Rigidity in Parkinson's Disease: The Objective Effect of Levodopa.

Background: Quantitative evidence of levodopa-induced beneficial effects on parkinsonian rigidity in Parkinson's disease (PD) is lacking. Recent research has demonstrated the velocity-dependent nature of objective rigidity in PD and revealed its neural underpinning.

Objective: The present study aimed to examine the effect of levodopa on objective rigidity in PD.

Unveiling the Unpredictable in Parkinson's Disease: Sensor-Based Monitoring of Dyskinesias and Freezing of Gait in Daily Life.

Background: Dyskinesias and freezing of gait are episodic disorders in Parkinson's disease, characterized by a fluctuating and unpredictable nature. This cross-sectional study aims to objectively monitor Parkinsonian patients experiencing dyskinesias and/or freezing of gait during activities of daily living and assess possible changes in spatiotemporal gait parameters.

Methods: Seventy-one patients with Parkinson's disease (40 with dyskinesias and 33 with freezing of gait) were continuously monitored at home for a minimum of 5 days using a single wearable sensor.

Disentangling Bradykinesia and Rigidity in Parkinson's Disease: Evidence from Short- and Long-Term Subthalamic Nucleus Deep Brain Stimulation.

Objective: Bradykinesia and rigidity are considered closely related motor signs in Parkinson disease (PD), but recent neurophysiological findings suggest distinct pathophysiological mechanisms. This study aims to examine and compare longitudinal changes in bradykinesia and rigidity in PD patients treated with bilateral subthalamic nucleus deep brain stimulation (STN-DBS).

Methods: In this retrospective cohort study, the clinical progression of appendicular and axial bradykinesia and rigidity was assessed up to 15 years after STN-DBS in the best treatment conditions (ON medication and ON stimulation).

Multisensor Integrated Platform Based on MEMS Charge Variation Sensing Technology for Biopotential Acquisition.

We propose a new methodology for long-term biopotential recording based on an MEMS multisensor integrated platform featuring a commercial electrostatic charge-transfer sensor. This family of sensors was originally intended for presence tracking in the automotive industry, so the existing setup was engineered for the acquisition of electrocardiograms, electroencephalograms, electrooculograms, and electromyography, designing a dedicated front-end and writing proper firmware for the specific application. Systematic tests on controls and nocturnal acquisitions from patients in a domestic environment will be discussed in detail.

Cohort analysis of novel variants in SPG4 patients and implementation of and studies to identify the pathogenic mechanism caused by splicing mutations.

Introduction: Pure hereditary spastic paraplegia (SPG) type 4 (SPG4) is caused by mutations of gene. This study aimed to analyze variants in SPG4 patients to highlight the occurrence of splicing mutations and combine functional studies to assess the relevance of these variants in the molecular mechanisms of the disease.

Methods: We performed an NGS panel in 105 patients, analysis for splicing mutations, and minigene assay.

Four Days Are Enough to Provide a Reliable Daily Step Count in Mild to Moderate Parkinson's Disease through a Commercial Smartwatch.

Daily steps could be a valuable indicator of real-world ambulation in Parkinson's disease (PD). Nonetheless, no study to date has investigated the minimum number of days required to reliably estimate the average daily steps through commercial smartwatches in people with PD. Fifty-six patients were monitored through a commercial smartwatch for 5 consecutive days.

Effects of deep brain stimulation of the subthalamic nucleus on patients with Parkinson's disease: a machine-learning voice analysis.

Introduction: Deep brain stimulation of the subthalamic nucleus (STN-DBS) can exert relevant effects on the voice of patients with Parkinson's disease (PD). In this study, we used artificial intelligence to objectively analyze the voices of PD patients with STN-DBS.

Materials And Methods: In a cross-sectional study, we enrolled 108 controls and 101 patients with PD.

Pain-motor integration in chronic pain: A neurophysiological study.

Objective: Chronic pain may lead to functional changes in several brain regions, including the primary motor cortex (M1). Our neurophysiological study aimed to probe M1 plasticity, through a non-invasive transcranial magnetic stimulation protocol, in a cohort of patients with chronic pain.

Methods: Twenty patients with chronic pain (age ± SD: 62.

Rigidity in Parkinson's disease: evidence from biomechanical and neurophysiological measures.

Although rigidity is a cardinal motor sign in patients with Parkinson's disease (PD), the instrumental measurement of this clinical phenomenon is largely lacking, and its pathophysiological underpinning remains still unclear. Further advances in the field would require innovative methodological approaches able to measure parkinsonian rigidity objectively, discriminate the different biomechanical sources of muscle tone (neural or visco-elastic components), and finally clarify the contribution to 'objective rigidity' exerted by neurophysiological responses, which have previously been associated with this clinical sign (i.e.

Machine Learning and Wearable Sensors for the Early Detection of Balance Disorders in Parkinson's Disease.

Dynamic posturography combined with wearable sensors has high sensitivity in recognizing subclinical balance abnormalities in patients with Parkinson's disease (PD). However, this approach is burdened by a high analytical load for motion analysis, potentially limiting a routine application in clinical practice. In this study, we used machine learning to distinguish PD patients from controls, as well as patients under and not under dopaminergic therapy (i.

Axial impairment and falls in Parkinson's disease: 15 years of subthalamic deep brain stimulation.

In this retrospective study, we longitudinally analyzed axial impairment and falls in people with Parkinson's disease (PD) and subthalamic nucleus deep brain stimulation (STN-DBS). Axial scores and falling frequency were examined at baseline, and 1, 10, and 15 years after surgery. Preoperative demographic and clinical data, including PD duration and severity, phenotype, motor and cognitive scales, medications, and vascular changes on neuroimaging were examined as possible risk factors through Kaplan-Meier and Cox regression analyses.

Handwriting Declines With Human Aging: A Machine Learning Study.

Background: Handwriting is an acquired complex cognitive and motor skill resulting from the activation of a widespread brain network. Handwriting therefore may provide biologically relevant information on health status. Also, handwriting can be collected easily in an ecological scenario, through safe, cheap, and largely available tools.

Decipher non-canonical SPAST splicing mutations with the help of functional assays in patients affected by spastic paraplegia 4 (SPG4).

Flowchart showing the molecular approach used to decipher the non-canonical splicing mutations.

Long-Term Polygraphic Monitoring through MEMS and Charge Transfer for Low-Power Wearable Applications.

In this work, we propose a wireless wearable system for the acquisition of multiple biopotentials through charge transfer electrostatic sensors realized in MEMS technology. The system is designed for low power consumption and low invasiveness, and thus candidates for long-time monitoring in free-living conditions, with data recording on an SD or wireless transmission to an external elaborator. Thanks to the wide horizon of applications, research is very active in this field, and in the last few years, some devices have been introduced on the market.

Wearable Electrochemical Sensors in Parkinson's Disease.

Parkinson's disease (PD) is a neurodegenerative disorder associated with widespread aggregation of α-synuclein and dopaminergic neuronal loss in the substantia nigra pars compacta. As a result, striatal dopaminergic denervation leads to functional changes in the cortico-basal-ganglia-thalamo-cortical loop, which in turn cause most of the parkinsonian signs and symptoms. Despite tremendous advances in the field in the last two decades, the overall management (i.

Predicting Axial Impairment in Parkinson's Disease through a Single Inertial Sensor.

Background: Current telemedicine approaches lack standardised procedures for the remote assessment of axial impairment in Parkinson's disease (PD). Unobtrusive wearable sensors may be a feasible tool to provide clinicians with practical medical indices reflecting axial dysfunction in PD. This study aims to predict the postural instability/gait difficulty (PIGD) score in PD patients by monitoring gait through a single inertial measurement unit (IMU) and machine-learning algorithms.

Long-term changes in short-interval intracortical facilitation modulate motor cortex plasticity and L-dopa-induced dyskinesia in Parkinson's disease.

Background: Abnormal glutamatergic neurotransmission in the primary motor cortex (M1) contributes to Parkinson's disease (PD) pathophysiology and is related to l-dopa-induced dyskinesia (LID). We previously showed that short-term treatment with safinamide, a monoamine oxidase type-B inhibitor with anti-glutamatergic properties, improves abnormally enhanced short-interval intracortical facilitation (SICF) in PD patients.

Objective: To examine whether a long-term SICF modulation has beneficial effects on clinical measures, including LID severity, and whether these changes parallel improvement in cortical plasticity mechanisms in PD.

Early balance impairment in Parkinson's Disease: Evidence from Robot-assisted axial rotations.

Objective: Early postural instability (PI) is a red flag for the diagnosis of Parkinson's disease (PD). Several patients, however, fall within the first three years of disease, particularly when turning. We investigated whether PD patients, without clinically overt PI, manifest abnormal reactive postural responses to ecological perturbations resembling turning.

The effect of gamma oscillations in boosting primary motor cortex plasticity is greater in young than older adults.

Objective: In healthy subjects, the long-term potentiation (LTP)-like plasticity of the primary motor cortex (M1) induced by intermittent theta-burst stimulation (iTBS) can be boosted by modulating gamma (γ) oscillations through transcranial alternating current stimulation (tACS). γ-tACS also reduces short-interval intracortical inhibition (SICI). We tested whether the effects of γ-tACS differ between young (YA) and older adults (OA).

Prediction of Freezing of Gait in Parkinson's Disease Using Wearables and Machine Learning.

Unlabelled: Freezing of gait (FOG) is one of the most troublesome symptoms of Parkinson's disease, affecting more than 50% of patients in advanced stages of the disease. Wearable technology has been widely used for its automatic detection, and some papers have been recently published in the direction of its prediction. Such predictions may be used for the administration of cues, in order to prevent the occurrence of gait freezing.

Gamma-transcranial alternating current stimulation and theta-burst stimulation: inter-subject variability and the role of BDNF.

Objective: The main limitation of neuromodulation techniques is inter-subject variability. Combining theta-burst stimulation (TBS) with gamma-transcranial alternating current stimulation (γ-tACS) allows to shape cortical plasticity. However, it is unknown whether γ-tACS modifies TBS-induced response variability.