Perioperative accelerometry for bradykinesia and tremor
Perioperative accelerometry for bradykinesia and tremor
Bradykinesia (slowness) and tremor (shaking) are common movement symptoms of Parkinson's disease (PD). In Essential Tremor (ET), tremor is the primary symptom. Physicians often use clinical rating scales to measure bradykinesia and tremor. However, the results of rating scales are not always reliable, depending on the varying experience of healthcare providers and the precise timing of the measurements.
While rating scales provide relevant information, their use requires expertise in PD and ET. PD and ET are currently incurable. Treatments are aimed at reducing symptoms such as bradykinesia and tremor. An advanced treatment option is surgery in the area of the brain involved in these abnormal movements. Brain surgery must be performed very precisely to achieve optimal effect on the movement symptoms without lasting side effects. Since the outcome of the surgery depends partly on the clinical assessments before and during the surgery, it is essential that the movement symptoms are measured accurately and consistently. This is key to achieve maximum suppression of movement symptoms without side effects. Objective measurements with motion sensors can contribute to this, like accelerometry. Accelerometers are small sensors that measure linear acceleration in three directions, suitable for detecting tremor and bradykinesia.
This dissertation of Annemarie Smid focuses on the application of accelerometry before, during, and after brain surgery, to objectively measure bradykinesia and tremor of the hands in PD and ET. For the first time, clinical measurements were literally translated into accelerometric methods to objectively measure bradykinesia and tremor during brain surgery, independent of the expertise of healthcare providers.