Clinical Neurophysiology最新文献_第6页

Towards precision medicine in non-invasive brain stimulation for chronic pain 迈向非侵入性脑刺激治疗慢性疼痛的精准医学

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-11 DOI: 10.1016/j.clinph.2025.2111435

Elisa Mantovani, Federico Ranieri, Stefano Tamburin

引用次数: 0

Multiple, not just Beta–Gamma, phase-amplitude couplings are associated with Parkinson’s disease and related intervention effects 多重，而不仅仅是β - γ，相位振幅耦合与帕金森病和相关干预效果有关

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-11 DOI: 10.1016/j.clinph.2025.2111425

Alireza Kazemi , Salar Nouri , Maryam S. Mirian , Soojin Lee , Martin J. McKeown

Objective

1) To evaluate the importance of various EEG Phase Amplitude Couplings (PACs) in predicting motor vigor (MV) in Parkinson’s Disease (PD). 2) To determine the effects of dopaminergic medication and non-invasive galvanic vestibular stimulation (GVS) on MV-related PACs.

Methods

EEG data from 18 PD patients in comparison to 20 HC controls, executing a simple overlearned handgrip task was used, to identify PD-specific alterations. A deep learning model, PACNET, based on the VGG-16 architecture, was used to predict MV from a visual representation of different PACs.

Results

Delta-Beta, Theta-, Alpha-, and Beta-Gamma PACs were important for MV prediction. In PD subjects, GVS affected Delta-Beta, and Theta-, Beta- Gamma PAC’s role in MV prediction in a stimulation-specific manner. Delta-Beta and Theta-Gamma PACs were more relevant for PD patients’ MV prediction after L-dopa medication.

Conclusions

Multiple PACs are important for MV in Parkinson’s disease. Therapeutic interventions affect PAC/MV associations.

Significance

Multiple PACs, not just Beta–Gamma, are important for MV in PD and may serve as targets for neuromodulation strategies. A combined assessment of PACs could be a valuable biomarker for both disease evaluation and therapeutic effects in PD.

目的1)评价各种EEG相幅耦合（PACs）在预测帕金森病（PD）运动活力（MV）中的重要性。2)探讨多巴胺能药物治疗和无创前庭电刺激（GVS）对mv相关PACs的影响。方法18例PD患者的seeg数据与20例HC对照，执行简单的过度学习握拳任务，以确定PD特异性改变。基于VGG-16架构的深度学习模型PACNET用于从不同pac的视觉表示中预测MV。结果δ - β、θ -、α -和β - γ PACs对MV预测有重要意义。在PD受试者中，GVS以刺激特异性的方式影响Delta-Beta、Theta-、Beta- Gamma PAC在MV预测中的作用。δ - β和θ - γ PACs与左旋多巴治疗后PD患者的MV预测更相关。结论多个PACs在帕金森病的MV中起重要作用。治疗干预影响PAC/MV关联。多种pac，而不仅仅是β - γ，对PD的MV很重要，可能作为神经调节策略的靶点。PACs的联合评估可能是PD疾病评估和治疗效果的有价值的生物标志物。

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引用次数: 0

Machine learning predicts cognitive outcome from preterm infants’ EEG 机器学习预测早产儿脑电图的认知结果

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-11 DOI: 10.1016/j.clinph.2025.2111433

Tom A. Campbell

引用次数: 0

EEG in the critical care setting 脑电图在重症监护环境

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-11 DOI: 10.1016/j.clinph.2025.2111431

Lawrence J. Hirsch , Margaret T. Gopaul

Continuous EEG (cEEG) is increasingly used in the intensive care unit (ICU), but implementation and interpretation remain variable. To better understand its clinical impact, this review evaluates its role in diagnosis, prognostication, and treatment. To do so, we conducted a narrative review of observational studies, randomized controlled trials, consensus recommendations, and illustrative cases across adult and pediatric critical care populations. In these studies, nonconvulsive seizures occur in ∼10–20 % of ICU patients undergoing cEEG, most without clinical signs, and risk is highest in coma, pediatrics, with prior clinical seizures (recent or remote), and acute structural brain injury. Seizure burden > 12 min/hour (20 % burden) qualifies as status epilepticus (SE). Furthermore, higher seizure burden consistently predicts poor outcomes, including hippocampal injury, functional and cognitive impairment, epilepsy, and increased mortality. Additionally, rapid-response EEG and AI-based tools improve diagnostic efficiency, expand access, and may improve outcomes and length of stay. Quantitative EEG can reliably detect other acute brain events, such as delayed cerebral ischemia after subarachnoid hemorrhage, usually sooner than any other practical method. In summary, cEEG has transformed seizure detection and outcome prediction in the ICU, though gaps persist in access, workforce capacity, interpretation, patient selection, and clinical implementation. Broader standardization, expansion of point-of-care rapid EEG devices, and AI integration are critical to scaling cEEG and improving patient outcomes.

连续脑电图（cEEG）越来越多地用于重症监护病房（ICU），但实施和解释仍然存在变数。为了更好地了解其临床影响，本综述评估了其在诊断、预后和治疗中的作用。为此，我们对观察性研究、随机对照试验、共识建议和成人和儿童重症监护人群的说明性病例进行了叙述性回顾。在这些研究中，非惊厥性癫痫发作发生在10 - 20%的ICU患者中，大多数没有临床症状，在昏迷、儿科、既往临床癫痫发作（近期或远期）和急性结构性脑损伤中风险最高。癫痫发作负担12分钟/小时（20%负担）为癫痫持续状态（SE）。此外，较高的癫痫发作负担始终预示着不良结果，包括海马损伤、功能和认知障碍、癫痫和死亡率增加。此外，快速反应脑电图和基于人工智能的工具提高了诊断效率，扩大了可及性，并可能改善结果和住院时间。定量脑电图可以可靠地检测到其他急性脑事件，如蛛网膜下腔出血后的延迟性脑缺血，通常比任何其他实用方法都要快。综上所述，脑电图已经改变了ICU的癫痫发作检测和结果预测，尽管在获取、劳动力能力、解释、患者选择和临床实施方面仍然存在差距。更广泛的标准化、医疗点快速脑电图设备的扩展和人工智能集成对于扩大脑电图和改善患者预后至关重要。

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引用次数: 0

Automated estimation of EEG maturity in preterm neonates and its association with long-term outcome 早产儿脑电图成熟度的自动估计及其与长期预后的关系

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-11 DOI: 10.1016/j.clinph.2025.2111432

Johannes Mader , Manfred Hartmann , Katrin Klebermass-Schrehof , Tobias Werther , Anastasia Dressler , Lisa Oberdorfer , Nadine Pointner , Renate Fuiko , Angelika Berger , Tilmann Kluge , Vito Giordano

Objective

To develop convolutional neural network (CNN) models to estimate EEG maturational age (EMA) from EEG recorded via amplitude-integrated EEG monitors in preterm infants and evaluate its association with long-term neurodevelopmental outcomes.

Methods

Three CNN models were trained on EEG data recorded from aEEG monitors from 92 preterm infants (23–41 weeks postmenstrual age) without major neurological complications and with normal cognitive outcomes at 2 years. The best-performing model based on MAE was applied to a broader cohort of 148 infants to assess the relationship between predicted age difference (PAD = EMA – PMA) and neurodevelopmental outcome using the Bayley Scales of Infant and Toddler Development (BSID-III).

Results

The best models achieved 87 % and 84 % accuracy within ± 1 week of actual PMA and a mean absolute error of 0.63 and 0.55 weeks. Infants with severely abnormal cognitive outcomes had significantly lower PAD scores compared to those with normal outcomes (P < 0.001). PAD and MAE showed moderate predictive value (AUC 0.69 and 0.77, respectively).

Conclusions

CNN-based EMA estimation from EEG recorded via aEEG monitors is accurate and correlates with long-term cognitive outcomes in preterm infants.

Significance

This study demonstrates the clinical potential of automated EEG maturity tracking using EEG as a real-time biomarker for neurodevelopmental risk.

目的建立卷积神经网络（CNN）模型，从幅度积分脑电图监测仪记录的早产儿脑电图中估计脑电图成熟年龄（EMA），并评估其与长期神经发育结局的关系。方法对92例经后23-41周龄早产儿（2岁时无重大神经系统并发症，认知功能正常）进行脑电监护，对3个CNN模型进行训练。将基于MAE的最佳模型应用于148名婴儿的更广泛队列，使用Bayley婴幼儿发育量表（bsidi - iii）评估预测年龄差异（PAD = EMA - PMA）与神经发育结局之间的关系。结果最佳模型在实际PMA±1周内的准确度分别为87%和84%，平均绝对误差分别为0.63和0.55周。与认知结果正常的婴儿相比，认知结果严重异常的婴儿PAD评分显著降低（P < 0.001）。PAD和MAE具有中等预测价值（AUC分别为0.69和0.77）。结论通过aEEG监护仪记录的脑电图中基于scnn的EMA估计是准确的，且与早产儿的长期认知结局相关。意义：本研究证明了利用脑电图作为神经发育风险的实时生物标志物进行脑电图成熟度自动跟踪的临床潜力。

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引用次数: 0

Effect of resting motor threshold availability on preoperative motor cortex localization using navigated-TMS in glioma surgery 脑胶质瘤手术中静息运动阈值可用性对术前运动皮质定位的影响。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-09 DOI: 10.1016/j.clinph.2025.2111429

Buntou Ro , Manabu Tamura , Atsushi Kuwano , Tomokazu Takakura , Sachiko Kodera , Akimasa Hirata , Takakazu Kawamata , Ken Masamune , Yoshihiro Muragaki

Objective

To assess the concordance between preoperative motor cortex mapping using navigated transcranial magnetic stimulation (nTMS) and intraoperative direct electrical stimulation (DES), and to determine whether the ability to obtain the resting motor threshold (RMT) affects mapping accuracy.

Methods

Seventeen patients with motor or premotor cortical gliomas underwent preoperative nTMS and intraoperative DES. Motor mapping was performed using the RMT or, if unobtainable, the active motor threshold (AMT). Concordance between nTMS and DES was analyzed using Fisher’s exact test.

Results

Spatial concordance between nTMS and DES was observed in 9 of 12 patients (75 %) with measurable RMT. None of the five AMT-only cases demonstrated concordance. The difference in concordance rates between RMT and AMT-only cases was statistically significant (p = 0.026). Representative cases illustrate the relationship between RMT availability and mapping accuracy.

Conclusions

Preoperative nTMS mapping showed high concordance with DES when the RMT was obtainable. The lack of an RMT may predict reduced intraoperative mapping reliability.

Significance

RMT preoperative assessment can guide surgical planning, including the need for subcortical mapping or adjusted resection margins. These findings highlight the utility of nTMS for motor localization and emphasize the value of the RMT for predicting intraoperative mapping success.

目的：评估术前经颅磁刺激（nTMS）和术中直接电刺激（DES）运动皮质映射的一致性，并确定获得静息运动阈值（RMT）的能力是否影响映射精度。方法：17例运动或运动前皮质胶质瘤患者术前接受nTMS和术中DES。运动映射使用RMT，如果无法获得，则使用活动运动阈值（AMT）。采用Fisher精确检验分析nTMS与DES的一致性。结果：在12例可测量RMT的患者中，有9例（75%）观察到nTMS和DES的空间一致性。5例仅amt的病例均未显示一致性。RMT与amt的一致性率差异有统计学意义（p = 0.026）。代表性的案例说明了RMT可用性和映射准确性之间的关系。结论：术前行RMT时，nTMS图谱与DES高度一致。缺乏RMT可能预示术中测图可靠性降低。意义：RMT术前评估可以指导手术计划，包括需要皮质下作图或调整切除边缘。这些发现强调了nTMS在运动定位中的应用，并强调了RMT在预测术中定位成功方面的价值。

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引用次数: 0

Identifying the epileptogenic zone by 18F-FDG PET/MRI in drug-resistant epilepsy with focal cortical dysplasia type IIIa 18F-FDG PET/MRI在伴有局灶性皮质发育不良的IIIa型耐药癫痫中确定致痫区。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-08 DOI: 10.1016/j.clinph.2025.2111412

Lingling Zhang , Hailing Zhou , Yongjin Tang , Jiefeng Gan , Xiangshu Hu , Hainan Li , Xueying Ling , Qiang Guo , Hao Xu

Objective

Focal cortical dysplasia (FCD) type IIIa, distinct from isolated FCD in drug-resistant epilepsy, is typically confirmed via postoperative histopathology. This study aimed to evaluate the diagnostic utility of preoperative noninvasive ¹⁸F-fludeoxyglucose (FDG) PET/MRI co-registration in localizing the epileptogenic zone (EZ) in FCD type IIIa.

Methods

We performed a retrospective study that included 60 patients with FCD type IIIa who underwent resection for drug-resistant epilepsy. The sensitivity of each modality for localizing the EZ was calculated, with invasive stereoelectroencephalography (SEEG) as a reference. Diagnostic accuracy and value of each modality were further assessed with respect to SEEG and postoperative outcomes for all patients and MRI negative/doubtful patients.

Results

We analyzed the diagnostic value of the different non-invasive diagnostic techniques with respect to concordance with SEEG findings and postsurgical seizure outcomes. For all included patients, ¹⁸F-FDG PET/MRI showed the highest sensitivity (75.7 %) for localizing the EZ across all modalities. We also found that ¹⁸F-FDG PET/MRI demonstrated the best accuracy and diagnostic value for localizing the EZ (60.0 %). Among MRI-doubtful/negative patients, ¹⁸F-FDG PET/MRI not only showed the highest sensitivity (79.3 %) but also achieved most promising accuracy and diagnostic value for identifying the EZ (61.7 % accuracy) across all modalities.

Significance

¹⁸F-FDG PET/MRI coregistration appears to be overwhelmingly rewarding in affording localization of EZ for patients with FCD type IIIa. This technique is potentially valuable as a noninvasive method to identify the EZ in patients with drug-resistant epilepsy due to FCD type IIIa, especially for MRI-negative/doubtful patients.

目的：局灶性皮质发育不良（FCD） IIIa型不同于耐药性癫痫的孤立性FCD，通常通过术后组织病理学确诊。本研究旨在评估术前无创18f -氟脱氧葡萄糖（FDG） PET/MRI联合登记在定位IIIa型FCD的致痫区（EZ）中的诊断价值。方法：我们进行了一项回顾性研究，包括60例IIIa型FCD患者，他们因耐药癫痫而接受了手术切除。以有创立体脑电图（SEEG）为参考，计算各模式定位EZ的灵敏度。对所有患者和MRI阴性/可疑患者的SEEG和术后结果进一步评估每种模式的诊断准确性和价值。结果：我们分析了不同的非侵入性诊断技术在与SEEG结果和术后癫痫发作结果的一致性方面的诊断价值。对于所有纳入的患者，18F-FDG PET/MRI在所有模式下对EZ的定位显示出最高的灵敏度（75.7%）。我们还发现18F-FDG PET/MRI对EZ的定位具有最佳的准确性和诊断价值（60.0%）。在MRI可疑/阴性患者中，18F-FDG PET/MRI不仅显示出最高的灵敏度（79.3%），而且在所有模式下识别EZ（61.7%）的准确性和诊断价值也最有希望。意义：18F-FDG PET/MRI共登记在为IIIa型FCD患者提供EZ定位方面似乎是非常有益的。该技术作为一种非侵入性方法，在IIIa型FCD致耐药癫痫患者中识别EZ具有潜在价值，特别是对于mri阴性/可疑患者。

{"title":"Identifying the epileptogenic zone by 18F-FDG PET/MRI in drug-resistant epilepsy with focal cortical dysplasia type IIIa","authors":"Lingling Zhang , Hailing Zhou , Yongjin Tang , Jiefeng Gan , Xiangshu Hu , Hainan Li , Xueying Ling , Qiang Guo , Hao Xu","doi":"10.1016/j.clinph.2025.2111412","DOIUrl":"10.1016/j.clinph.2025.2111412","url":null,"abstract":"<div><h3>Objective</h3><div>Focal cortical dysplasia (FCD) type IIIa, distinct from isolated FCD in drug-resistant epilepsy, is typically confirmed via postoperative histopathology. This study aimed to evaluate the diagnostic utility of preoperative noninvasive <sup>18</sup>F-fludeoxyglucose (FDG) PET/MRI co-registration in localizing the epileptogenic zone (EZ) in FCD type IIIa.</div></div><div><h3>Methods</h3><div>We performed a retrospective study that included 60 patients with FCD type IIIa who underwent resection for drug-resistant epilepsy. The sensitivity of each modality for localizing the EZ was calculated, with invasive stereoelectroencephalography (SEEG) as a reference. Diagnostic accuracy and value of each modality were further assessed with respect to SEEG and postoperative outcomes for all patients and MRI negative/doubtful patients.</div></div><div><h3>Results</h3><div>We analyzed the diagnostic value of the different non-invasive diagnostic techniques with respect to concordance with SEEG findings and postsurgical seizure outcomes. For all included patients, <sup>18</sup>F-FDG PET/MRI showed the highest sensitivity (75.7 %) for localizing the EZ across all modalities. We also found that <sup>18</sup>F-FDG PET/MRI demonstrated the best accuracy and diagnostic value for localizing the EZ (60.0 %). Among MRI-doubtful/negative patients, <sup>18</sup>F-FDG PET/MRI not only showed the highest sensitivity (79.3 %) but also achieved most promising accuracy and diagnostic value for identifying the EZ (61.7 % accuracy) across all modalities.</div></div><div><h3>Significance</h3><div><sup>18</sup>F-FDG PET/MRI coregistration appears to be overwhelmingly rewarding in affording localization of EZ for patients with FCD type IIIa. This technique is potentially valuable as a noninvasive method to identify the EZ in patients with drug-resistant epilepsy due to FCD type IIIa, especially for MRI-negative/doubtful patients.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111412"},"PeriodicalIF":3.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feasibility and prognostic utility of laryngeal adductor reflex monitoring in anterior cervical spine surgery 喉内收肌反射监测在颈椎前路手术中的可行性及预后价值

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-08 DOI: 10.1016/j.clinph.2025.2111430

Jongsuk Choi , Ki Eob Kim , Min Jun Song , Joo Hyeong Lee , Byung Hoon Yoon , Kyung Seok Park

Objective

To evaluate the feasibility and clinical relevance of intraoperative laryngeal adductor reflex (LAR) monitoring for detecting recurrent laryngeal nerve (RLN) dysfunction during anterior cervical discectomy and fusion (ACDF).

Methods

LAR monitoring was performed in 104 patients undergoing ACDF using an electromyographic endotracheal tube. R1 amplitudes were recorded, and significant reductions were classified as transient or permanent. Swallowing and voice outcomes were assessed on postoperative day 7 (POD7), and at 3 and 6 months (POM3, POM6). Receiver operating characteristic (ROC) analysis was used to identify amplitude-reduction thresholds associated with RLN dysfunction.

Results

LAR signals were successfully obtained in 89.4 % of patients. Transient amplitude reductions occurred in 55 patients and were associated with short-term symptoms at POD7 (sensitivity 100 %, specificity 46.6 %, area under the curve [AUC] = 0.88), which resolved by POM6. Permanent reductions (n = 4) corresponded to persistent RLN dysfunction, with 100 % specificity and positive predictive value. Sensitivity increased over time, reaching 100 % at POM6. Post hoc ROC analysis identified an 81 % amplitude-reduction threshold that accurately predicted persistent RLN dysfunction at final follow-up (AUC = 1.000).

Conclusions

Intraoperative LAR monitoring was feasible and demonstrated strong predictive value for RLN dysfunction during ACDF.

Significance

LAR monitoring may enhance intraoperative neurophysiological monitoring by enabling real-time assessment of vagus nerve function in cervical spine surgery.

目的评价术中喉内收反射（LAR）监测在颈前椎间盘切除术融合术（ACDF）中检测喉返神经（RLN）功能障碍的可行性及临床意义。方法采用肌电图气管内管对104例ACDF患者进行slar监测。R1振幅被记录下来，显著的减少被分类为短暂或永久的。在术后第7天（POD7）、第3个月和第6个月（POM3、POM6）评估吞咽和语音结果。受试者工作特征（ROC）分析用于识别与RLN功能障碍相关的降幅阈值。结果89.4%的患者成功获得slar信号。55例患者出现短暂的波幅降低，并伴有短期症状（敏感性100%，特异性46.6%，曲线下面积[AUC] = 0.88），经POM6缓解。永久性减少（n = 4）对应于持续性RLN功能障碍，具有100%的特异性和阳性预测值。灵敏度随时间增加，在POM6时达到100%。事后ROC分析发现81%的幅度降低阈值可以准确预测最终随访时持续的RLN功能障碍（AUC = 1.000）。结论术中LAR监测是可行的，对ACDF中RLN功能障碍具有较强的预测价值。通过实时评估颈椎手术中迷走神经功能，ar监测可增强术中神经生理监测。

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引用次数: 0

Classic midline versus lateral scalp montages in lower limb somatosensory evoked potentials during intra-operative neuromonitoring 术中神经监测中下肢躯体感觉诱发电位的经典中线与外侧头皮蒙太奇。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-08 DOI: 10.1016/j.clinph.2025.2111428

Danilo E. Lopez-Garcia , Luis A. Marin-Castaneda , Huguette Heredia Martínez , Daniel Murra-Talamas , Fabiola M. López-Castellanos , Antonio de León , Gerson Ángel Alavez , Daniel San-Juan , Geronimo Pacheco-Aispuro

引用次数: 0

Perioperative quantification of clinical bradykinesia measurements in patients with Parkinson’s disease using accelerometry 应用加速计量化帕金森病患者临床运动迟缓围手术期测量。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-07 DOI: 10.1016/j.clinph.2025.2111424

Annemarie Smid , Teus van Laar , Amber E. Pinkster , Jolien M. ten Kate , Naomi I. Kremer , D. L. Marinus Oterdoom , Katalin Tamasi , J. Marc C. van Dijk , Gea Drost

Objective

The gold standard for assessing bradykinesia in Parkinson’s disease (PD) is the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS), although it is inherently subjective and relies on experienced raters. Therefore, we translated MDS-UPDRS upper limb bradykinesia assessments into an objective scoring method with 3D-accelerometry.

Methods

In this study, 44 PD-patients and 44 healthy controls (sex and age matched) were included. Two raters assessed MDS-UPDRS criteria for bradykinesia, while accelerometric measurements were conducted at the index fingers. Measurements were performed in an off-medication state. The 3D-acceleration data produced quantitative measures, like frequency and amplitude of hand movement. The algorithm for calculating accelerometric scores was based on MDS-UPDRS criteria with thresholds from healthy controls. Agreement between MDS-UPDRS bradykinesia scores and accelerometric scores was estimated with Cohen’s kappa-coefficient (κ).

Results

The accelerometric scores showed moderate agreement (κ ≥ 0.548) with MDS-UPDRS ratings. The inter-rater agreement between the two MDS-UPDRS raters was moderate for all tests (κ ≥ 0.595). Accelerometric test–retest reliability was good to excellent (ICC ≥ 0.764, p < 0.001).

Conclusions

This study introduces an accelerometric algorithm to classify upper extremity bradykinesia according to MDS-UPDRS criteria, yielding high test–retest reliability.

Significance

Given its consistency, this method could reduce MDS-UPDRS rater-dependency and improve objective monitoring of upper limb bradykinesia.

目的：评估帕金森病（PD）运动迟缓的金标准是运动障碍协会统一PD评定量表（MDS-UPDRS），尽管它本身是主观的，依赖于经验丰富的评分者。因此，我们将MDS-UPDRS上肢运动迟缓评估转化为一种带有3d加速度计的客观评分方法。方法：本研究纳入44例pd患者和44例健康对照（性别和年龄相匹配）。两名评分员评估运动迟缓的MDS-UPDRS标准，同时在食指进行加速度测量。在停药状态下进行测量。3d加速数据产生了定量测量，比如手部运动的频率和幅度。计算加速度计评分的算法基于MDS-UPDRS标准和健康对照的阈值。用Cohen's kappa系数（κ）估计MDS-UPDRS慢动评分和加速评分之间的一致性。结果：加速度计评分与MDS-UPDRS评分具有中等一致性（κ≥0.548）。两个MDS-UPDRS评分者之间的一致性在所有测试中均为中等（κ≥0.595）。结论：本研究根据MDS-UPDRS标准，引入加速度计算法对上肢运动迟缓进行分类，获得较高的重测信度。意义：该方法具有一致性，可降低MDS-UPDRS评分依赖性，改善上肢运动迟缓的客观监测。

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引用次数: 0