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Mirelman A, Volkov J, Salomon A, Gazit E, Nieuwboer A, Rochester L, Del Din S, Avanzino L, Pelosin E, Bloem BR, Della Croce U, Cereatti A, Thaler A, Roggen D, Mazza C, Shirvan J, Cedarbaum JM, Giladi N, Hausdorff JM. Digital Mobility Measures: A Window into Real-World Severity and Progression of Parkinson's Disease. Mov Disord 2024; 39:328-338. [PMID: 38151859 DOI: 10.1002/mds.29689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Real-world monitoring using wearable sensors has enormous potential for assessing disease severity and symptoms among persons with Parkinson's disease (PD). Many distinct features can be extracted, reflecting multiple mobility domains. However, it is unclear which digital measures are related to PD severity and are sensitive to disease progression. OBJECTIVES The aim was to identify real-world mobility measures that reflect PD severity and show discriminant ability and sensitivity to disease progression, compared to the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scale. METHODS Multicenter real-world continuous (24/7) digital mobility data from 587 persons with PD and 68 matched healthy controls were collected using an accelerometer adhered to the lower back. Machine learning feature selection and regression algorithms evaluated associations of the digital measures using the MDS-UPDRS (I-III). Binary logistic regression assessed discriminatory value using controls, and longitudinal observational data from a subgroup (n = 33) evaluated sensitivity to change over time. RESULTS Digital measures were only moderately correlated with the MDS-UPDRS (part II-r = 0.60 and parts I and III-r = 0.50). Most associated measures reflected activity quantity and distribution patterns. A model with 14 digital measures accurately distinguished recently diagnosed persons with PD from healthy controls (81.1%, area under the curve: 0.87); digital measures showed larger effect sizes (Cohen's d: [0.19-0.66]), for change over time than any of the MDS-UPDRS parts (Cohen's d: [0.04-0.12]). CONCLUSIONS Real-world mobility measures are moderately associated with clinical assessments, suggesting that they capture different aspects of motor capacity and function. Digital mobility measures are sensitive to early-stage disease and to disease progression, to a larger degree than conventional clinical assessments, demonstrating their utility, primarily for clinical trials but ultimately also for clinical care. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anat Mirelman
- Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jana Volkov
- Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Amit Salomon
- Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Eran Gazit
- Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Alice Nieuwboer
- Department of Rehabilitation Science, KU Leuven, Neuromotor Rehabilitation Research Group, Leuven, Belgium
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Silvia Del Din
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Laura Avanzino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Policlinico San Martino Teaching Hospital, Genoa, Italy
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Ugo Della Croce
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Cereatti
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Avner Thaler
- Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Jesse M Cedarbaum
- Coeruleus Clinical Sciences, Woodbridge, Connecticut, USA
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nir Giladi
- Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physical Therapy, Tel Aviv University, Tel Aviv, Israel
- Department of Orthopedic Surgery, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
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Postolache TT, Stiller JW, Herrell R, Goldstein MA, Shreeram SS, Zebrak R, Thrower CM, Volkov J, No MJ, Volkov I, Rohan KJ, Redditt J, Parmar M, Mohyuddin F, Olsen C, Moca M, Tonelli LH, Merikangas K, Komarow HD. Tree pollen peaks are associated with increased nonviolent suicide in women. Mol Psychiatry 2005; 10:232-5. [PMID: 15599378 PMCID: PMC7100718 DOI: 10.1038/sj.mp.4001620] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- T T Postolache
- Mood and Anxiety Disorder Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD USA
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - J W Stiller
- Mood and Anxiety Disorder Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD USA
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - R Herrell
- Section on Developmental Genetic Epidemiology, the National Institute of Mental Health, the National Institutes of Health, Department of Health and Human Services, Bethesda, MD USA
| | - M A Goldstein
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - S S Shreeram
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - R Zebrak
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - C M Thrower
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - J Volkov
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - M J No
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - I Volkov
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - K J Rohan
- Department of Medical Psychology, Uniform Services University, Bethesda, MD USA
| | - J Redditt
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - M Parmar
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - F Mohyuddin
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - C Olsen
- Department of Preventive Medicine and Biometrics, Uniform Services University of the Health Services, Bethesda, MD USA
| | - M Moca
- DC DMH, St Elizabeth's Hospital Psychiatry Residency Training Program, Washington, DC USA
| | - L H Tonelli
- Section on Neuroendocrine Immunology and Behavior, the National Institute of Mental Health, the National Institutes of Health, Department of Health and Human Services, Bethesda, MD USA
| | - K Merikangas
- Section on Developmental Genetic Epidemiology, the National Institute of Mental Health, the National Institutes of Health, Department of Health and Human Services, Bethesda, MD USA
| | - H D Komarow
- Mood and Anxiety Disorder Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD USA
- Genetics and Genomics Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institutes of Health, Department of Health and Human Services, Bethesda, MD USA
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Hossain JL, Reinish LW, Heslegrave RJ, Hall GW, Kayumov L, Chung SA, Bhuiya P, Jovanovic D, Huterer N, Volkov J, Shapiro CM. Subjective and Objective Evaluation of Sleep and Performance in Daytime Versus Nighttime Sleep in Extended-Hours Shift-Workers at an Underground Mine. J Occup Environ Med 2004; 46:212-26. [PMID: 15091283 DOI: 10.1097/01.jom.0000117421.95392.31] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Extended hours of shift work has the potential for adverse consequences for workers, particularly during the nightshift, such as poorer sleep quality during the day, increased worker fatigue, and fatigue-related accidents and decreased work performance. This study examined subjective and objective measurements of sleep and performance in a group of underground miners before and after the change from a backward-rotating 8-hour to a forward-rotating 10-hour shift schedule. The purpose of this study was to evaluate the short- and long-term impact of a shift schedule change on sleep and performance. The results demonstrated improved subjective and objective measures of sleep and performance on the new 10-hour nightshift schedule. The 10-hour nightshift workers subjectively reported more refreshing sleep, fewer performance impairments and driving difficulties than 8-hour nightshift workers. The results of the objective measures of sleep and performance on the 10-hour nightshifts were overall similar or possibly better than those measured on the 10-hour dayshifts. These are some of the first data to suggest that a nightshift that does not encompass the entire night period could have significant benefits to shift-workers. We suggest that these benefits are mostly the result of the timing of the new nightshift start and end times rather than other shift-schedule factors.
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Affiliation(s)
- Jamil L Hossain
- Sleep Research Laboratory and the Department of Psychiatry, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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