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Habets J, Heijmans M, Herff C, Simons C, Leentjens AF, Temel Y, Kuijf M, Kubben P. Mobile Health Daily Life Monitoring for Parkinson Disease: Development and Validation of Ecological Momentary Assessments. JMIR Mhealth Uhealth 2020; 8:e15628. [PMID: 32339999 PMCID: PMC7248801 DOI: 10.2196/15628] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/25/2019] [Accepted: 12/15/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parkinson disease monitoring is currently transitioning from periodic clinical assessments to continuous daily life monitoring in free-living conditions. Traditional Parkinson disease monitoring methods lack intraday fluctuation detection. Electronic diaries (eDiaries) hold the potential to collect subjective experiences on the severity and burden of motor and nonmotor symptoms in free-living conditions. OBJECTIVE This study aimed to develop a Parkinson disease-specific eDiary based on ecological momentary assessments (EMAs) and to explore its validation. METHODS An observational cohort of 20 patients with Parkinson disease used the smartphone-based EMA eDiary for 14 consecutive days without adjusting free-living routines. The eDiary app presented an identical questionnaire consisting of questions regarding affect, context, motor and nonmotor symptoms, and motor performance 7 times daily at semirandomized moments. In addition, patients were asked to complete a morning and an evening questionnaire. RESULTS Mean affect correlated moderate-to-strong and moderate with motor performance (R=0.38 to 0.75; P<.001) and motor symptom (R=0.34 to 0.50; P<.001) items, respectively. The motor performance showed a weak-to-moderate negative correlation with motor symptoms (R=-0.31 to -0.48; P<.001). Mean group answers given for on-medication conditions vs wearing-off-medication conditions differed significantly (P<.05); however, not enough questionnaires were completed for the wearing-off-medication condition to reproduce these findings on individual levels. CONCLUSIONS We presented a Parkinson disease-specific EMA eDiary. Correlations between given answers support the internal validity of the eDiary and underline EMA's potential in free-living Parkinson disease monitoring. Careful patient selection and EMA design adjustment to this targeted population and their fluctuations are necessary to generate robust proof of EMA validation in future work. Combining clinical Parkinson disease knowledge with practical EMA experience is inevitable to design and perform studies, which will lead to the successful integration of eDiaries in free-living Parkinson disease monitoring.
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Affiliation(s)
- Jeroen Habets
- Department of Neurosurgery, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Margot Heijmans
- Department of Neurosurgery, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Christian Herff
- Department of Neurosurgery, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Claudia Simons
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands.,GGzE, Institute for Mental Health Care Eindhoven, Eindhoven, Netherlands
| | - Albert Fg Leentjens
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Yasin Temel
- Department of Neurosurgery, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Mark Kuijf
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Pieter Kubben
- Department of Neurosurgery, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands.,Department of Neurosurgery, Radboud University Medical Center, Nijmegen, Netherlands
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Heijmans M, Habets J, Kuijf M, Kubben P, Herff C. Evaluation of Parkinson's Disease at Home: Predicting Tremor from Wearable Sensors. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:584-587. [PMID: 31945966 DOI: 10.1109/embc.2019.8857717] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The continuous monitoring of Parkinsons's disease (PD) symptoms would allow to automatically adjust medication or deep brain stimulation parameters to a patient's momentary condition. Wearable sensors have been proposed to monitor PD symptoms and have been validated in a number of lab and hospital settings. However, taking these sensors into the daily life of patients introduces a number of difficulties, most notably the absence of an observable ground truth of what the user is currently doing. In this pilot study, we investigate PD symptoms by combining wearable sensors on both wrist and the chest with a questionnaire based evaluation of PD symptoms, in the form of experience sampling method. For a tremor dominant patient, we show that experienced tremor severity can be predicted from the sensor data with correlations of up to r = 0.43. We evaluated different window lengths to calculate the features in and see better results for longer window lengths. Our results show that continuous monitoring of PD symptoms in daily life is feasible using wearable sensors.
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Plantinga B, Temel Y, Duchin Y, Uludag K, Roebroeck A, Kuijf M, Jahanshahi A, Haar Romenij BT, Vitek J, Harel N. SP 9. Individualized identification of the motor part of the subthalamic nucleus in Parkinson’s disease. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kubben P, Kuijf M, Ackermans L, Leentjens A, Temel Y. EP 12. TREMOR12: An open-source mobile app for tremor quantification. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tonge M, Ackermans L, Kocabicak E, van Kranen-Mastenbroek V, Kuijf M, Oosterloo M, Kubben P, Temel Y. A detailed analysis of intracerebral hemorrhages in DBS surgeries. Clin Neurol Neurosurg 2015; 139:183-7. [PMID: 26513430 DOI: 10.1016/j.clineuro.2015.10.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/11/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Deep brain stimulation is nowadays a frequently performed surgery in patients with movement disorders, intractable epilepsy, and severe psychiatric disorders. The most feared complication of this surgery is an intracerebral hemorrhage due to the electrode placement, either for intraoperative electrophysiology (microelectrode recording) and/or implantation of the final electrode (macroelectrode). Here, we have investigated the risk of developing an intracerebral hemorrhage in our cohort of deep brain stimulation patients over a period of 15 years. PATIENTS AND METHODS We have collected demographic data and analyzed the effect of performing surgery with single-electrode versus multiple electrode guided DBS. The effect of using single-dose versus double-dose contrast enhanced MRI to visualize vessels for the electrode trajectory planning has been investigated as well. RESULTS We have found that the overall calculated risk of an intracerebral hemorrhage in our series was 1.81% per patient, 0.3% per recording electrode and 0.23% per brain insertion. While three out of four patients recovered without neurological deficits, there was one mortality in a patient with cardiovascular comorbidities. Statistical comparisons between the groups of single-electrode versus multiple electrode guided surgery and single-dose gadolinium versus double-dose contrast enhanced MRI revealed no significant differences. In addition, there was no meaningful correlation between the age at surgery and the risk of bleeding. CONCLUSION We have found that the risk of developing an intracerebral hemorrhage due to deep brain stimulation surgery is low. The clinical course of the patients with an intracerebral hemorrhage was generally favorable.
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Affiliation(s)
- Mehmet Tonge
- Department of Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ersoy Kocabicak
- Department of Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Neurosurgery, Ondokuz Mayis University, Samsun, Turkey
| | | | - Mark Kuijf
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mayke Oosterloo
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Pieter Kubben
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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Kocabicak E, Alptekin O, Ackermans L, Kubben P, Kuijf M, Kurt E, Esselink R, Temel Y. Is there still need for microelectrode recording now the subthalamic nucleus can be well visualized with high field and ultrahigh MR imaging? Front Integr Neurosci 2015; 9:46. [PMID: 26321929 PMCID: PMC4531226 DOI: 10.3389/fnint.2015.00046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 07/15/2015] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ersoy Kocabicak
- Department of Neurosurgery, Maastricht Medical Center Maastricht, Netherlands ; Department of Neuroscience, Maastricht University Medical Center Maastricht, Netherlands ; Department of Neurosurgery, Ondokuz Mayis University Samsun, Turkey
| | - Onur Alptekin
- Department of Neuroscience, Maastricht University Medical Center Maastricht, Netherlands
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht Medical Center Maastricht, Netherlands
| | - Pieter Kubben
- Department of Neurosurgery, Maastricht Medical Center Maastricht, Netherlands
| | - Mark Kuijf
- Department of Neurology, Maastricht Medical Center Maastricht, Netherlands
| | - Erkan Kurt
- Department of Neurosurgery, Donders Institute for Cognition, Brain and Behaviour, Radboud University Medical Center Nijmegen, Netherlands
| | - Rianne Esselink
- Department of Neurology, Donders Institute for Cognition, Brain and Behaviour, Radboud University Medical Center Nijmegen, Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht Medical Center Maastricht, Netherlands ; Department of Neuroscience, Maastricht University Medical Center Maastricht, Netherlands
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Tonge M, Kocabicak E, Ackermans L, Kuijf M, Temel Y. Final electrode position in subthalamic nucleus deep brain stimulation surgery: a comparison of indirect and direct targeting methods. Turk Neurosurg 2015; 26:900-903. [DOI: 10.5137/1019-5149.jtn.13739-14.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kuijf M, Ruts L, van Doorn PA, Koudstaal PJ, Jacobs BC. Diagnostic value of anti-GQ1b antibodies in a patient with relapsing dysarthria and ataxia. Case Reports 2009; 2009:bcr08.2008.0783. [DOI: 10.1136/bcr.08.2008.0783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ang CW, Krogfelt K, Herbrink P, Keijser J, van Pelt W, Dalby T, Kuijf M, Jacobs BC, Bergman MP, Schiellerup P, Visser CE. Validation of an ELISA for the diagnosis of recent Campylobacter infections in Guillain–Barré and reactive arthritis patients. Clin Microbiol Infect 2007; 13:915-22. [PMID: 17608745 DOI: 10.1111/j.1469-0691.2007.01765.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [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: 11/30/2022]
Abstract
Weeks or months following Campylobacter infection, a small proportion of infected individuals develop Guillain-Barré syndrome (GBS) or reactive arthritis (ReA). Stool culture for Campylobacter is often negative in these patients, and serology is therefore the method of choice for diagnosing a recent infection with Campylobacter. This study developed a capture ELISA system to detect anti-Campylobacter IgA and IgM antibodies indicative of a recent infection. The sensitivity of the assay was 82.0% in uncomplicated Campylobacter enteritis patients, 96.2% in GBS patients who were culture-positive for Campylobacter, and 93.1% in culture-positive ReA patients, with a specificity of 93.0%. The assay allows identification of Campylobacter infection in patients with post-infectious neurological and rheumatological complications.
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Affiliation(s)
- C W Ang
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, Department of Medical Microbiology, Reinier de Graad Gasthuis, Delft, The Netherlands.
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