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1.
Neuroimage ; 288: 120531, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38331333

RESUMO

Gait is an excellent indicator of physical, emotional, and mental health. Previous studies have shown that gait impairments in ageing are common, but the neural basis of these impairments are unclear. Existing methodologies are suboptimal and novel paradigms capable of capturing neural activation related to real walking are needed. In this study, we used a hybrid PET/MR system and measured glucose metabolism related to both walking and standing with a dual-injection paradigm in a single study session. For this study, 15 healthy older adults (10 females, age range: 60.5-70.7 years) with normal cognition were recruited from the community. Each participant received an intravenous injection of [18F]-2-fluoro-2-deoxyglucose (FDG) before engaging in two distinct tasks, a static postural control task (standing) and a walking task. After each task, participants were imaged. To discern independent neural functions related to walking compared to standing, we applied a bespoke dose correction to remove the residual 18F signal of the first scan (PETSTAND) from the second scan (PETWALK) and proportional scaling to the global mean, cerebellum, or white matter (WM). Whole-brain differences in walking-elicited neural activity measured with FDG-PET were assessed using a one-sample t-test. In this study, we show that a dual-injection paradigm in healthy older adults is feasible with biologically valid findings. Our results with a dose correction and scaling to the global mean showed that walking, compared to standing, increased glucose consumption in the cuneus (Z = 7.03), the temporal gyrus (Z = 6.91) and the orbital frontal cortex (Z = 6.71). Subcortically, we observed increased glucose metabolism in the supraspinal locomotor network including the thalamus (Z = 6.55), cerebellar vermis and the brainstem (pedunculopontine/mesencephalic locomotor region). Exploratory analyses using proportional scaling to the cerebellum and WM returned similar findings. Here, we have established the feasibility and tolerability of a novel method capable of capturing neural activations related to actual walking and extended previous knowledge including the recruitment of brain regions involved in sensory processing. Our paradigm could be used to explore pathological alterations in various gait disorders.


Assuntos
Fluordesoxiglucose F18 , Neuroanatomia , Feminino , Humanos , Idoso , Pessoa de Meia-Idade , Marcha/fisiologia , Caminhada/fisiologia , Tomografia por Emissão de Pósitrons/métodos , Glucose/metabolismo
2.
Org Biomol Chem ; 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39007293

RESUMO

Bicyclic peptides are a powerful modality for engaging challenging drug targets such as protein-protein interactions. Here, we use 1,2,3-tris(bromomethyl)benzene (1,2,3-TBMB) to access bicyclic peptides with diverse conformations that differ from conventional bicyclisation products formed with 1,3,5-TBMB. Bicyclisation at cysteine residues under aqueous buffer conditions proceeds efficiently, with broad substrate scope, compatibility with high-throughput screening, and clean conversion (>90%) for 96 of the 115 peptides tested. We envisage that the 1,2,3-TBMB linker will be applicable to a variety of peptide screening techniques in drug discovery.

3.
Brain ; 146(3): 1053-1064, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35485491

RESUMO

Free-water imaging can predict and monitor dopamine system degeneration in people with Parkinson's disease. It can also enhance the sensitivity of traditional diffusion tensor imaging (DTI) metrics for indexing neurodegeneration. However, these tools are yet to be applied to investigate cholinergic system degeneration in Parkinson's disease, which involves both the pedunculopontine nucleus and cholinergic basal forebrain. Free-water imaging, free-water-corrected DTI and volumetry were used to extract structural metrics from the cholinergic basal forebrain and pedunculopontine nucleus in 99 people with Parkinson's disease and 46 age-matched controls. Cognitive ability was tracked over 4.5 years. Pearson's partial correlations revealed that free-water-corrected DTI metrics in the pedunculopontine nucleus were associated with performance on cognitive tasks that required participants to make rapid choices (behavioural flexibility). Volumetric, free-water content and DTI metrics in the cholinergic basal forebrain were elevated in a sub-group of people with Parkinson's disease with evidence of cognitive impairment, and linear mixed modelling revealed that these metrics were differently associated with current and future changes to cognition. Free water and free-water-corrected DTI can index cholinergic degeneration that could enable stratification of patients in clinical trials of cholinergic interventions for cognitive decline. In addition, degeneration of the pedunculopontine nucleus impairs behavioural flexibility in Parkinson's disease, which may explain this region's role in increased risk of falls.


Assuntos
Prosencéfalo Basal , Doença de Parkinson , Núcleo Tegmental Pedunculopontino , Humanos , Doença de Parkinson/complicações , Imagem de Tensor de Difusão , Prosencéfalo Basal/diagnóstico por imagem , Colinérgicos , Água , Neurônios Colinérgicos
4.
Blood ; 138(23): 2313-2326, 2021 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-34110416

RESUMO

CRLF2-rearranged (CRLF2r) acute lymphoblastic leukemia (ALL) accounts for more than half of Philadelphia chromosome-like (Ph-like) ALL and is associated with a poor outcome in children and adults. Overexpression of CRLF2 results in activation of Janus kinase (JAK)-STAT and parallel signaling pathways in experimental models, but existing small molecule inhibitors of JAKs show variable and limited efficacy. Here, we evaluated the efficacy of proteolysis-targeting chimeras (PROTACs) directed against JAKs. Solving the structure of type I JAK inhibitors ruxolitinib and baricitinib bound to the JAK2 tyrosine kinase domain enabled the rational design and optimization of a series of cereblon (CRBN)-directed JAK PROTACs utilizing derivatives of JAK inhibitors, linkers, and CRBN-specific molecular glues. The resulting JAK PROTACs were evaluated for target degradation, and activity was tested in a panel of leukemia/lymphoma cell lines and xenograft models of kinase-driven ALL. Multiple PROTACs were developed that degraded JAKs and potently killed CRLF2r cell lines, the most active of which also degraded the known CRBN neosubstrate GSPT1 and suppressed proliferation of CRLF2r ALL in vivo, e.g. compound 7 (SJ988497). Although dual JAK/GSPT1-degrading PROTACs were the most potent, the development and evaluation of multiple PROTACs in an extended panel of xenografts identified a potent JAK2-degrading, GSPT1-sparing PROTAC that demonstrated efficacy in the majority of kinase-driven xenografts that were otherwise unresponsive to type I JAK inhibitors, e.g. compound 8 (SJ1008030). Together, these data show the potential of JAK-directed protein degradation as a therapeutic approach in JAK-STAT-driven ALL and highlight the interplay of JAK and GSPT1 degradation activity in this context.


Assuntos
Janus Quinases/antagonistas & inibidores , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Inibidores de Proteínas Quinases/farmacologia , Proteólise/efeitos dos fármacos , Receptores de Citocinas/genética , Animais , Linhagem Celular Tumoral , Descoberta de Drogas , Feminino , Regulação Leucêmica da Expressão Gênica/efeitos dos fármacos , Humanos , Janus Quinases/metabolismo , Camundongos Endogâmicos NOD , Modelos Moleculares , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Inibidores de Proteínas Quinases/química , Inibidores de Proteínas Quinases/uso terapêutico
5.
Cerebellum ; 2023 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-37955812

RESUMO

With disease-modifying drugs on the horizon for degenerative ataxias, ecologically valid, finely granulated, digital health measures are highly warranted to augment clinical and patient-reported outcome measures. Gait and balance disturbances most often present as the first signs of degenerative cerebellar ataxia and are the most reported disabling features in disease progression. Thus, digital gait and balance measures constitute promising and relevant performance outcomes for clinical trials.This narrative review with embedded consensus will describe evidence for the sensitivity of digital gait and balance measures for evaluating ataxia severity and progression, propose a consensus protocol for establishing gait and balance metrics in natural history studies and clinical trials, and discuss relevant issues for their use as performance outcomes.

6.
BMC Neurol ; 23(1): 58, 2023 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-36737716

RESUMO

BACKGROUND: Parkinson's disease (PD) is the fastest growing neurological condition worldwide. Recent theories suggest that symptoms of PD may arise due to spread of Lewy-body pathology where the process begins in the gut and propagate transynaptically via the vagus nerve to the central nervous system. In PD, gait impairments are common motor manifestations that are progressive and can appear early in the disease course. As therapies to mitigate gait impairments are limited, novel interventions targeting these and their consequences, i.e., reducing the risk of falls, are urgently needed. Non-invasive vagus nerve stimulation (nVNS) is a neuromodulation technique targeting the vagus nerve. We recently showed in a small pilot trial that a single dose of nVNS improved (decreased) discrete gait variability characteristics in those receiving active stimulation relative to those receiving sham stimulation. Further multi-dose, multi-session studies are needed to assess the safety and tolerability of the stimulation and if improvement in gait is sustained over time. DESIGN: This will be an investigator-initiated, single-site, proof-of-concept, double-blind sham-controlled randomised pilot trial in 40 people with PD. Participants will be randomly assigned on a 1:1 ratio to receive either active or sham transcutaneous cervical VNS. All participants will undergo comprehensive cognitive, autonomic and gait assessments during three sessions over 24 weeks, in addition to remote monitoring of ambulatory activity and falls, and exploratory analyses of cholinergic peripheral plasma markers. The primary outcome measure is the safety and tolerability of multi-dose nVNS in PD. Secondary outcomes include improvements in gait, cognition and autonomic function that will be summarised using descriptive statistics. DISCUSSION: This study will report on the proportion of eligible and enrolled patients, rates of eligibility and reasons for ineligibility. Adverse events will be recorded informing on the safety and device tolerability in PD. This study will additionally provide us with information for sample size calculations for future studies and evidence whether improvement in gait control is enhanced when nVNS is delivered repeatedly and sustained over time. TRIAL REGISTRATION: This trial is prospectively registered at www.isrctn.com/ISRCTN19394828 . Registered August 23, 2021.


Assuntos
Doença de Parkinson , Estimulação do Nervo Vago , Humanos , Resultado do Tratamento , Doença de Parkinson/terapia , Estimulação do Nervo Vago/efeitos adversos , Estimulação do Nervo Vago/métodos , Marcha , Progressão da Doença , Método Duplo-Cego , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
J Neuroeng Rehabil ; 20(1): 78, 2023 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-37316858

RESUMO

BACKGROUND: Although digital mobility outcomes (DMOs) can be readily calculated from real-world data collected with wearable devices and ad-hoc algorithms, technical validation is still required. The aim of this paper is to comparatively assess and validate DMOs estimated using real-world gait data from six different cohorts, focusing on gait sequence detection, foot initial contact detection (ICD), cadence (CAD) and stride length (SL) estimates. METHODS: Twenty healthy older adults, 20 people with Parkinson's disease, 20 with multiple sclerosis, 19 with proximal femoral fracture, 17 with chronic obstructive pulmonary disease and 12 with congestive heart failure were monitored for 2.5 h in the real-world, using a single wearable device worn on the lower back. A reference system combining inertial modules with distance sensors and pressure insoles was used for comparison of DMOs from the single wearable device. We assessed and validated three algorithms for gait sequence detection, four for ICD, three for CAD and four for SL by concurrently comparing their performances (e.g., accuracy, specificity, sensitivity, absolute and relative errors). Additionally, the effects of walking bout (WB) speed and duration on algorithm performance were investigated. RESULTS: We identified two cohort-specific top performing algorithms for gait sequence detection and CAD, and a single best for ICD and SL. Best gait sequence detection algorithms showed good performances (sensitivity > 0.73, positive predictive values > 0.75, specificity > 0.95, accuracy > 0.94). ICD and CAD algorithms presented excellent results, with sensitivity > 0.79, positive predictive values > 0.89 and relative errors < 11% for ICD and < 8.5% for CAD. The best identified SL algorithm showed lower performances than other DMOs (absolute error < 0.21 m). Lower performances across all DMOs were found for the cohort with most severe gait impairments (proximal femoral fracture). Algorithms' performances were lower for short walking bouts; slower gait speeds (< 0.5 m/s) resulted in reduced performance of the CAD and SL algorithms. CONCLUSIONS: Overall, the identified algorithms enabled a robust estimation of key DMOs. Our findings showed that the choice of algorithm for estimation of gait sequence detection and CAD should be cohort-specific (e.g., slow walkers and with gait impairments). Short walking bout length and slow walking speed worsened algorithms' performances. Trial registration ISRCTN - 12246987.


Assuntos
Tecnologia Digital , Fraturas Proximais do Fêmur , Humanos , Idoso , Marcha , Caminhada , Velocidade de Caminhada , Modalidades de Fisioterapia
8.
Sensors (Basel) ; 23(15)2023 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-37571703

RESUMO

Gait speed declines with age and slower walking speeds are associated with poor health outcomes. Understanding why we do not walk faster as we age, despite being able to, has implications for rehabilitation. Changes in regional oxygenated haemoglobin (HbO2) across the frontal lobe were monitored using functional near infrared spectroscopy in 17 young and 18 older adults while they walked on a treadmill for 5 min, alternating between 30 s of walking at a preferred and fast (120% preferred) speed. Gait was quantified using a triaxial accelerometer (lower back). Differences between task (preferred/fast) and group (young/old) and associations between regional HbO2 and gait were evaluated. Paired tests indicated increased HbO2 in the supplementary motor area (right) and primary motor cortex (left and right) in older adults when walking fast (p < 0.006). HbO2 did not significantly change in the young when walking fast, despite both groups modulating gait. When evaluating the effect of age (linear mixed effects model), greater increases in HbO2 were observed for older adults when walking fast (prefrontal cortex, premotor cortex, supplementary motor area and primary motor cortex) compared to young adults. In older adults, increased step length and reduced step length variability were associated with larger increases in HbO2 across multiple regions when walking fast. Walking fast required increased activation of motor regions in older adults, which may serve as a therapeutic target for rehabilitation. Widespread increases in HbO2 across the frontal cortex highlight that walking fast represents a resource-intensive task as we age.


Assuntos
Córtex Motor , Velocidade de Caminhada , Idoso , Humanos , Adulto Jovem , Marcha/fisiologia , Oxiemoglobinas , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Caminhada/fisiologia , Velocidade de Caminhada/fisiologia
9.
Mov Disord ; 37(6): 1222-1234, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35285068

RESUMO

BACKGROUND: Gait impairments are characteristic motor manifestations and significant predictors of poor quality of life in Parkinson's disease (PD). Neuroimaging biomarkers for gait impairments in PD could facilitate effective interventions to improve these symptoms and are highly warranted. OBJECTIVE: The aim of this study was to identify neural networks of discrete gait impairments in PD. METHODS: Fifty-five participants with early-stage PD and 20 age-matched healthy volunteers underwent quantitative gait assessment deriving 12 discrete spatiotemporal gait characteristics and [18 F]-2-fluoro-2-deoxyglucose-positron emission tomography measuring resting cerebral glucose metabolism. A multivariate spatial covariance approach was used to identify metabolic brain networks that were related to discrete gait characteristics in PD. RESULTS: In PD, we identified two metabolic gait-related covariance networks. The first correlated with mean step velocity and mean step length (pace gait network), which involved relatively increased and decreased metabolism in frontal cortices, including the dorsolateral prefrontal and orbital frontal, insula, supplementary motor area, ventrolateral thalamus, cerebellum, and cuneus. The second correlated with swing time variability and step time variability (temporal variability gait network), which included relatively increased and decreased metabolism in sensorimotor, superior parietal cortex, basal ganglia, insula, hippocampus, red nucleus, and mediodorsal thalamus. Expression of both networks was significantly elevated in participants with PD relative to healthy volunteers and were not related to levodopa dosage or motor severity. CONCLUSIONS: We have identified two novel gait-related brain networks of altered glucose metabolism at rest. These gait networks could serve as a potential neuroimaging biomarker of gait impairments in PD and facilitate development of therapeutic strategies for these disabling symptoms. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.


Assuntos
Doença de Parkinson , Marcha , Glucose , Humanos , Levodopa/uso terapêutico , Imageamento por Ressonância Magnética/métodos , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/tratamento farmacológico , Qualidade de Vida
10.
J Neuroeng Rehabil ; 19(1): 141, 2022 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-36522646

RESUMO

BACKGROUND: Measuring mobility in daily life entails dealing with confounding factors arising from multiple sources, including pathological characteristics, patient specific walking strategies, environment/context, and purpose of the task. The primary aim of this study is to propose and validate a protocol for simulating real-world gait accounting for all these factors within a single set of observations, while ensuring minimisation of participant burden and safety. METHODS: The protocol included eight motor tasks at varying speed, incline/steps, surface, path shape, cognitive demand, and included postures that may abruptly alter the participants' strategy of walking. It was deployed in a convenience sample of 108 participants recruited from six cohorts that included older healthy adults (HA) and participants with potentially altered mobility due to Parkinson's disease (PD), multiple sclerosis (MS), proximal femoral fracture (PFF), chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF). A novelty introduced in the protocol was the tiered approach to increase difficulty both within the same task (e.g., by allowing use of aids or armrests) and across tasks. RESULTS: The protocol proved to be safe and feasible (all participants could complete it and no adverse events were recorded) and the addition of the more complex tasks allowed a much greater spread in walking speeds to be achieved compared to standard straight walking trials. Furthermore, it allowed a representation of a variety of daily life relevant mobility aspects and can therefore be used for the validation of monitoring devices used in real life. CONCLUSIONS: The protocol allowed for measuring gait in a variety of pathological conditions suggests that it can also be used to detect changes in gait due to, for example, the onset or progression of a disease, or due to therapy. TRIAL REGISTRATION: ISRCTN-12246987.


Assuntos
Marcha , Doença de Parkinson , Adulto , Humanos , Caminhada , Velocidade de Caminhada , Projetos de Pesquisa
11.
Sensors (Basel) ; 22(3)2022 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-35161617

RESUMO

Participating in habitual physical activity (HPA) may slow onset of dependency and disability for people with Parkinson's disease (PwP). While cognitive and physical determinants of HPA are well understood, psychosocial influences are not. This pilot study aimed to identify psychosocial factors associated with HPA to guide future intervention development. Sixty-four PwP participated in this study; forty had carer informants. PwP participants wore a tri-axial accelerometer on the lower back continuously for seven days at two timepoints (18 months apart), measuring volume, pattern and variability of HPA. Linear mixed effects analysis identified relationships between demographic, clinical and psychosocial data and HPA from baseline to 18 months. Key results in PwP with carers indicated that carer anxiety and depression were associated with increased HPA volume (p < 0.01), while poorer carer self-care was associated with reduced volume of HPA over 18 months (p < 0.01). Greater carer strain was associated with taking longer walking bouts after 18 months (p < 0.01). Greater carer depression was associated with lower variability of HPA cross-sectionally (p = 0.009). This pilot study provides preliminary novel evidence that psychosocial outcomes from PwP's carers may impact HPA in Parkinson's disease. Interventions to improve HPA could target both PwP and carers and consider approaches that also support psychosocial wellbeing.


Assuntos
Cuidadores , Doença de Parkinson , Exercício Físico , Humanos , Projetos Piloto , Qualidade de Vida
12.
Mov Disord ; 36(3): 611-621, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33382126

RESUMO

BACKGROUND: Gait disturbance is an early, disabling feature of Parkinson's disease (PD) that is typically refractory to dopaminergic medication. The cortical cholinergic system, originating in the nucleus basalis of Meynert of the basal forebrain, has been implicated. However, it is not known if degeneration in this region relates to a worsening of disease-specific gait impairment. OBJECTIVE: To evaluate associations between sub-regional cholinergic basal forebrain volumes and longitudinal progression of gait impairment in PD. METHODS: 99 PD participants and 47 control participants completed gait assessments via an instrumented walkway during 2 minutes of continuous walking, at baseline and for up to 3 years, from which 16 spatiotemporal characteristics were derived. Sub-regional cholinergic basal forebrain volumes were measured at baseline via MRI and a regional map derived from post-mortem histology. Univariate analyses evaluated cross-sectional associations between sub-regional volumes and gait. Linear mixed-effects models assessed whether volumes predicted longitudinal gait changes. RESULTS: There were no cross-sectional, age-independent relationships between sub-regional volumes and gait. However, nucleus basalis of Meynert volumes predicted longitudinal gait changes unique to PD. Specifically, smaller nucleus basalis of Meynert volume predicted increasing step time variability (P = 0.019) and shortening swing time (P = 0.015); smaller posterior nucleus portions predicted shortening step length (P = 0.007) and increasing step time variability (P = 0.041). CONCLUSIONS: This is the first study to demonstrate that degeneration of the cortical cholinergic system predicts longitudinal progression of gait impairments in PD. Measures of this degeneration may therefore provide a novel biomarker for identifying future mobility loss and falls. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.


Assuntos
Prosencéfalo Basal , Doença de Parkinson , Prosencéfalo Basal/diagnóstico por imagem , Colinérgicos , Estudos Transversais , Marcha , Humanos , Doença de Parkinson/complicações
13.
Sensors (Basel) ; 21(24)2021 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-34960317

RESUMO

Optoelectronic stereophotogrammetric (SP) systems are widely used in human movement research for clinical diagnostics, interventional applications, and as a reference system for validating alternative technologies. Regardless of the application, SP systems exhibit different random and systematic errors depending on camera specifications, system setup and laboratory environment, which hinders comparing SP data between sessions and across different systems. While many methods have been proposed to quantify and report the errors of SP systems, they are rarely utilized due to their complexity and need for additional equipment. In response, an easy-to-use quality control (QC) check has been designed that can be completed immediately prior to a data collection. This QC check requires minimal training for the operator and no additional equipment. In addition, a custom graphical user interface ensures automatic processing of the errors in an easy-to-read format for immediate interpretation. On initial deployment in a multicentric study, the check (i) proved to be feasible to perform in a short timeframe with minimal burden to the operator, and (ii) quantified the level of random and systematic errors between sessions and systems, ensuring comparability of data in a variety of protocol setups, including repeated measures, longitudinal studies and multicentric studies.


Assuntos
Movimento , Fotogrametria , Humanos , Controle de Qualidade
14.
Chembiochem ; 21(9): 1329-1334, 2020 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-31802583

RESUMO

Rapid detection of cysteine oxidation in living cells is critical in advancing our understanding of responses to reactive oxygen species (ROS) and oxidative stress. Accordingly, there is a need to develop chemical probes that facilitate proteome-wide detection of cysteine's many oxidation states. Herein, we report the first whole-cell proteomics analysis using a norbornene probe to detect the initial product of cysteine oxidation: cysteine sulfenic acid. The oxidised proteins identified in the HeLa cell model represent the first targets of the ROS hydrogen peroxide. The panel of protein hits provides new and important information about the targets of oxidative stress, including 148 new protein members of the sulfenome. These findings provide new leads for the study and understanding of redox signalling and diseases associated with oxidative stress.


Assuntos
Cisteína/análogos & derivados , Cisteína/química , Norbornanos/química , Estresse Oxidativo , Proteoma/metabolismo , Ácidos Sulfênicos/química , Células HeLa , Humanos , Oxirredução , Proteoma/análise , Transdução de Sinais
15.
Sensors (Basel) ; 20(18)2020 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-32961799

RESUMO

Parkinson's disease (PD) is a common neurodegenerative disorder resulting in a range of mobility deficits affecting gait, balance and turning. In this paper, we present: (i) the development and validation of an algorithm to detect turns during gait; (ii) a method to extract turn characteristics; and (iii) the classification of PD using turn characteristics. Thirty-seven people with PD and 56 controls performed 180-degree turns during an intermittent walking task. Inertial measurement units were attached to the head, neck, lower back and ankles. A turning detection algorithm was developed and validated by two raters using video data. Spatiotemporal and signal-based characteristics were extracted and used for PD classification. There was excellent absolute agreement between the rater and the algorithm for identifying turn start and end (ICC ≥ 0.99). Classification modeling (partial least square discriminant analysis (PLS-DA)) gave the best accuracy of 97.85% when trained on upper body and ankle data. Balanced sensitivity (97%) and specificity (96.43%) were achieved using turning characteristics from the neck, lower back and ankles. Turning characteristics, in particular angular velocity, duration, number of steps, jerk and root mean square distinguished mild-moderate PD from controls accurately and warrant future examination as a marker of mobility impairment and fall risk in PD.


Assuntos
Análise da Marcha , Transtornos Neurológicos da Marcha , Doença de Parkinson , Idoso , Algoritmos , Feminino , Transtornos Neurológicos da Marcha/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico , Caminhada
16.
Sensors (Basel) ; 20(23)2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33297395

RESUMO

Falls are the leading cause of mortality, morbidity and poor quality of life in older adults with or without neurological conditions. Applying machine learning (ML) models to gait analysis outcomes offers the opportunity to identify individuals at risk of future falls. The aim of this study was to determine the effect of different data pre-processing methods on the performance of ML models to classify neurological patients who have fallen from those who have not for future fall risk assessment. Gait was assessed using wearables in clinic while walking 20 m at a self-selected comfortable pace in 349 (159 fallers, 190 non-fallers) neurological patients. Six different ML models were trained on data pre-processed with three techniques such as standardisation, principal component analysis (PCA) and path signature method. Fallers walked more slowly, with shorter strides and longer stride duration compared to non-fallers. Overall, model accuracy ranged between 48% and 98% with 43-99% sensitivity and 48-98% specificity. A random forest (RF) classifier trained on data pre-processed with the path signature method gave optimal classification accuracy of 98% with 99% sensitivity and 98% specificity. Data pre-processing directly influences the accuracy of ML models for the accurate classification of fallers. Using gait analysis with trained ML models can act as a tool for the proactive assessment of fall risk and support clinical decision-making.


Assuntos
Análise da Marcha , Doenças do Sistema Nervoso , Dispositivos Eletrônicos Vestíveis , Acidentes por Quedas , Idoso , Feminino , Marcha , Humanos , Masculino , Qualidade de Vida , Caminhada
17.
Mov Disord ; 34(11): 1690-1698, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31442355

RESUMO

BACKGROUND: Cumulative dementia incidence in Parkinson's disease (PD) is significant, with major personal and socioeconomic impacts on individuals with PD and their carers. Early identification of dementia risk is vital to ensuring optimal intervention. Saccadic deficits often distinguish neurodegenerative disorders and cognitive impairment, but their ability to predict cognitive decline in PD has yet to be determined. The aims of this study were to (1) evaluate baseline (6.4 ± 6.1 months since PD diagnosis) differences in pro-saccadic metrics between those with early PD and healthy age-matched adults; and (2) assess the ability of baseline pro-saccades to predict subsequent cognitive decline over 4.5 years. METHODS: One hundred and forty-one PD and 90 age-matched participants recruited at diagnosis underwent saccadometric assessment of pro-saccades at baseline and had cognition assessed at baseline, 18, 36, and 54 months. Pro-saccadic characteristics included latency, duration, amplitude, peak, and average velocity. Cognitive assessment included executive function, attention, fluctuating attention, and memory. Linear mixed-effects models examined pro-saccadic metrics as predictors of cognitive decline over 54 months. RESULTS: Pro-saccades were significantly impaired at baseline in PD compared with controls. Pro-saccadic characteristics of latency, duration, peak, and average velocity predicted decline in global cognition, executive function, attention, and memory over 54 months in PD. In addition, only reduction in global cognition and attention were predicted by pro-saccadic metrics in age-matched adults, indicating that PD findings were not purely age related. CONCLUSIONS: Saccadic characteristics are impaired in early PD and are predictive of cognitive decline in several domains. Assessment of saccades may provide a useful non-invasive biomarker for long-term PD cognitive decline in early disease. © 2019 International Parkinson and Movement Disorder Society.


Assuntos
Cognição/fisiologia , Disfunção Cognitiva/fisiopatologia , Memória/fisiologia , Doença de Parkinson/fisiopatologia , Adulto , Idoso , Atenção/fisiologia , Disfunção Cognitiva/etiologia , Demência/complicações , Demência/fisiopatologia , Função Executiva/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações
19.
Chem Soc Rev ; 47(1): 231-268, 2018 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-29242887

RESUMO

Cysteine residues in proteins are subject to diverse redox chemistry. Oxidation of cysteine to S-nitrosocysteine, cysteine sulfenic and sulfinic acids, disulfides and persulfides are a few prominent examples of these oxidative post-translational modifications. In living organisms, these modifications often play key roles in cell signalling and protein function, but a full account of this biochemistry is far from complete. It is therefore an important goal in chemical biology to identify what proteins are subjected to these modifications and understand their physiological function. This review provides an overview of these modifications, how they can be detected and quantified using chemical probes, and how this information provides insight into their role in biology. This survey also highlights future opportunities in the study of cysteine redox chemistry, the challenges that await chemists and biologists in this area of study, and how meeting such challenges might reveal valuable information for biomedical science.


Assuntos
Cisteína/análogos & derivados , Cisteína/química , S-Nitrosotióis/análise , Animais , Cisteína/análise , Humanos , Oxirredução , S-Nitrosotióis/química
20.
Org Biomol Chem ; 16(8): 1351-1358, 2018 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-29404557

RESUMO

Two putative structures of spongosoritin A, with syn (6R,8R) and anti (6S,8R) configurations, were each synthesised in a total of 11 linear steps with only 8 purification procedures. The key steps in our strategy included Evans alkylation and olefin dihydroxylation to install the C8 and C6 stereocentres, a transacetalisation/dehydration cascade to construct the furanylidene core, and chromatographic separation of 9E- and 9Z-isomers of the final compounds with silver nitrate impregnated silica. Comparison of the 1H and 13C NMR data for the synthetic syn- and anti-isomers to that reported for the natural product revealed that the relative configuration of spongosoritin A is syn. The absolute stereochemistry was also confirmed as 6R,8R based on optical rotation measurements where the synthetic syn (6R,8R) and natural product had the same sign of optical rotation (negative).

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