SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Constantinescu Radu) ;lar1:(oru)"

Sökning: WFRF:(Constantinescu Radu) > Örebro universitet

  • Resultat 1-7 av 7
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  • Memedi, Mevludin, 1983-, et al. (författare)
  • Construction of levodopa-response index from wearable sensors for quantifying Parkinson's disease motor functions
  • 2016
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The goal of this study was to investigate the feasibility of wrist worn motion sensors to objectively measure motor functions in Parkinson’s disease (PD). More specifically, the aim was to construct a sensor-based levodopa-response index (SBLRI) and evaluate its clinimetric properties (convergent validity and internal consistency). Nineteen advanced PD patients and 22 healthy controls were recruited in a single center, open label, single dose clinical trial in Sweden. The subjects performed standardized motor tasks while wearing one sensor on each wrist and one on each ankle. Each sensor unit consisted of three-dimensional accelerometer and gyroscope. The patients were video recorded and the videos were blindly rated by three independent movement disorder specialists. The clinical scores were given using the Treatment Response Scale (TRS) on a scale from -3 = ‘Very Off’ to 0 = ‘On’ to +3 = ‘Very dyskinetic’. The clinical assessments were based on the overall motor function of the patients. A mean TRS was defined as the mean of the three specialists’ assessments per time point. The measurements were repeated over several time points following a single levodopa/carbidopa morning dose (50% over normal to induce dyskinesias). Sensor measurements during rapid alternating movements of hands were processed with time series analysis methods to calculate spatiotemporal parameters designed to measure bradykinesia and dyskinesia. For each hand, 96 spatiotemporal parameters were calculated and their average scores were then used in a principal component analysis to reduce the dimensionality by retaining 6 principal components. These components were then used as predictors to support vector machines and to be mapped to the mean TRS ratings of the three specialists and to calculate the SBLRI. For this analysis, a 10-fold stratified cross-validation was performed. The SBLRI was strongly correlated to mean TRS with a Pearson correlation coefficient of 0.79 (CI: 0.74-0.83, p<0.001). The 95% confidence interval for the mean squared error of SBLRI on patients data was ± 1.62 with a mean value of 0.57 whereas on healthy controls data was ± 1 with a mean value of 0.27. The sensor-based spatiotemporal parameters had good internal consistency with a Cronbach’s Alpha coefficient of 0.87 and significantly differed between patients and healthy controls. The results demonstrated that the SBLRI had good clinimetric properties for measuring motor functions (Off and dyskinesia) in PD patients. The method could also distinguish hand rotation movements exhibited by patients from those exhibited by healthy controls. The SBLRI provides effect-time profiles, which could be useful during therapy individualization of advanced PD patients.
  •  
2.
  •  
3.
  • Senek, Marina, et al. (författare)
  • Levodopa/carbidopa microtablets in Parkinson disease : pharmacokinetics and blinded motor assessment
  • 2016
  • Ingår i: Twentieth International Congress of Parkinson's Disease and Movement Disorders.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this study was to characterize the levodopa and carbidopa plasma concentration in relation to blinded motor function ratings. This is a part of a study where a Multimodal motor Symptoms Quantification (MuSyQ) platform consisting of three different types of sensors were tested while evoking motor fluctuations with levodopa/carbidopa(LD/CD) microtablets in fluctuating Parkinson’s disease (PD) patients. Today, dose titration and chronic treatment largely relies on the patient’s subjective assessment of symptoms and clinicians’ assessment of patient status during a visit at the clinic. This was a single-center, open-label, single dose study in patients experiencing motor fluctuations. Patients were given 150% of their individual levodopa equivalent morning dose. Blood sampling and motor function testing were conducted for up to 6.5 hours at prespecified time points. The patients performed standardized motor activities for clinical rating in accordance with parts of the Unified Parkinson’s disease Rating Scale (UPDRS) and Unified Dyskinesia RatingScale (UDysRS). Each test cycle was video recorded, and the video sequences were presented to three movement disorder specialists in a randomized order for blinded rating of UPDRS items and the treatment response scale (TRS). Concentration versus time profiles and the pharmacokinetics were compared with a study previously conducted in healthy subjects. Nineteen patients, 14 male and 5 female, were included in the study. The individual LD/CD doses ranged between 110/27.5mg to 410/102.5 mg. The concentration time profiles are similar to the LD/CD microtablet profiles reported in healthy subjects. The blinded video ratings managed to capture the most distinctive movements. This is the first pharmacokinetic study where patients received LD/CD microtablets. For patients fluctuating from 'off' to dyskinetic, the relationship between the plasma concentration and motor function was clearer compared to the patients that fluctuated to a lesser extent.
  •  
4.
  • Senek, Marina, et al. (författare)
  • Levodopa/carbidopa microtablets in Parkinson's disease : a study of pharmacokinetics and blinded motor assessment
  • 2017
  • Ingår i: European Journal of Clinical Pharmacology. - Heidelberg, Germany : Springer. - 0031-6970 .- 1432-1041 .- 0014-2999. ; 73:5, s. 563-571
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Motor function assessments with rating scales in relation to the pharmacokinetics of levodopa may increase the understanding of how to individualize and fine-tune treatments.Objectives: This study aimed to investigate the pharmacokinetic profiles of levodopa-carbidopa and the motor function following a single-dose microtablet administration in Parkinson’s disease.Methods: This was a single-center, open-label, single-dose study in 19 patients experiencing motor fluctuations. Patients received 150% of their individual levodopa equivalent morning dose in levodopa-carbidopa microtablets. Blood samples were collected at pre-specified time points. Patients were video recorded and motor function was assessed with six UPDRS part III motor items, dyskinesia score, and the treatment response scale (TRS), rated by three blinded movement disorder specialists.Results: AUC0–4/dose and Cmax/dose for levodopa was found to be higher in Parkinson’s disease patients compared with healthy subjects from a previous study, (p = 0.0008 and p = 0.026, respectively). The mean time to maximum improvement in sum of six UPDRS items score was 78 min (±59) (n = 16), and the mean time to TRS score maximum effect was 54 min (±51) (n = 15). Mean time to onset of dyskinesia was 41 min (±38) (n = 13).Conclusions: In the PD population, following levodopa/carbidopa microtablet administration in fasting state, the Cmax and AUC0–4/dose were found to be higher compared with results from a previous study in young, healthy subjects. A large between subject variability in response and duration of effect was observed, highlighting the importance of a continuous and individual assessment of motor function in order to optimize treatment effect.
  •  
5.
  • Senek, Marina, et al. (författare)
  • Motor fluctuations in relation to plasma concentrations following a single-dose of levodopa/carbidopa microtablets in advanced Parkinson's disease
  • 2016
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Objective: The aim of this study was to characterize the levodopa and carbidopa plasma concentration in relation to blinded motor function ratings. This is a part of a study where a Multimodal motor Symptoms Quantification (MuSyQ) platform consisting of three different types of sensors were tested while evoking motor fluctuations with levodopa/car-bidopa (LD/CD) microtablets in fluctuating Parkinson’s disease (PD) patients.Background: Today, dose titration and chronic treatment largely relies on the patient’s subjective assessment of symptoms and clinicians’ assessment of patient status during a visit at the clinic.Methods: This was a single-center, open-label, single dose study in patients experiencing motor fluctuations. Patients were given 150% of their individual levodopa equivalent morning dose. Blood sampling and motor function testing were conducted for up to 6.5 hours at prepecified time points. The patients performed standardized motor activities for clinical rating in accordance with parts of the Unified Parkinson’s disease Rating Scale (UPDRS) and Unified Dyskinesia Rating Scale (UDysRS). Each test cycle was video recorded, and the video sequences were presented to three movement disorder specialists in a randomized order for blinded rating of UPDRS items and the treatment response scale (TRS). Concentration versus time profiles and the pharmacokinetics were compared with a study previously conducted in healthy subjects.Results: Nineteen patients, 14 male and 5 female, were included in the study. The individual LD/CD doses ranged between 110/27.5 mg to 410/102.5 mg. The concentration time profiles are similar to the LD/CD microtablet profiles reported in healthy subjects. The blinded video ratings managed to capture the most distinctive movements.Conclusions: This is the first pharmacokinetic study where patients received LD/CD microtablets. For patients fluctuating from ‘off’ to dyskinetic, the relationship between the plasma concentration and motor function was clearer compared to the patients that fluctuated to a lesser extent.
  •  
6.
  • Thomas, Ilias, et al. (författare)
  • Using measurements from wearable sensors for automatic scoring of Parkinson’s disease motor states
  • 2017
  • Ingår i: Abstracts of the 21<sup>st</sup> International Congress of Parkinson's Disease and Movement Disorders. - : John Wiley & Sons.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Objective: The aim of this study was to investigate the concurrent validity of an objective gait measure for assessment of motor states in advanced Parkinson’s disease (PD) patients.Background: Five million people suffer from Parkinson’s disease (PD) worldwide. The use of wearable sensors could help monitor disease progression and medication efficacy.Methods: A single center, single dose, open label clinical trial was conducted in Uppsala, Sweden in 2015. Patients repeatedly performed a walk task while wearing 3D accelerometry and gyroscope sensor units on all four limbs. Assessments were made once before dose administration, once at time of administration, and at pre-specified timepoints until the medication effect had worn off. Each test took approximately 15 seconds and consisted of a 2.5 meter straight walk, which was repeated three times by making 2 U-turns in the process. The patients were also video recorded and the videos were rated by three movement disorder experts according to a Treatment Response Scale (TRS), ranging from -3 (very Off) to +3 (very dyskinetic) and a Dyskinesia Rating scale (DysRS), ranging from 0 (no dyskinesia) to 4 (severe dyskinesia). For the predictive modelling, 32 features from each sensor were extracted together with 24 features that quantified the differences in symmetry between the sensors (152 total features). Principal component analysis was employed on the features of each sensor and the principal components of the four sensors together with the symmetry features were used as predictors in two separate support vector machine (SVM) models. One model mapped the features to the TRS scale and the other to the DysRS scale.Results: Preliminary results from 7 patients showed good predictive ability of the SVM models in a leave-one-individual out cross-validation setting. The predictions on the TRS scale had correlation of 0.79 to the experts’ mean ratings and Root Mean Square Error (RMSE) of 0.70. The predictions in the DysRS scale had correlation of 0.79 and RMSE of 0.47.Conclusions: The results of the study indicate that the use of wearable sensors when performing walking tasks can generate measurements that have a good correlation to subjective expert assessments. This could be useful during individualized evaluation of symptoms and treatments.
  •  
7.
  • Thomas, Ilias, et al. (författare)
  • Using measurements from wearable sensors for automatic scoring of Parkinson's disease motor states : Results from 7 patients
  • 2017
  • Ingår i: 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). - New York : IEEE. - 1094-687X. - 9781509028092 - 9781509028108 ; , s. 131-134
  • Konferensbidrag (refereegranskat)abstract
    • The objective of this study was to investigate the validity of an objective gait measure for assessment of different motor states of advanced Parkinson's disease (PD) patients. Seven PD patients performed a gait task up to 15 times while wearing sensors on their upper and lower limbs. Each task was performed at specific points during a test day, following a single dose of levodopa-carbidopa. At the time of the tasks the patients were video recorded and three movement disorder experts rated their motor function on three clinical scales: a treatment response scale (TRS) that ranged from −3 (very bradykinetic) to 0 (ON) to +3 (very dyskinetic), a dyskinesia score that ranged from 0 (no dyskinesia) to 4 (extreme dyskinesia), and a bradykinesia score that ranged from 0 (no bradykinesia) to 4 (extreme bradykinesia). Raw accelerometer and gyroscope data of the sensors were processed and analyzed with time series analysis methods to extract features. The utilized features quantified separate limb movements as well as movement symmetries between the limbs. The features were processed with principal component analysis and the components were used as predictors for separate support vector machine (SVM) models for each of the three scales. The performance of each model was evaluated in a leave-one-patient out setting where the observations of a single patient were used as the testing set and the observations of the other 6 patients as the training set. Root mean square error (RMSE) and correlation coefficients for the predictions showed a good ability of the models to map the sensor data into the rating scales. There were strong correlations between the SVM models and the mean ratings of TRS (0.79; RMSE=0.70), bradykinesia score (0.79; RMSE=0.47), and bradykinesia score (0.78; RMSE=0.46). The results presented in this paper indicate that the use of wearable sensors when performing gait tasks can generate measurements that have a good correlation to subjective expert assessments.
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-7 av 7

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy