Quantification of movement pathologies is an important challenge of the clinical and research lab... more Quantification of movement pathologies is an important challenge of the clinical and research laboratories today. Basically, two problems must be addressed. The first one is to find the appropriate technology; the second is to develop adequate measures from the raw data which will best discriminate between health and pathology. In this paper, we propose a simple method to record and analyse tremor and other microdisplacements of the upper extremities based on the recording of position by laser analog sensors. Any microcomputer equipped to perform analog-digital conversion is compatible for use with this system. The performance of the laser system is examined and compared with the performance of accelerometers. Finally, data recorded with a laser analog sensor from a patient with Parkinson's disease and a control subject are presented. This new laser-based quantitative method may prove to be an important tool in early and differential diagnosis of neurodegenerative diseases of the central nervous system.
ABSTRACT Parkinson’s disease is a complex disorder for which there is no known cure. Nor do we un... more ABSTRACT Parkinson’s disease is a complex disorder for which there is no known cure. Nor do we understand fully the origin of one of the disease’s cardinal symptoms: tremor. A non-traditional approach to research in Parkinson’s disease and in Parkinsonian tremor involves the application of mathematical models. The purpose of this article is to review briefly the contributions of mathematical models to the study of Parkinsonian tremor. There is little evidence that modelling attempts have built on previous ones but there has been a trend to move the focus of modelling from the periphery to the brain, and from abstracted to more physiologically detailed views. We hope that this review will encourage more mathematical modelling in the study of Parkinson’s disease and Parkinsonian tremor.
This exploratory study investigates possible relationships between fluctuations in tremor at rest... more This exploratory study investigates possible relationships between fluctuations in tremor at rest (TR) and fluctuations in eye movement amplitude during ocular fixation. TR of the hand and eye movements were analyzed in five subjects with Parkinson's disease (PD) and five age-matched controls. TR was recorded using a position laser system and eye movements were recorded using an infrared reflectometry technique (Ober2). TR amplitudes were significantly larger in the group of subjects with PD than in the control group (p</=0.01). In addition, subjects with PD showed more fluctuations in their TR (p</=0.01). Eye movements did not present more fluctuations in amplitude during ocular fixation (p>/=0.05). Changes in TR amplitude were not systematically correlated with modifications of eye movement amplitude in either group. However, occasional but distinct monocular oscillations were found in subjects with PD. Coherence values between frequencies of TR from the tested hand (3.5-7Hz) and frequencies of oscillatory eye movements (within the same frequency band) were clearly higher for the eye ipsilateral to the side of the body most affected by the disease in three subjects with PD. It is believed that these monocular oscillations may be a consequence of PD. Results from two previously published exploratory studies are integrated with the present results and new avenues of research are proposed.
The discrimination between normal and pathological tremor is difficult when amplitude is relative... more The discrimination between normal and pathological tremor is difficult when amplitude is relatively small. The WFLC algorithm, a time domain adaptive Fourier transform, is designed to control physiological tremor and to improve precision during microsurgery. We added two iterative optimization processes to initialize the following parameters: initial frequency weight (omega0), amplitude adaptation rate (mu) and frequency adaptation rate (mu0). Then, we applied the methods on data sets recorded on patients with different tremors (control, parkinsonian, cerebellar, and essential) sampled at 200 Hz. After filtering the data, the WFLC algorithm tracked the time-varying dominant frequencies and amplitudes of the transformed data sets. Our results illustrate the potential of using this algorithm as an approach to discriminate between normal and pathological signals even when amplitude is not a significant discriminating factor.
Kinetic tremor recorded with a laser system during a compensatory tracking task of the index fing... more Kinetic tremor recorded with a laser system during a compensatory tracking task of the index finger was analyzed in 21 patients with PD whose tremor amplitude was between low and moderate, and 30 control subjects. Nine characteristics quantifying the tracking task and tremor including mean tracking error, reaction time, peakedness, harmonicity, median frequency, proportional power in the 3-4 Hz, 4-6 Hz and 7-12 Hz ranges, and power at 0.25 Hz, were applied to the processed signal. The discriminating power of each characteristic was evaluated using differences between group means (p values), maximum percentage discrimination, and number of outliers in the patient group using z-score and 96.7(th) percentile of the control group. All nine characteristics showed significant differences between means of the two groups using Welch-modified t-tests for unequal variances. The most discriminating characteristics reflected differences in the frequency distribution of the movement and did not correlate highly with postural tremor amplitude nor with clinical ratings of tremor. Discrimination methods classified correctly up to 66.7 p.cent of the patients. Combining representative information about proportional power during posture and tracking gave a much higher discrimination (90 p.cent) with respect to the 96.7th percentile of the control group. These results suggest that by combining information coming from postural and kinetic tremors it is possible to isolate a specific aspect of PD symptomatology which could be used to reevaluate the classic distinction made between the akineto-rigid and tremulous forms of PD independently of tremor amplitude.
In this study we examine the bifurcation of the transition between walking and running. Beuter an... more In this study we examine the bifurcation of the transition between walking and running. Beuter and Lalonde (1986) have conjectured that the pertinent parameters separating walking and running can be described by a cusp singularity (Thom, 1972). In this model, the unidimensional state space is characterized by support duration and the bidimensional parameter space is characterized by the subject's weight and speed. To test this model eight males walked and ran on a motor driven treadmill at an increasing or decreasing speed with or without additional loads corresponding to 0%, 7% and 14% of their body weight. Velocities corresponding to transitions between the two modes of locomotion indicate that on the average the walk-run transition occurs at higher speed than the run-walk transition illustrating an hysteresis effect. In addition, the average difference between the transitions decreases as the load increases [mean 0 = 0.235 m/s, +/- 0.09 m/s, mean 7 = 0.104 m/s, +/- 0.07 m/s and mean 14 = 0.041 m/s, +/- 0.06 m/s] corresponding to an F ratio of F = 2.72, 0.05 less than p less than 0.1. A comparison of the differences in transition velocity at 0% and 14% is statistically different (t = 2.8, p less than 0.025). These results tend to support the existence of an elementary cusp singularity separating the two locomotion modes and suggest that the mechanisms controlling these transitions can be described by a hysterisis cycle and a small number of parameters.
The aim of this study was: (1) To determine the minimum number of characteristics necessary to di... more The aim of this study was: (1) To determine the minimum number of characteristics necessary to discriminate between postural tremor recorded in control subjects (CO), in subjects exposed to manganese (MN), and in patients with Parkinson's disease (PD), and (2) to examine the continuum of changes between the three groups examined. Workers previously exposed to Mn (n = 10), patients with PD (n = 10), and control subjects (CO) (n = 11) underwent a clinical examination. Blood Mn was measured at the end of exposure time for the MN group and 12 months later at the beginning of the experiment for all groups. Postural tremor with visual feedback was recorded in the index finger with a laser system. Statistical criteria were used to reduce computed tremor characteristics to a minimal set of reliable discriminating variables. Two variables were retained namely corrected wobble (CW), describing the morphology of the tremor oscillations, and variability ratio (VR), describing proportional power of tremor. Both variables had an overall correct classification rate of 77.4%. Blood Mn levels at the time of the experiment were similar for all groups and had insignificant correlation with tremor variables. However, blood Mn levels in workers which were also measured at the end of exposure time (i.e., 12 months before) showed significant correlation (Spearman's rank coefficient) with both harmonic index (rho = 0.70, P = 0.03) and first maximum of the autocorrelation function (rho = 0.89, P = 0.001). We conclude that (1) the tremor of workers exposed to Mn could be adequately described with only two variables; (2) a continuum of changes between tremor recorded in control subjects, in subjects exposed to Mn and in patients with PD was observed, with the MN group always found in between the control (CO) and the PD groups; (3) while blood Mn levels in workers were back at control levels at the time of the experiment, the effect of Mn on postural tremor was still detected. Thus our method has the potential to detect the effect of Mn on tremor with only two variables even after Mn level in the blood is back to normal values.
The basal ganglia form one of the main reentrant subcortical loops which modulate the output of t... more The basal ganglia form one of the main reentrant subcortical loops which modulate the output of the cerebral cortex via thalam-ocortical projections. These neural structures play a major role in sensorimotor integration which is evident to anyone who has observed the disturbances of movement, posture, and muscle tone that result when these nuclei are damaged through injury or disease (DeLong and Georgopoulos, 1979). The role of sensorimotor integration is also evident in some dystonic patients whose movements can be improved by cutaneous stimulation of the affected body part (Albin et al., 1989). However, little is known about the nature of the sensorimotor integration that takes place in these subcortical structures (Mitchell et al, 1991) and the complex relationships existing between basal ganglia lesions and behavioral functions remains largely to be understood.
In this study, phase plane analysis was used to describe the mechanisms involved in human intrali... more In this study, phase plane analysis was used to describe the mechanisms involved in human intralimb dynamics during a multijoint coordinated task. Nonhandicapped, spastic, and athetoid cerebral palsied individuals were videotaped as they performed a stepping task. Kinematic data for the hip and knee joint angles were digitized, smoothed, differentiated, and plotted. Phase plane analysis of movement data reveals striking differences between nonhandicapped and cerebral palsied individuals. Whereas nonhandicapped individuals have trajectories in the phase plane that suggest a self-contained second-order dynamical system, cerebral palsied individuals have self-interesting loops in their phase planes. Based upon these patterns some dynamical distinctions are offered, and suggestions are made toward a possible model.
Quantification of movement pathologies is an important challenge of the clinical and research lab... more Quantification of movement pathologies is an important challenge of the clinical and research laboratories today. Basically, two problems must be addressed. The first one is to find the appropriate technology; the second is to develop adequate measures from the raw data which will best discriminate between health and pathology. In this paper, we propose a simple method to record and analyse tremor and other microdisplacements of the upper extremities based on the recording of position by laser analog sensors. Any microcomputer equipped to perform analog-digital conversion is compatible for use with this system. The performance of the laser system is examined and compared with the performance of accelerometers. Finally, data recorded with a laser analog sensor from a patient with Parkinson's disease and a control subject are presented. This new laser-based quantitative method may prove to be an important tool in early and differential diagnosis of neurodegenerative diseases of the central nervous system.
ABSTRACT Parkinson’s disease is a complex disorder for which there is no known cure. Nor do we un... more ABSTRACT Parkinson’s disease is a complex disorder for which there is no known cure. Nor do we understand fully the origin of one of the disease’s cardinal symptoms: tremor. A non-traditional approach to research in Parkinson’s disease and in Parkinsonian tremor involves the application of mathematical models. The purpose of this article is to review briefly the contributions of mathematical models to the study of Parkinsonian tremor. There is little evidence that modelling attempts have built on previous ones but there has been a trend to move the focus of modelling from the periphery to the brain, and from abstracted to more physiologically detailed views. We hope that this review will encourage more mathematical modelling in the study of Parkinson’s disease and Parkinsonian tremor.
This exploratory study investigates possible relationships between fluctuations in tremor at rest... more This exploratory study investigates possible relationships between fluctuations in tremor at rest (TR) and fluctuations in eye movement amplitude during ocular fixation. TR of the hand and eye movements were analyzed in five subjects with Parkinson's disease (PD) and five age-matched controls. TR was recorded using a position laser system and eye movements were recorded using an infrared reflectometry technique (Ober2). TR amplitudes were significantly larger in the group of subjects with PD than in the control group (p</=0.01). In addition, subjects with PD showed more fluctuations in their TR (p</=0.01). Eye movements did not present more fluctuations in amplitude during ocular fixation (p>/=0.05). Changes in TR amplitude were not systematically correlated with modifications of eye movement amplitude in either group. However, occasional but distinct monocular oscillations were found in subjects with PD. Coherence values between frequencies of TR from the tested hand (3.5-7Hz) and frequencies of oscillatory eye movements (within the same frequency band) were clearly higher for the eye ipsilateral to the side of the body most affected by the disease in three subjects with PD. It is believed that these monocular oscillations may be a consequence of PD. Results from two previously published exploratory studies are integrated with the present results and new avenues of research are proposed.
The discrimination between normal and pathological tremor is difficult when amplitude is relative... more The discrimination between normal and pathological tremor is difficult when amplitude is relatively small. The WFLC algorithm, a time domain adaptive Fourier transform, is designed to control physiological tremor and to improve precision during microsurgery. We added two iterative optimization processes to initialize the following parameters: initial frequency weight (omega0), amplitude adaptation rate (mu) and frequency adaptation rate (mu0). Then, we applied the methods on data sets recorded on patients with different tremors (control, parkinsonian, cerebellar, and essential) sampled at 200 Hz. After filtering the data, the WFLC algorithm tracked the time-varying dominant frequencies and amplitudes of the transformed data sets. Our results illustrate the potential of using this algorithm as an approach to discriminate between normal and pathological signals even when amplitude is not a significant discriminating factor.
Kinetic tremor recorded with a laser system during a compensatory tracking task of the index fing... more Kinetic tremor recorded with a laser system during a compensatory tracking task of the index finger was analyzed in 21 patients with PD whose tremor amplitude was between low and moderate, and 30 control subjects. Nine characteristics quantifying the tracking task and tremor including mean tracking error, reaction time, peakedness, harmonicity, median frequency, proportional power in the 3-4 Hz, 4-6 Hz and 7-12 Hz ranges, and power at 0.25 Hz, were applied to the processed signal. The discriminating power of each characteristic was evaluated using differences between group means (p values), maximum percentage discrimination, and number of outliers in the patient group using z-score and 96.7(th) percentile of the control group. All nine characteristics showed significant differences between means of the two groups using Welch-modified t-tests for unequal variances. The most discriminating characteristics reflected differences in the frequency distribution of the movement and did not correlate highly with postural tremor amplitude nor with clinical ratings of tremor. Discrimination methods classified correctly up to 66.7 p.cent of the patients. Combining representative information about proportional power during posture and tracking gave a much higher discrimination (90 p.cent) with respect to the 96.7th percentile of the control group. These results suggest that by combining information coming from postural and kinetic tremors it is possible to isolate a specific aspect of PD symptomatology which could be used to reevaluate the classic distinction made between the akineto-rigid and tremulous forms of PD independently of tremor amplitude.
In this study we examine the bifurcation of the transition between walking and running. Beuter an... more In this study we examine the bifurcation of the transition between walking and running. Beuter and Lalonde (1986) have conjectured that the pertinent parameters separating walking and running can be described by a cusp singularity (Thom, 1972). In this model, the unidimensional state space is characterized by support duration and the bidimensional parameter space is characterized by the subject's weight and speed. To test this model eight males walked and ran on a motor driven treadmill at an increasing or decreasing speed with or without additional loads corresponding to 0%, 7% and 14% of their body weight. Velocities corresponding to transitions between the two modes of locomotion indicate that on the average the walk-run transition occurs at higher speed than the run-walk transition illustrating an hysteresis effect. In addition, the average difference between the transitions decreases as the load increases [mean 0 = 0.235 m/s, +/- 0.09 m/s, mean 7 = 0.104 m/s, +/- 0.07 m/s and mean 14 = 0.041 m/s, +/- 0.06 m/s] corresponding to an F ratio of F = 2.72, 0.05 less than p less than 0.1. A comparison of the differences in transition velocity at 0% and 14% is statistically different (t = 2.8, p less than 0.025). These results tend to support the existence of an elementary cusp singularity separating the two locomotion modes and suggest that the mechanisms controlling these transitions can be described by a hysterisis cycle and a small number of parameters.
The aim of this study was: (1) To determine the minimum number of characteristics necessary to di... more The aim of this study was: (1) To determine the minimum number of characteristics necessary to discriminate between postural tremor recorded in control subjects (CO), in subjects exposed to manganese (MN), and in patients with Parkinson's disease (PD), and (2) to examine the continuum of changes between the three groups examined. Workers previously exposed to Mn (n = 10), patients with PD (n = 10), and control subjects (CO) (n = 11) underwent a clinical examination. Blood Mn was measured at the end of exposure time for the MN group and 12 months later at the beginning of the experiment for all groups. Postural tremor with visual feedback was recorded in the index finger with a laser system. Statistical criteria were used to reduce computed tremor characteristics to a minimal set of reliable discriminating variables. Two variables were retained namely corrected wobble (CW), describing the morphology of the tremor oscillations, and variability ratio (VR), describing proportional power of tremor. Both variables had an overall correct classification rate of 77.4%. Blood Mn levels at the time of the experiment were similar for all groups and had insignificant correlation with tremor variables. However, blood Mn levels in workers which were also measured at the end of exposure time (i.e., 12 months before) showed significant correlation (Spearman's rank coefficient) with both harmonic index (rho = 0.70, P = 0.03) and first maximum of the autocorrelation function (rho = 0.89, P = 0.001). We conclude that (1) the tremor of workers exposed to Mn could be adequately described with only two variables; (2) a continuum of changes between tremor recorded in control subjects, in subjects exposed to Mn and in patients with PD was observed, with the MN group always found in between the control (CO) and the PD groups; (3) while blood Mn levels in workers were back at control levels at the time of the experiment, the effect of Mn on postural tremor was still detected. Thus our method has the potential to detect the effect of Mn on tremor with only two variables even after Mn level in the blood is back to normal values.
The basal ganglia form one of the main reentrant subcortical loops which modulate the output of t... more The basal ganglia form one of the main reentrant subcortical loops which modulate the output of the cerebral cortex via thalam-ocortical projections. These neural structures play a major role in sensorimotor integration which is evident to anyone who has observed the disturbances of movement, posture, and muscle tone that result when these nuclei are damaged through injury or disease (DeLong and Georgopoulos, 1979). The role of sensorimotor integration is also evident in some dystonic patients whose movements can be improved by cutaneous stimulation of the affected body part (Albin et al., 1989). However, little is known about the nature of the sensorimotor integration that takes place in these subcortical structures (Mitchell et al, 1991) and the complex relationships existing between basal ganglia lesions and behavioral functions remains largely to be understood.
In this study, phase plane analysis was used to describe the mechanisms involved in human intrali... more In this study, phase plane analysis was used to describe the mechanisms involved in human intralimb dynamics during a multijoint coordinated task. Nonhandicapped, spastic, and athetoid cerebral palsied individuals were videotaped as they performed a stepping task. Kinematic data for the hip and knee joint angles were digitized, smoothed, differentiated, and plotted. Phase plane analysis of movement data reveals striking differences between nonhandicapped and cerebral palsied individuals. Whereas nonhandicapped individuals have trajectories in the phase plane that suggest a self-contained second-order dynamical system, cerebral palsied individuals have self-interesting loops in their phase planes. Based upon these patterns some dynamical distinctions are offered, and suggestions are made toward a possible model.
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