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075 MODULATION OF THE RELEASE OF ANTICIPATORY POSTURAL ADJUSTMENTS (APAS) DURING STEP INITIATION: WHAT IS THE ROLE OF ATTENTION?
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Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
is needed to determine whether executive function abilities also relate causally to walking in elderly. It can be hypothesized from this study that interventions that want to influence dual task costs of gait should especially focus on divided attention. 073 A WEARABLE SYSTEM FOR MONITORING GESTURE, POSTURE AND PHYSIOLOGICAL CORRELATES OF EMOTION U. Debarnot, F. Lorussi, E.P. Scilingo, A. Tognetti, D. De Rossi. Interdepartmental Research Center ‘E. Piaggio’, University of Pisa, Pisa, Italy Studies on behaviour and emotive emergence by coupling humancentred perception with interacting human physiological and behavioural signals are still in their infancy. Indeed, major difficulties emerge in the acquisition of measurements relative to both peripheral vegetative activity and movement acquired through an ambulant, long-term human acquisition monitoring. For this purpose, we developed an unobtrusive Personal Biomonitoring System (PBS) based on sensing textile platforms connected to portable acquiring devices. In practice, the PBS recording includes the transduction of heart rate, surface electromiographic signals, electrodermal response, respiratory values as well as postural and gestural kinetic data via integrated wearable sensors embedded in garments. In comparison with traditional non-wearable systems, the PBS performed robust and efficient data acquisition in poststroke and cardiovascular rehabilitation patient treatment. This methodological progress reinforces and provides strong theoretical and practical applications in the neuropsychological rehabilitation field. More specifically, the psycho-physiological responses obtained by extracting features from a subset of physiological and behavioural signals is under development for the status evaluation of patients affected by mood disorders such as bi-polar and stress disorders. Our ultimate goal is to use the Personal Biomonitoring System for managing mental illnesses by monitoring and predicting critical events through the detection of movement, gesture and vegetative efferences that elicit peripheral response accompanying behaviour. 074 EARLY EVALUATION OF THE CONNECTIONS BETWEEN AUTISM AND ALTERATIONS OF MOVEMENT E. Nardini, G. Valenza, C. Mancuso, A. Armato, A. Lanata, ` E.P. Scilingo, D. De Rossi. Interdipartmental Research Center ‘E.Piaggio’, University of Pisa, Pisa, Italy Background and aim: Several anomalies in autistic children appearing as clear and permanent movement alterations such as deficiency in coordination, head bending, tiptoe walking, hand gesture and body rocking under the legs, or of the upper body, accompanied by frequent falls. The aim of this work will be to monitor the movement alterations jointly to vital signs in order to investigate the connections between movement disturbances and autism. In particular, this paper would monitor body posture, head bending, hand gesture and vital signs from groups of normal and autistic children in a controlled environment, for making diagnosis and monitoring trend of the therapy. Methods: Two groups should be recruited: autism affected children (AC) and controls (C), both of them will be monitored by a sensorized system for movements and physiologic investigation jointly to a camera. The system could be constituted of a shirt for posture and vital signs, gloves for hand gesture, “baseball-like” hat for head movement, and shoes for the foot pressure. A Walking Observation Scale could be used to analyze the gait through three axes: foot’s movements; arms movements; global movements. Results and Conclusion: This comparison aims at investigating possible connections between the autism pathology and the movement disturbances in the patients. Results will be addressed to determine possible indicators of patient state and/or therapy
trend. Future works aim to extract robust features for monitoring variations of the patient state and to make the system user friendly in order to minimize problems of patient acceptance. 075 MODULATION OF THE RELEASE OF ANTICIPATORY POSTURAL ADJUSTMENTS (APAS) DURING STEP INITIATION: WHAT IS THE ROLE OF ATTENTION? A. Delval, S. Willart, J.-L. Bourriez, C. Tard, J. Bouchez, A. Destee, ´ P. Derambure, K. Dujardin, L. Defebvre. CHRU Lille, Lille, France Background and Aims: Step initiation is accompanied by APAs. Presentation of an acoustic stimulus evoking a startle response (subcortical mechanism) before the imperative “Go” stimulus results in the release of early APAs (Mac Kinnon, 2008). We addressed which other mechanisms facilitate the release of APAs. How an auditory stimulus that modulated attention (oddball paradigm) could modify the release of the APAs and what were the consequences for both preparation and execution of the step? Methods: 15 subjects received an auditory tone burst of 115 dB, 80 dB and 40 dB before or at the time of an imperative visual “Go” signal. Tibialis anterior activation and COP trajectories were studied. In a second part, an auditory oddball paradigm was used to direct attention of the subject 1.4 s before the Go signal. In addition to previous measurements, cortical P3 response was studied. Results: Auditory stimulus at 80 and 120 dB could evoke early release of small APAs (Pre APAs) not followed by step execution only when the task was known in advance (Figure). The classic ‘APAs-step execution’ sequence was perturbed when this auditory stimulus occurred at around 100 ms of the imperative go signal (resulting in some cases in multiple APAs). Pre APAs were more frequently evoked when the auditory stimulus was rare and provoked an attentional cortical process (identified by a P3 wave). Conclusions: The APAs are stored and could be triggered in different ways. Subcortical and cortical processes provoked the release of the APAs and attention could modify it. 076 TRAIL MAKING TEST ENHANCES DISCRIMINATION WITH THE DYNAMIC GAIT INDEX TO DISTINGUISH ELDERLY FALLERS AND NON-FALLERS WITHOUT KNOWN COGNITIVE DECLINE J. Dewane1 , J. Mahoney2 , S. Bobula1 , T. Nelson1 , B. Heiderscheit1 . 1 Orthopedics and Rehabilitation Medicine, 2 Geriatric Medicine, UW Madison School of Medicine and Public Health, Madison, WI, USA Background and Aims: Cognitive impairment and gait instability are associated in people with significant cognitive deficits, such as Alzheimer’s disease or dementia, thereby increasing falls risk. However, it is unknown whether sub-clinical changes in executive function can have a similar effect. The purpose of this investigation was to determine if a measure of executive function when used in combination with postural control during gait could better discriminate falls history in older adults with no known cognitive decline (MMSE > 24). Methods: Cross sectional design. Subjects: Community dwelling older adults aged 65 to 85 yrs (n = 100). Measures: Each subject performed the Dynamic Gait Index (DGI) and Trail Making Test B (TMT-B), with cut scores to differentiate fallers from non-fallers determined by cross validation (DGI = 19.5; TMT-B = 74 s). The additive effect of TMT-B to DGI to discriminate falls history was assessed by the odds ratio and fitted logistic regression. Results: Fallers scored significantly worse on both the DGI and TMT-B than non-fallers. Subjects with a DGI <19.5 (OR = 5.4) or TMT-B >74 s (OR = 4.1) had a greater risk of a falls history. However, subjects meeting both criteria had a substantially greater risk (OR = 17.8). Conclusions: While the DGI was a strong independent measure to differentiate fallers from non-fallers, the DGI combined with TMT-B
Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
is needed to determine whether executive function abilities also relate causally to walking in elderly. It can be hypothesized from this study that interventions that want to influence dual task costs of gait should especially focus on divided attention. 073 A WEARABLE SYSTEM FOR MONITORING GESTURE, POSTURE AND PHYSIOLOGICAL CORRELATES OF EMOTION U. Debarnot, F. Lorussi, E.P. Scilingo, A. Tognetti, D. De Rossi. Interdepartmental Research Center ‘E. Piaggio’, University of Pisa, Pisa, Italy Studies on behaviour and emotive emergence by coupling humancentred perception with interacting human physiological and behavioural signals are still in their infancy. Indeed, major difficulties emerge in the acquisition of measurements relative to both peripheral vegetative activity and movement acquired through an ambulant, long-term human acquisition monitoring. For this purpose, we developed an unobtrusive Personal Biomonitoring System (PBS) based on sensing textile platforms connected to portable acquiring devices. In practice, the PBS recording includes the transduction of heart rate, surface electromiographic signals, electrodermal response, respiratory values as well as postural and gestural kinetic data via integrated wearable sensors embedded in garments. In comparison with traditional non-wearable systems, the PBS performed robust and efficient data acquisition in poststroke and cardiovascular rehabilitation patient treatment. This methodological progress reinforces and provides strong theoretical and practical applications in the neuropsychological rehabilitation field. More specifically, the psycho-physiological responses obtained by extracting features from a subset of physiological and behavioural signals is under development for the status evaluation of patients affected by mood disorders such as bi-polar and stress disorders. Our ultimate goal is to use the Personal Biomonitoring System for managing mental illnesses by monitoring and predicting critical events through the detection of movement, gesture and vegetative efferences that elicit peripheral response accompanying behaviour. 074 EARLY EVALUATION OF THE CONNECTIONS BETWEEN AUTISM AND ALTERATIONS OF MOVEMENT E. Nardini, G. Valenza, C. Mancuso, A. Armato, A. Lanata, ` E.P. Scilingo, D. De Rossi. Interdipartmental Research Center ‘E.Piaggio’, University of Pisa, Pisa, Italy Background and aim: Several anomalies in autistic children appearing as clear and permanent movement alterations such as deficiency in coordination, head bending, tiptoe walking, hand gesture and body rocking under the legs, or of the upper body, accompanied by frequent falls. The aim of this work will be to monitor the movement alterations jointly to vital signs in order to investigate the connections between movement disturbances and autism. In particular, this paper would monitor body posture, head bending, hand gesture and vital signs from groups of normal and autistic children in a controlled environment, for making diagnosis and monitoring trend of the therapy. Methods: Two groups should be recruited: autism affected children (AC) and controls (C), both of them will be monitored by a sensorized system for movements and physiologic investigation jointly to a camera. The system could be constituted of a shirt for posture and vital signs, gloves for hand gesture, “baseball-like” hat for head movement, and shoes for the foot pressure. A Walking Observation Scale could be used to analyze the gait through three axes: foot’s movements; arms movements; global movements. Results and Conclusion: This comparison aims at investigating possible connections between the autism pathology and the movement disturbances in the patients. Results will be addressed to determine possible indicators of patient state and/or therapy
trend. Future works aim to extract robust features for monitoring variations of the patient state and to make the system user friendly in order to minimize problems of patient acceptance. 075 MODULATION OF THE RELEASE OF ANTICIPATORY POSTURAL ADJUSTMENTS (APAS) DURING STEP INITIATION: WHAT IS THE ROLE OF ATTENTION? A. Delval, S. Willart, J.-L. Bourriez, C. Tard, J. Bouchez, A. Destee, ´ P. Derambure, K. Dujardin, L. Defebvre. CHRU Lille, Lille, France Background and Aims: Step initiation is accompanied by APAs. Presentation of an acoustic stimulus evoking a startle response (subcortical mechanism) before the imperative “Go” stimulus results in the release of early APAs (Mac Kinnon, 2008). We addressed which other mechanisms facilitate the release of APAs. How an auditory stimulus that modulated attention (oddball paradigm) could modify the release of the APAs and what were the consequences for both preparation and execution of the step? Methods: 15 subjects received an auditory tone burst of 115 dB, 80 dB and 40 dB before or at the time of an imperative visual “Go” signal. Tibialis anterior activation and COP trajectories were studied. In a second part, an auditory oddball paradigm was used to direct attention of the subject 1.4 s before the Go signal. In addition to previous measurements, cortical P3 response was studied. Results: Auditory stimulus at 80 and 120 dB could evoke early release of small APAs (Pre APAs) not followed by step execution only when the task was known in advance (Figure). The classic ‘APAs-step execution’ sequence was perturbed when this auditory stimulus occurred at around 100 ms of the imperative go signal (resulting in some cases in multiple APAs). Pre APAs were more frequently evoked when the auditory stimulus was rare and provoked an attentional cortical process (identified by a P3 wave). Conclusions: The APAs are stored and could be triggered in different ways. Subcortical and cortical processes provoked the release of the APAs and attention could modify it. 076 TRAIL MAKING TEST ENHANCES DISCRIMINATION WITH THE DYNAMIC GAIT INDEX TO DISTINGUISH ELDERLY FALLERS AND NON-FALLERS WITHOUT KNOWN COGNITIVE DECLINE J. Dewane1 , J. Mahoney2 , S. Bobula1 , T. Nelson1 , B. Heiderscheit1 . 1 Orthopedics and Rehabilitation Medicine, 2 Geriatric Medicine, UW Madison School of Medicine and Public Health, Madison, WI, USA Background and Aims: Cognitive impairment and gait instability are associated in people with significant cognitive deficits, such as Alzheimer’s disease or dementia, thereby increasing falls risk. However, it is unknown whether sub-clinical changes in executive function can have a similar effect. The purpose of this investigation was to determine if a measure of executive function when used in combination with postural control during gait could better discriminate falls history in older adults with no known cognitive decline (MMSE > 24). Methods: Cross sectional design. Subjects: Community dwelling older adults aged 65 to 85 yrs (n = 100). Measures: Each subject performed the Dynamic Gait Index (DGI) and Trail Making Test B (TMT-B), with cut scores to differentiate fallers from non-fallers determined by cross validation (DGI = 19.5; TMT-B = 74 s). The additive effect of TMT-B to DGI to discriminate falls history was assessed by the odds ratio and fitted logistic regression. Results: Fallers scored significantly worse on both the DGI and TMT-B than non-fallers. Subjects with a DGI <19.5 (OR = 5.4) or TMT-B >74 s (OR = 4.1) had a greater risk of a falls history. However, subjects meeting both criteria had a substantially greater risk (OR = 17.8). Conclusions: While the DGI was a strong independent measure to differentiate fallers from non-fallers, the DGI combined with TMT-B