Mov Disord: High-tech wearable device to help diagnose ataxia

The development of treatments for spinocerebellar ataxia (SCAs) has been hampered by our inability to accurately and reproducibly measure the severity and progress of ataxia
.

We need to accurately and reliably quantify the early subtle nervous system signs and disease severity in order to conduct adequate clinical research on candidate therapies

As the first step in the development of quantifiable and objective measures of ataxia, the researchers quantified the gait abnormalities of SCA patients.

These measures are sensitive to changes, useful for both the prodromal and manifestation phases, and are very useful.

In fact, stride variability may be the most basic feature of the cerebellar gait, because of the importance of the cerebellum in the following aspects
.

(1) Balance control; (2) Multi-joint coordination; (3) Eye movement dysfunction; and because of compensatory posture and gait strategies for restoring balance while walking

Wearable inertial sensors have been increasingly used to automatically quantify gait in a clinical environment suitable for clinical trials
.

Recent studies have used wearable sensors to quantify ataxia gait,

Wearable inertial sensors have been increasingly used to automatically quantify gait in a clinical environment suitable for clinical trials

For example, as reported in a recent review, previous studies did not include trunk, upper limbs, feet, or turning characteristics, and were limited to a maximum of 51 SCA subjects, mainly SCA6 and SCA31 subtypes
.

Therefore, it is necessary to expand the scope of mobility measures and determine the most sensitive and objective mobility measures obtained from wearable sensors in order to distinguish the gait characteristics of SCA patients from healthy people in a large cohort

In this way, Oregon Health & Science University of Vrutangkumar V.

et al.

Unlike previous studies, they used six synchronized wearable sensors, including sensors that provide foot space orientation, and the tests were incorporated into normal clinical visits
.

It is also assumed that space-time gait variability will provide the most sensitive and specific measurement of gait ataxia for the four different types of SCA (1, 2, 3, and 6) and the precursor SCA, and it is reliable and clinically consistent.

163 SCA patients (subtypes 1, 2, 3, and 6), 42 prodromal SCA patients, and 96 HC wore 6 inertial sensors during natural gait and 2 minutes of walking
.

The area under the receiver operating characteristic curve (AUC) of 25 gait measurements was compared, including the standard deviation as the variability, to distinguish between ataxia and normal gait
.
The Pearson correlation coefficient assesses the relationship between gait measurement and the severity of ataxia
.

Increased gait variability is the most discriminative gait feature of SCA; external toe angle variability (AUC=0.
936; sensitivity=0.
871; specificity=0.
896) and double support time variability (AUC=0.
932; sensitivity=0.
834 ; Specificity=0.
865) is the most sensitive and specific measure
.

Increased gait variability is the most discriminating gait feature of SCA;

These variability measures are also significantly related to the Ataxia Assessment and Rating Scale (SARA) and disease duration
.
The same gait measurement method can distinguish the gait of patients with prodromal SCA and that of HC (AUC=0.
610, and 0.
670)
.

The important significance of this research lies in the discovery: wearable inertial sensors provide sensitive and specific measurements of the excessive gait variability of patients with obvious and proactive SCA.
These measurements are reliable and are related to the severity of the disease.
This suggests that they may be useful clinical trial performance outcome measures
.

The wearable inertial sensor provides a sensitive and specific measurement of the excessive gait variability of patients with obvious and proactive SCA,

Original source:
Shah VV, Rodriguez-Labrada R, Horak FB, et al.
Gait Variability in Spinocerebellar Ataxia Assessed Using Wearable Inertial Sensors.
Mov Disord.
Published online August 23, 2021:mds.
28740.
doi:10.
1002/mds.
28740

Gait Variability in Spinocerebellar Ataxia Assessed Using Wearable Inertial Sensors.
Mov Disord.
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