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Kinect-based objective assessment of the acute levodopa challenge test in parkinsonism: a feasibility study

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Abstract

Introduction

The acute levodopa challenge test (ALCT) is an important and valuable examination but there are still some shortcomings with it. We aimed to objectively assess ALCT based on a depth camera and filter out the best indicators.

Methods

Fifty-nine individuals with parkinsonism completed ALCT and the improvement rate (IR, which indicates the change in value before and after levodopa administration) of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS III) was calculated. The kinematic features of the patients’ movements in both the OFF and ON states were collected with an Azure Kinect depth camera.

Results

The IR of MDS-UPDRS III was significantly correlated with the IRs of many kinematic features for arising from a chair, pronation-supination movements of the hand, finger tapping, toe tapping, leg agility, and gait (rs =  − 0.277 ~  − 0.672, P < 0.05). Moderate to high discriminative values were found in the selected features in identifying a clinically significant response to levodopa with sensitivity, specificity, and area under the curve (AUC) in the range of 50–100%, 47.22%–97.22%, and 0.673–0.915, respectively. The resulting classifier combining kinematic features of toe tapping showed an excellent performance with an AUC of 0.966 (95% CI = 0.922–1.000, P < 0.001). The optimal cut-off value was 21.24% with sensitivity and specificity of 94.44% and 87.18%, respectively.

Conclusion

This study demonstrated the feasibility of measuring the effect of levodopa and objectively assessing ALCT based on kinematic data derived from an Azure Kinect-based system.

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Data availability

The data used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank all the participants for their understanding and participation.

Funding

This study was supported by the (1) Clinical Technology Innovation Project of Shanghai Shenkang Hospital Development Center (SHDC12020119); (2) Shanghai outstanding academic leaders’ plan of Shanghai Municipal Science and Technology Commission (20XD1403400); (3) National Clinical Key Specialty Construction Project of China (Z155080000004); (4) Shanghai Rehabilitation Medical Research Center (Top Priority Research Center of Shanghai) (2023ZZ02027); (5) Shanghai Clinical Research Ward (SHDC2023CRW018B); and (6) Shanghai Hospital Development Center Foundation—Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance (SHDC22023304).

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Authors and Affiliations

  1. Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China

    Ronghua Hong, Zhuang Wu & Lingjing Jin

  2. Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China

    Ronghua Hong, Zhuang Wu, Kangwen Peng, Jingxing Zhang, Yijing He, Zhuoyu Zhang, Qiang Guan, Lizhen Pan & Lingjing Jin

  3. IFLYTEK Suzhou Research Institute, Suzhou, China

    Yichen Gao, Yue Jin, Xiaoyun Su & Hongping Zhi

  4. Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China

    Lingjing Jin

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  1. Ronghua Hong
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  2. Zhuang Wu
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  3. Kangwen Peng
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Contributions

LJJ and LZP conceived and designed the study with the help of QG. XYS, YJ, YCG, and HPZ developed the algorithms. Data acquisition and analysis were done by KWP, JXZ, YJH, ZYZ, RHH, and ZW. RHH and ZW were major contributors in writing the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Lizhen Pan or Lingjing Jin.

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Ethical approval

All procedures performed in this study involving human participants were in accordance with the Ethical Standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Shanghai Tongji Hospital (IRB no. 2019–061).

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Informed consent was obtained from all individual participants included in the study.

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The participants have consented to the submission of their data to the journal.

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The authors declare no competing interests.

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Ronghua Hong and Zhuang Wu contributed equally to this work.

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Hong, R., Wu, Z., Peng, K. et al. Kinect-based objective assessment of the acute levodopa challenge test in parkinsonism: a feasibility study. Neurol Sci 45, 2661–2670 (2024). https://doi.org/10.1007/s10072-023-07296-5

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