (CO) subjects when uttering three phonemes using two complexity measures: fractal dimension (FD) and normalised mutual information (NMI). Three sustained phonetic voice recordings, /a/, /u/ and /m/, from 22 CO (mean age = 66.91) and 24 PD (mean age = 71.

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Progressive micrographia is decrement in character size during writing and is commonly associated with Parkinson's disease (PD). This study has investigated the kinematic features of progressive micrographia during a repetitive writing task. Twenty-four PD patients with duration since diagnosis of <10 years and 24 age-matched controls wrote the letter "" repeatedly.

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This study investigated the difference in the gait of patients with Parkinson's disease (PD), age-matched controls and young controls during three walking patterns. Experiments were conducted with 24 PD, 24 age-matched controls and 24 young controls, and four gait intervals were measured using inertial measurement units (IMU). Group differences between the mean and variance of the gait parameters (stride interval, stance interval, swing interval and double support interval) for the three groups were calculated and statistical significance was tested.

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Levodopa treatment does improve Parkinson's disease (PD) dysgraphia, but previous research is not in agreement about which aspects are most responsive. This study investigated the effect of levodopa on the kinematics of writing. Twenty-four patients with PD of less than 10 years duration and 25 age-matched controls were recruited.

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Background: Change of handwriting can be an early marker for severity of Parkinson's disease but suffers from poor sensitivity and specificity due to inter-subject variations.

Aim: This study has investigated the group-difference in the dynamic features during sketching of spiral between PD and control subjects with the aim of developing an accurate method for diagnosing PD patients.

Method: Dynamic handwriting features were computed for 206 specimens collected from 62 Subjects (31 Parkinson's and 31 Controls).

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The speed and pen-pressure while sketching a spiral are lower among Parkinson's disease (PD) patients with higher severity of the disease. However, the correlation between these features and the severity level (SL) of PD has been reported to be 0.4.

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Background And Objective: Abnormal vocal cord movement may coexist with asthma and cause additional upper/middle airway obstruction. The condition may be a form of muscular dystonia that could contribute to asthma resistant to optimised treatments. Botulinum toxin causes temporary paralysis of muscle and may be an effective local treatment that improves asthma control.

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There is a need for objective measures of dyskinesia and bradykinesia of Parkinson's disease (PD) that are continuous throughout the day and related to levodopa dosing. The output of an algorithm that calculates dyskinesia and bradykinesia scores every two minutes over 10 days (PKG: Global Kinetics Corporation) was compared with conventional rating scales for PD in PD subjects. The algorithm recognises bradykinesia as movements made with lower acceleration and amplitude and with longer intervals between movement.

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Background: This randomized double blind, placebo-controlled crossover study investigated the antidyskinetic effects of levetiracetam in Parkinson's disease.

Methods: Sixteen participants with levodopa-induced dyskinesia were enrolled. Hourly videotaped dyskinesia assessments scored by the Goetz method and hourly Unified Parkinson's Disease Rating Scale motor subscale scoring were conducted on 1 day at the end of each treatment period.

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Warfarin embryopathy is a well-defined manifestation of intrauterine warfarin exposure. The embryopathy phenotype as it relates to the nervous system is broad and poorly recognised. We describe an adult with neurological sequelae of fetal warfarin exposure.

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Background: Some patients with focal cerebral calcification (FCC) have no seizure or a benign course of epilepsy, whilst others with a similar lesion have uncontrolled epilepsy.

Aims: To look for perilesional hyperintensity, presumed to be indicative of gliosis, around FCC on magnetization transfer (MT) MRI and to correlate seizure outcome with its presence.

Setting And Design: Case control study.

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