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Continuous monitoring of PD with an affordable novel computerised motor test based on a tablet
Abstracts / Parkinsonism and Related Disorders 22 (2016) e29ee75
intervention dropped from a mean, X¼ 63.1 (±18.2) to a mean, X¼43.4 (±15.7) after one week of treatment, whereas one year later it was reduced to X¼7.2 (± 4.2). The scores of each domain of OHRQoL after one year of FPD insertion were almost the same as with the comparison group. Conclusion: The results of our study indicated a very good satisfactory impact on Oral health related quality of life of FPD wearers. P 1.130. CONTINUOUS MONITORING OF PD WITH AN AFFORDABLE NOVEL COMPUTERISED MOTOR TEST BASED ON A TABLET Mauro Da Lio 1, Mariolino De Cecco 1, Paolo Bosetti 1, Mariachiara degli Studi di Trento, Dept. Industrial Engineering, Malaguti 2. 1 Universita Italy; 2 Azienda Provinciale per i Servizi Sanitari - Trento, Neurology Department, Italy Objectives: This work presents a novel computerized motor task, implemented on an affordable tablet (under development in a UE project). The task consists of tracking a target moving with random steps on the touch screen of a tablet. The aim is to provide a tool for continuous monitoring of motor abilities in PD. Methods: Two PD subjects and two controls have been monitored for approximately 6 months, carrying out the motor test daily. The recorded time-histories of the task have been processed in multiple ways to extract several metrics (among which reaction time, movement time, motor control delays, correction patterns etc.). Results: The evolution of selected metrics, among which reaction time (mean and SD), movement time (mean and SD), peak movement speed, etc., will be presented as function of the time in the test period for both PD and controls; highlighting the potential applications of this technology and showing features that cannot be appreciated with discontinuous observation (months apart). Conclusions: The novel computerized test easily allows monitoring PD with continuous and frequent observations in home environments. The EU project within which the tool is being developed has tentative plans to release the tool for open use and access. P 1.131. N30 SOMATOSENSORY EVOKED POTENTIAL IS NEGATIVELY CORRELATED WITH MOTOR FUNCTION IN PARKINSON'S DISEASE Suk Yun Kang 1, Hyeo-Il Ma 2, Hong-Ki Song 3, Young Ho Sohn 4. 1 Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea; 2 Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, College of Medicine, Anyang, Republic of Korea; 3 Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Republic of Korea; 4 Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea Objectives: The aim of this study is to investigate frontal N30 status in Parkinson's disease (PD), and to examine the correlation between amplitude of frontal N30 and severity of motor deficits. Methods: Frontal N30 was compared between 17 PD patients and 18 healthy volunteers. Correlation between amplitude of frontal N30 and Unified Parkinson's Disease Rating Scale (UPDRS) motor score of the moreseverely affected side was examined. Results: The mean latency of N30 between patients and healthy volunteers was not significantly different (p ¼ 0.981), but the mean amplitude was lower in PD patients (p < 0.025). There was a significantly negative correlation between the amplitude and UPDRS motor score (r ¼ -0.715, p ¼ 0.013). Conclusions: Frontal N30 status indicates the motor severity of PD which may be suitable for monitoring clinical severity and treatment response. It is a useful biomarker reflecting dopaminergic deficits, and an objective measurement for monitoring clinical severity of PD. References: 1. Cebolla AM, Palmero-Soler E, Dan B, Cheron G. Modulation of the N30 generators of the somatosensory evoked potentials by the mirror neuron system. Neuroimage. 2014;95:48-60. 2. Drory VE, Inzelberg R, Groozman GB, Korczyn AD. N30 somatosensory
e63
evoked potentials in patients with unilateral Parkinson's disease. Acta Neurol Scand. 1998;97:73-76. 3. Garcia PA, Aminoff MJ, Goodin DS. The frontal N30 component of the median-derived SEP in patients with predominantly unilateral Parkinson's disease. Neurology. 1995;45:989-992. 4. Rossini PM, Babiloni F, Bernardi G, et al., Abnormalities of short-latency somatosensory evoked potentials in parkinsonian patients. Electroencephalogr Clin Neurophysiol. 1989;74:277-289. 5. Rossini PM, Traversa R, Boccasena P, et al., Parkinson's disease and somatosensory evoked potentials: apomorphine-induced transient potentiation of frontal components. Neurology. 1993;43:2495-2500. P 1.132. RECONSIDERING DIAGNOSIS AND PREVALENCE OF NEUROPATHY IN PD Alfonso Rubino 1, Maria Elena Di Battista 1, Marcella Valente 2, Luca De Lipsis 3, Gabriele O.R. Valente 4, Giuseppe Meco 1. 1 Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza University, Rome, Italy; 2 Research Centre of Social Diseases (CIMS), Sapienza University, Rome, Italy; 3 Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy; 4 Department of Neurology and Psychiatry, Sapienza University, Rome, Italy Objectives: Peripheral neuropathies are thought to be prevalent among patients with Parkinson disease (PD). However, some important questions remain open, mainly due to some methodological limitations. Aim of study is to assess the prevalence of distal symmetric polyneuropathy (DSP) in PD patients on chronic levodopa exposure on basis of neurophysiological criteria. Methods: We consecutively enrolled 54 patients with diagnosis of PD. Patients with history of other illnesses that potentially present an involvement of peripheral nervous system (PNS) were excluded. Moreover, laboratory screening tests for neuropathy were performed. We determined serum vitamin B12, folate and homocysteine levels for all patients involved in the study. An extensive nerve conduction studies were performed in all patients using standard laboratory techniques. As control group for neurophysiological findings we evaluated 63 age and gender matched healthy subject. Results: Although we observed a relative depression of sensorial potential amplitude, applying stringent neurophysiological criteria for chronic axonal neuropathy only four PD patients fulfilled the diagnosis of DSP. Conclusions: In our study emerges a much lower prevalence of DSP in PD patients than previously reported. These findings rise the question of reliability of clinical criteria for neuropathy in PD. Indeed, the malady is characterized per se by an altered codifying of sensorial stimuli, that could lead to an overestimation of symptoms mistakenly attributed to a PNS dysfunction. Therefore, it should be defined the significance of PNS clinical signs and subtle depression of nerve action potentials, and discerned from that observed in a frank neuropathy. P 1.133. METHYLMALONIC ACID IS AN IMPORTANT FACTOR THAT CAUSE PERIPHERAL NEUROPATHY IN IDIOPATHIC PARKINSON'S DISEASE Jin-Sung Park, Pan-Woo Go, Kyunghun Kang, Ho-Won Lee. Department of Neurology, Kyungpook National University School of Medicine, Daegu, Republic of Korea Objectives: Peripheral neuropathy has recently described in significantly higher proportions in patients with IPD than in normal controls. The aim of our study was to find the most important surrogate marker that plays an important role in causing peripheral neuropathy in IPD. Methods: We enrolled 47 IPD patients. The peripheral neuropathy was determined by the clinical symptom, neurological examination and/or nerve conduction study. We checked neuropathic scales such as total neuropathy scale (TNS) and Korean Neuropathy Questionnaire (KNQ), and also determined the correlation between age, IPD duration, levodopa equivalent dose (LED), UPDRS III, vitamin B12, methylmalonic acid(MMA) and homocysteine levels. Results: Seventeen of 47 IPD patients were diagnosed with peripheral neuropathy. There was no statistical difference in the sex, LED, UPDRS III, vitamin B12, MMA and homocysteine in the IPD patients with neuropathy.
intervention dropped from a mean, X¼ 63.1 (±18.2) to a mean, X¼43.4 (±15.7) after one week of treatment, whereas one year later it was reduced to X¼7.2 (± 4.2). The scores of each domain of OHRQoL after one year of FPD insertion were almost the same as with the comparison group. Conclusion: The results of our study indicated a very good satisfactory impact on Oral health related quality of life of FPD wearers. P 1.130. CONTINUOUS MONITORING OF PD WITH AN AFFORDABLE NOVEL COMPUTERISED MOTOR TEST BASED ON A TABLET Mauro Da Lio 1, Mariolino De Cecco 1, Paolo Bosetti 1, Mariachiara degli Studi di Trento, Dept. Industrial Engineering, Malaguti 2. 1 Universita Italy; 2 Azienda Provinciale per i Servizi Sanitari - Trento, Neurology Department, Italy Objectives: This work presents a novel computerized motor task, implemented on an affordable tablet (under development in a UE project). The task consists of tracking a target moving with random steps on the touch screen of a tablet. The aim is to provide a tool for continuous monitoring of motor abilities in PD. Methods: Two PD subjects and two controls have been monitored for approximately 6 months, carrying out the motor test daily. The recorded time-histories of the task have been processed in multiple ways to extract several metrics (among which reaction time, movement time, motor control delays, correction patterns etc.). Results: The evolution of selected metrics, among which reaction time (mean and SD), movement time (mean and SD), peak movement speed, etc., will be presented as function of the time in the test period for both PD and controls; highlighting the potential applications of this technology and showing features that cannot be appreciated with discontinuous observation (months apart). Conclusions: The novel computerized test easily allows monitoring PD with continuous and frequent observations in home environments. The EU project within which the tool is being developed has tentative plans to release the tool for open use and access. P 1.131. N30 SOMATOSENSORY EVOKED POTENTIAL IS NEGATIVELY CORRELATED WITH MOTOR FUNCTION IN PARKINSON'S DISEASE Suk Yun Kang 1, Hyeo-Il Ma 2, Hong-Ki Song 3, Young Ho Sohn 4. 1 Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea; 2 Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, College of Medicine, Anyang, Republic of Korea; 3 Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Republic of Korea; 4 Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea Objectives: The aim of this study is to investigate frontal N30 status in Parkinson's disease (PD), and to examine the correlation between amplitude of frontal N30 and severity of motor deficits. Methods: Frontal N30 was compared between 17 PD patients and 18 healthy volunteers. Correlation between amplitude of frontal N30 and Unified Parkinson's Disease Rating Scale (UPDRS) motor score of the moreseverely affected side was examined. Results: The mean latency of N30 between patients and healthy volunteers was not significantly different (p ¼ 0.981), but the mean amplitude was lower in PD patients (p < 0.025). There was a significantly negative correlation between the amplitude and UPDRS motor score (r ¼ -0.715, p ¼ 0.013). Conclusions: Frontal N30 status indicates the motor severity of PD which may be suitable for monitoring clinical severity and treatment response. It is a useful biomarker reflecting dopaminergic deficits, and an objective measurement for monitoring clinical severity of PD. References: 1. Cebolla AM, Palmero-Soler E, Dan B, Cheron G. Modulation of the N30 generators of the somatosensory evoked potentials by the mirror neuron system. Neuroimage. 2014;95:48-60. 2. Drory VE, Inzelberg R, Groozman GB, Korczyn AD. N30 somatosensory
e63
evoked potentials in patients with unilateral Parkinson's disease. Acta Neurol Scand. 1998;97:73-76. 3. Garcia PA, Aminoff MJ, Goodin DS. The frontal N30 component of the median-derived SEP in patients with predominantly unilateral Parkinson's disease. Neurology. 1995;45:989-992. 4. Rossini PM, Babiloni F, Bernardi G, et al., Abnormalities of short-latency somatosensory evoked potentials in parkinsonian patients. Electroencephalogr Clin Neurophysiol. 1989;74:277-289. 5. Rossini PM, Traversa R, Boccasena P, et al., Parkinson's disease and somatosensory evoked potentials: apomorphine-induced transient potentiation of frontal components. Neurology. 1993;43:2495-2500. P 1.132. RECONSIDERING DIAGNOSIS AND PREVALENCE OF NEUROPATHY IN PD Alfonso Rubino 1, Maria Elena Di Battista 1, Marcella Valente 2, Luca De Lipsis 3, Gabriele O.R. Valente 4, Giuseppe Meco 1. 1 Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza University, Rome, Italy; 2 Research Centre of Social Diseases (CIMS), Sapienza University, Rome, Italy; 3 Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy; 4 Department of Neurology and Psychiatry, Sapienza University, Rome, Italy Objectives: Peripheral neuropathies are thought to be prevalent among patients with Parkinson disease (PD). However, some important questions remain open, mainly due to some methodological limitations. Aim of study is to assess the prevalence of distal symmetric polyneuropathy (DSP) in PD patients on chronic levodopa exposure on basis of neurophysiological criteria. Methods: We consecutively enrolled 54 patients with diagnosis of PD. Patients with history of other illnesses that potentially present an involvement of peripheral nervous system (PNS) were excluded. Moreover, laboratory screening tests for neuropathy were performed. We determined serum vitamin B12, folate and homocysteine levels for all patients involved in the study. An extensive nerve conduction studies were performed in all patients using standard laboratory techniques. As control group for neurophysiological findings we evaluated 63 age and gender matched healthy subject. Results: Although we observed a relative depression of sensorial potential amplitude, applying stringent neurophysiological criteria for chronic axonal neuropathy only four PD patients fulfilled the diagnosis of DSP. Conclusions: In our study emerges a much lower prevalence of DSP in PD patients than previously reported. These findings rise the question of reliability of clinical criteria for neuropathy in PD. Indeed, the malady is characterized per se by an altered codifying of sensorial stimuli, that could lead to an overestimation of symptoms mistakenly attributed to a PNS dysfunction. Therefore, it should be defined the significance of PNS clinical signs and subtle depression of nerve action potentials, and discerned from that observed in a frank neuropathy. P 1.133. METHYLMALONIC ACID IS AN IMPORTANT FACTOR THAT CAUSE PERIPHERAL NEUROPATHY IN IDIOPATHIC PARKINSON'S DISEASE Jin-Sung Park, Pan-Woo Go, Kyunghun Kang, Ho-Won Lee. Department of Neurology, Kyungpook National University School of Medicine, Daegu, Republic of Korea Objectives: Peripheral neuropathy has recently described in significantly higher proportions in patients with IPD than in normal controls. The aim of our study was to find the most important surrogate marker that plays an important role in causing peripheral neuropathy in IPD. Methods: We enrolled 47 IPD patients. The peripheral neuropathy was determined by the clinical symptom, neurological examination and/or nerve conduction study. We checked neuropathic scales such as total neuropathy scale (TNS) and Korean Neuropathy Questionnaire (KNQ), and also determined the correlation between age, IPD duration, levodopa equivalent dose (LED), UPDRS III, vitamin B12, methylmalonic acid(MMA) and homocysteine levels. Results: Seventeen of 47 IPD patients were diagnosed with peripheral neuropathy. There was no statistical difference in the sex, LED, UPDRS III, vitamin B12, MMA and homocysteine in the IPD patients with neuropathy.