A population model-based linear-quadratic Gaussian compensator for the control of intravenously infused alcohol studies and withdrawal symptom prophylaxis using transdermal sensing.

An output feedback LQG compensator (combined controller and state estimator) for the regulation of intravenous-infused alcohol studies and treatment using a noninvasive transdermal alcohol biosensor is developed. The design is based on a population model involving an abstract semi-linear parabolic hybrid reaction-diffusion system involving coupled partial and ordinary differential equations with random parameters known only up to their distributions. The scheme developed is based on a weak formulation of the model equations in an appropriately constructed Gelfand triple of Bochner spaces wherein the unknown random parameters are treated as additional spatial variables. Implementation relies on a Galerkin-based approximation and convergence theory and an abstract formulation involving linear semigroups of operators. The model is fit and validated using laboratory collected human subject data and the method of moments. The results of numerical simulations of controlled intravenous alcohol infusion are presented and discussed.

Tracking and blind deconvolution of blood alcohol concentration from transdermal alcohol biosensor data: A population model-based LQG approach in Hilbert space.

LQG control in Hilbert space, a novel approach for random abstract parabolic systems, and new transdermal alcohol biosensor technology are combined to yield tracking controllers that can be used to automate inpatient management of alcohol withdrawal syndrome and human subject intravenous alcohol infusion studies, and to blindly deconvolve blood or breath alcohol concentration from biosensor measured transdermal alcohol level. The approach taken is based on a full-body alcohol population model in the form of a random, nonlinear, hybrid system of ordinary and partial differential equations and its abstract formulation in a Gelfand triple of Bochner spaces. The efficacy of the approach is demonstrated through simulation studies based on laboratory collected drinking data.

Impaired Ocular Tracking and Cortical Atrophy in Idiopathic Rapid Eye Movement Sleep Behavior Disorder.

BACKGROUND: Idiopathic rapid eye movement sleep behavior disorder (iRBD) is a prodromal stage of synucleinopathies. Patients with synucleinopathies frequently display eye movement abnormalities. However, whether patients with iRBD have eye movement abnormalities remains unknown. OBJECTIVE: The aim of this study was to assess eye movement abnormalities and related gray matter alterations and explore whether such abnormalities can serve as biomarkers to indicate phenoconversion to synucleinopathies in iRBD. METHODS: Forty patients with iRBD with early disease progression and 35 healthy control subjects participated in a 15-minute ocular-tracking task that evaluated their control of eye movement abilities. They also underwent clinical assessments for olfactory function, nonmotor symptoms, and autonomic symptoms, all of which are biomarkers to predict phenoconversion to synucleinopathies in iRBD. A subgroup of the participants (20 patients with iRBD and 20 healthy control subjects) also participated in structural magnetic resonance imaging. RESULTS: The ocular-tracking ability in patients with iRBD was inferior to that of healthy control subjects in two aspects: pursuit initiation and steady-state tracking. Cortical thinning in the right visual area V4 in patients with iRBD is coupled with impaired pursuit initiation. Furthermore, prolonged pursuit initiation in patients with iRBD exhibits a trend of correlation with olfactory loss, the earliest biomarker that develops prior to other prodromal biomarkers. CONCLUSIONS: We found ocular-tracking abnormalities in patients with iRBD even early in their disease progression that have not been reported before. These abnormalities are coupled with atrophy of brain areas involved in the perception of object motion and might indicate phenoconversion to synucleinopathies in iRBD. © 2022 International Parkinson and Movement Disorder Society.

Gait Characteristics and Brain Activity in Parkinson's Disease with Concomitant Postural Abnormalities.

To explore the underlying pathogenic mechanism of Parkinson's disease (PD) with concomitant postural abnormalities (PDPA) through the relationship between its gait and brain function characteristics. PD patients from the neurology outpatient clinic at Ruijin Hospital were recruited and grouped according to whether postural abnormalities (including camptocormia and Pisa syndrome) were present. PD-related scale assessments, three-dimensional gait tests and brain resting-state functional magnetic imaging were performed and analyzed. The gait characteristics independently associated with PDPA were decreased pelvic obliquity angle and progressive downward movement of the center of mass during walking. PDPA features included decreased functional connectivity between the left insula and bilateral supplementary motor area, which was significantly correlated with reduced Berg Balance Scale scores. Functional connectivity between the right insula and bilateral middle frontal gyrus was decreased and significantly correlated with a decreased pelvic obliquity angle and poor performance on the Timed Up and Go test. Moreover, through diffusion tensor imaging analysis, the average fractional anisotropy value of the fibers connecting the left insula and left supplementary motor area was shown to be decreased in PDPA. There is decreased functional connectivity among the insula, supplementary motor area and middle frontal gyrus with structural abnormalities between the left insula and the left supplementary motor area; these changes in brain connectivity are probably among the causes of gait dysfunction in PDPA and provide some clues regarding the pathogenic mechanisms of PDPA.

Abnormal intrinsic brain activity of the putamen is correlated with dopamine deficiency in idiopathic rapid eye movement sleep behavior disorder.

OBJECTIVES: To investigate the changes in spontaneous neuronal activity of the striatum in idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) patients using regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) analysis. Furthermore, we tested the association between abnormal spontaneous brain activity and dopamine deficit in patients with iRBD. METHODS: Fifteen iRBD patients and 15 matched healthy controls received resting state magnetic resonance imaging (MRI) and neuropsychological assessments. ReHo and ALFF in subregions of the striatum were calculated and compared between groups in a voxel-by-voxel manner. In addition, 15 iRBD patients and seven healthy controls underwent dopamine transporter single photon computed emission tomography (DAT-SPECT) imaging. Correlation analysis was also performed to investigate whether the altered spontaneous brain activity could be correlated with dopamine deficiency in iRBD patients. RESULTS: We found that iRBD patients, compared with healthy controls, exhibited significantly reduced ReHo in the bilateral putamen. Patients also had significantly decreased tracer uptake in the bilateral putamen and left caudate. In addition, a significantly positive correlation was observed between the mean ReHo value and the tracer uptake ratio in the left putamen of iRBD patients. CONCLUSIONS: We detected abnormal spontaneous brain activity of the bilateral putamen in iRBD patients. These findings could be complementary to the Braak staging model and could help to clarify the pathophysiology of iRBD.

Variants in the SNCA Locus Are Associated With the Progression of Parkinson's Disease.

Background: Genetic factors have a well-known influence on Parkinson's disease (PD) susceptibility; however, no previous studies have investigated the influence of SNCA mutations on the natural history of PD using a prospective follow-up study. The aim of this study was to assess the risk factors of variation of SNCA on the prognosis symptoms of PD patients. Methods: Fifty PD patients were recruited with 38 v-PSG confirmed PD+RBD patients, and the median follow-up period was 30 months. All patients underwent a comprehensive clinical evaluation at baseline and follow-up, and six SNPs of SNCA (rs356165, rs3857053, rs1045722, rs894278, rs356186, and rs356219) were analyzed. Cox proportional hazards regression models and Kaplan-Meier plot analysis were used to assess the associations between the SNCA variation and the primary and secondary progression outcomes. Results: Based on the clinical assessment, we found that hyposmia was substantially easier to aggravate. Regression analysis showed that patients with the T allele of rs1045722 and the G allele of rs356219 presented a 34 and 20% decreased risk of progression to the H-Y stage, respectively (p = 0.022; p = 0.005). While for rs894278, G allele patients showed a 47% decreased risk of olfactory dysfunction (p = 0.029). Further subgroup analysis showed that PD+RBD patients with rs356219/G exhibited a 30% and 20% decreased risk of progression on the H-Y stage and MoCA score (p = 0.038; p = 0.045). Conclusions: Our results indicated that genetic variation in SNCA may contribute to variability natural progression of PD and could possibly be used as a prognostic marker.