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Mancini M, Afshari M, Almeida Q, Amundsen-Huffmaster S, Balfany K, Camicioli R, Christiansen C, Dale ML, Dibble LE, Earhart GM, Ellis TD, Griffith GJ, Hackney ME, Hopkins J, Horak FB, Jones KE, Ling L, O'Keefe JA, Kwei K, Olivier G, Rao AK, Sivaramakrishnan A, Corcos DM. Digital gait biomarkers in Parkinson's disease: susceptibility/risk, progression, response to exercise, and prognosis. NPJ Parkinsons Dis 2025; 11:51. [PMID: 40118834 PMCID: PMC11928532 DOI: 10.1038/s41531-025-00897-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 02/17/2025] [Indexed: 03/24/2025] Open
Abstract
This narrative review examines the utility of gait digital biomarkers in Parkinson's disease (PD) research and clinical trials across four contexts: disease susceptibility/risk, disease progression, response to exercise, and fall prediction. The review of the literature to date suggests that upper body characteristics of gait (e.g., arm swing, trunk motion) may indicate susceptibility/risk of PD, while pace aspects (e.g., gait speed, stride length) are informative for tracking disease progression, exercise response, and fall likelihood. Dynamic stability aspects (e.g., trunk regularity, double-support time) worsen with disease progression but can improve with exercise. Gait variability emerges as a sensitive biomarker across all 4 contexts but with low specificity. The lack of standardized gait testing protocols and the lack of a minimum set of quantified digital gait biomarkers limit data harmonization across studies. Future studies, using a commonly agreed upon protocol, could be used to demonstrate the utility of specific gait biomarkers for clinical practice.
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Affiliation(s)
- Martina Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
| | - Mitra Afshari
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Katherine Balfany
- Department of Physical Medicine & Rehabilitation, University of Colorado, Aurora, CO, USA
| | - Richard Camicioli
- Department of Medicine (Neurology) and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Cory Christiansen
- Department of Physical Medicine & Rehabilitation, University of Colorado, Aurora, CO, USA
| | - Marian L Dale
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Leland E Dibble
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake, UT, USA
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, St Louis, MO, USA
| | - Terry D Ellis
- Department of Physical Therapy, Boston University, Boston, MA, USA
| | - Garett J Griffith
- Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Madeleine E Hackney
- Emory University School of Medicine, Department of Medicine, Division of Geriatrics and Gerontology, Atlanta, GA, USA
- VA Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA, USA
| | - Jammie Hopkins
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Kelvin E Jones
- Department of Medicine, Faculty of Kinesiology, Sport, & Recreation and Neuroscience and Mental Health Institute, University of Alberta, Alberta, AB, Canada
| | - Leah Ling
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake, UT, USA
| | - Joan A O'Keefe
- Departments of Anatomy & Cell Biology and Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Kimberly Kwei
- Department of Rehabilitation & Regenerative Medicine (Programs in Physical Therapy), and GH Sergievsky Center, Columbia University, New York, NY, USA
| | - Genevieve Olivier
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake, UT, USA
| | - Ashwini K Rao
- Department of Rehabilitation & Regenerative Medicine (Programs in Physical Therapy), and GH Sergievsky Center, Columbia University, New York, NY, USA
| | - Anjali Sivaramakrishnan
- Department of Physical Therapy at the School of Health Professions at UT Health San Antonio, San Antonio, TX, USA
| | - Daniel M Corcos
- Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL, USA
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Kwon KY, Joo BE, You J, Kim RO. Impact of motor features on non-motor symptoms in patients with de novo Parkinson's disease: Cognition, depression, anxiety, fatigue, and dysautonomia. Geriatr Gerontol Int 2025; 25:392-397. [PMID: 39833111 DOI: 10.1111/ggi.15083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Revised: 12/23/2024] [Accepted: 01/07/2025] [Indexed: 01/22/2025]
Abstract
AIM Patients with Parkinson's disease (PD) present with both motor and non-motor symptoms, and understanding the interplay between these symptoms is crucial for individualized patient care. This study aims to investigate the relationship between motor features and non-motor symptoms in patients with de novo PD. METHODS A total of 105 patients were analyzed, focusing on motor subtypes or subscores and their impact on cognition, depression, anxiety, fatigue, and dysautonomia. We utilized the Unified Parkinson's Disease Rating Scale-part III (UPDRS-III) for motor assessment, and various validated scales for non-motor symptoms. RESULTS Compared with tremor-dominant (TD) patients, non-TD patients showed severe scores in fatigue and dysautonomia, but no difference in other non-motor symptoms, including global cognition, depression, and anxiety. Linear regression analysis revealed that the total motor score of UPDRS-III was negatively related to global cognition (β = -0.4454, P = 0.0121). As a post-hoc analysis, partial correlation analysis showed that rigidity and bradykinesia subscores were associated with global cognition (r = -0.3527, P = 0.0004; r = -0.2206, P = 0.0299, respectively), whereas the postural instability/gait difficulty subscore was associated with depression, anxiety, fatigue, and dysautonomia (r = 0.2181, P = 0.0319; r = 0.2371, P = 0.0194; r = 0.3659, P = 0.0002; r = 0.3968, P = 0.0001, respectively) but not with global cognition. CONCLUSIONS These results suggest that motor features in the early stages of PD can serve as important indicators of non-motor symptoms, potentially guiding more personalized therapeutic approaches. Geriatr Gerontol Int 2025; 25: 392-397.
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Affiliation(s)
- Kyum-Yil Kwon
- Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Byung-Euk Joo
- Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Jihwan You
- Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Rae On Kim
- Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
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Hong JP, Baik K, Park E, Lee SU, Lee CN, Kim BJ, Kim JS, Park KW. The vestibulospinal dysfunction has little impact on falls in patients with mild Parkinson's disease. Parkinsonism Relat Disord 2024; 122:106081. [PMID: 38461689 DOI: 10.1016/j.parkreldis.2024.106081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Jun-Pyo Hong
- Department of Neurology, Korea University Medical Center, Seoul, South Korea
| | - Kyoungwon Baik
- Department of Neurology, Korea University Medical Center, Seoul, South Korea
| | - Euyhyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea; Neurotology and Neuro-ophthalmology Laboratory, Korea University Anam Hospital, Seoul, South Korea
| | - Sun-Uk Lee
- Department of Neurology, Korea University Medical Center, Seoul, South Korea; Neurotology and Neuro-ophthalmology Laboratory, Korea University Anam Hospital, Seoul, South Korea.
| | - Chan-Nyoung Lee
- Department of Neurology, Korea University Medical Center, Seoul, South Korea.
| | - Byung-Jo Kim
- Department of Neurology, Korea University Medical Center, Seoul, South Korea; BK21 FOUR Program in Learning Health Systems, Korea University, Seoul, South Korea
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea; Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kun-Woo Park
- Department of Neurology, Korea University Medical Center, Seoul, South Korea
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