Gait disturbance in patients with Parkinson’s disease

Strmčnik, Ana (author), Georgiev, Dejan (mentor), Groznik, Vida (comentor)

Parkinson's disease is a chronic, neurodegenerative condition that manifests with symptoms such as slow movement, tremor, muscle stiffness, and coordination difficulties. The disease originates from the degeneration of dopaminergic neurons in the substantia nigra pars compacta, and its exact cause remains unknown. Treatment aims to alleviate symptoms and improve the quality of life for patients through medication, therapy, and, in some cases, surgical intervention. Deep Brain Stimulation (DBS) is a surgical procedure used to treat advanced-stage Parkinson's disease. During the operation, small electrodes are implanted into the brain, delivering electrical impulses to specific brain regions. This procedure helps to alleviate certain motor and non-motor symptoms of Parkinson's disease. However, it can also deteriorate others, such as gait and axial symptoms. The aim of this thesis was to confirm or refute the following hypothesis: Patients who have undergone the DBS operation experience a greater deterioration in axial symptoms, including gait and postural instability, compared to patients who have not received the DBS operation. Using data from the PPMI database, patients were divided into experimental and control groups based on predefined criteria. We primarily employed the standardized MDS-UPDRS scale to assess the condition of Parkinson's disease patients. Subsequently, we compared patients within the same group at various time points and conducted comparisons between the groups. We have determined that there is a statistically significant difference in gait deterioration between patients who underwent the DBS operation and those who did not. However, when it comes to axial or postural stability deterioration, we did not observe the same level of significance. Our machine learning models, trained on the available data, achieved an AUC score accuracy of 0.76 and an F1 score accuracy of 0.65 when predicting which patients from the experimental group would experience gait deterioration.

• Language: English
• Keywords: Parkinson's disease, DBS, axial symptoms, postural stability, gait
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: FRI - Faculty of Computer and Information Science
• Year: 2023
• PID: 20.500.12556/RUL-152729
• COBISS.SI-ID: 168065027
• Publication date in RUL: 04.12.2023

Secondary language

• Language: Slovenian
• Title: Motnja hoje pri pacientih s Parkinsonovo boleznijo

Abstract

Parkinsonova bolezen je kronična, napredujoča, nevrodegenerativna bolezen, ki povzroča simptome, kot so počasnost gibanja, tremor, mišična togost in težave s koordinacijo. Bolezen je posledica propadanja dopaminskih nevronov v črni substanci v možganih, vzroka bolezni ne poznamo. Zdravljenje je usmerjeno v lajšanje simptomov in izboljšanje kakovosti življenja bolnikov s pomočjo zdravil, terapije in v nekaterih primerih kirurškega posega. Globoka možganska stimulacija (DBS) je kirurški postopek, ki se uporablja pri zdravljenju pacientov z napredovalo Parkinsonove bolezni. Med operacijo se v možgane vstavita elektrodi, ki oddajata električne impulze v določene možganske regije. Postopek izboljša številne motorične in nemotorične simptome bolezni, vendar lahko povzroči poslabšanje nekaterih, kot so naprimer hoja in aksialni simptomi. Cilj te diplomske naloge je bil potrditi ali ovreči sledečo hipotezo: Pacientom, ki so prejeli operacijo globoke možganske stimulacije, se aksialni simptomi (hoja in posturalna stabilnost) poslabšajo bolj kot pacientom, ki DBS operacije niso prejeli. Paciente iz PPMI podatkovne baze smo razdelili v eksperimentalne in kontrolne skupine glede na vnaprej definirane kriterije. Večinoma smo se posluževali standardizirane lestvice MDS-UPDRS za oceno stanja bolnikov s Parkinsonovo boleznijo. Nato smo med seboj primerjali paciente znotraj skupine v različnih časovnih točkah ter opravili medsebojno primerjavo skupin. Ugotovili smo, da obstaja statistično signifikantna razlika v poslabšanju hoje med pacienti, ki so prestali DBS operacijo, in tistimi, ki je niso. Nismo pa opazili enake ravni statistične signifikantnosti pri poslabšanju aksialnih simptomov ali posturalne stabilnosti. Naši modeli strojnega učenja, ki so bili naučeni na razpoložljivih podatkih, so dosegli AUC natančnost 0,76 in F1 natančnost 0,65 pri napovedovanju poslabšanja hoje pacientov iz eksperimentalne skupine.

• Keywords: Parkinsonova bolezen, DBS, aksialni simptomi, posturalna stabilnost, hoja