Assessment of involuntary choreatic movements in Huntington's disease—Toward objective and quantitative measures
Identifieur interne : 000B04 ( Istex/Corpus ); précédent : 000B03; suivant : 000B05Assessment of involuntary choreatic movements in Huntington's disease—Toward objective and quantitative measures
Auteurs : Ralf Reilmann ; Stefan Bohlen ; Florian Kirsten ; E. Bernd Ringelstein ; Herwig W. LangeSource :
- Movement Disorders [ 0885-3185 ] ; 2011-10.
English descriptors
Abstract
Objective measures of motor impairment may improve the sensitivity and reliability of motor end points in clinical trials. In Huntington's disease, involuntary choreatic movements are one of the hallmarks of motor dysfunction. Chorea is commonly assessed by subitems of the Unified‐Huntington's Disease Rating Scale. However, clinical rating scales are limited by inter‐ and intrarater variability, subjective error, and categorical design. We hypothesized that assessment of position and orientation changes interfering with a static upper extremity holding task may provide objective and quantitative measures of involuntary movements in patients with Huntington's disease. Subjects with symptomatic Huntington's disease (n = 19), premanifest gene carriers (n = 15; Unified‐Huntington's Disease Rating Scale total motor score ≤ 3), and matched controls (n = 19) were asked to grasp and lift a device (250 and 500 g) equipped with an electromagnetic sensor. While subjects were instructed to hold the device as stable as possible, changes in position (x, y, z) and orientation (roll, pitch, yaw) were recorded. These were used to calculate a position index and an orientation index, both depicting the amount of choreatic movement interfering with task performance. Both indices were increased in patients with symptomatic Huntington's disease compared with controls and premanifest gene carriers for both weights, whereas only the position index with 500 g was increased in premanifest gene carriers compared with controls. Correlations were observed with the Disease Burden Score based on CAG‐repeat length and age and with the Unified‐Huntington's Disease Rating Scale. We conclude that quantitative assessment of chorea is feasible in Huntington's disease. The method is safe, noninvasive, and easily applicable and can be used repeatedly in outpatient settings. A use in clinical trials should be further explored in larger cohorts and follow‐up studies. © 2011 Movement Disorder Society
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DOI: 10.1002/mds.23816
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ISTEX:9194B55558E3CEBBB9194983DF3BFC479EFCB6B2Le document en format XML
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In Huntington's disease, involuntary choreatic movements are one of the hallmarks of motor dysfunction. Chorea is commonly assessed by subitems of the Unified‐Huntington's Disease Rating Scale. However, clinical rating scales are limited by inter‐ and intrarater variability, subjective error, and categorical design. We hypothesized that assessment of position and orientation changes interfering with a static upper extremity holding task may provide objective and quantitative measures of involuntary movements in patients with Huntington's disease. Subjects with symptomatic Huntington's disease (n = 19), premanifest gene carriers (n = 15; Unified‐Huntington's Disease Rating Scale total motor score ≤ 3), and matched controls (n = 19) were asked to grasp and lift a device (250 and 500 g) equipped with an electromagnetic sensor. While subjects were instructed to hold the device as stable as possible, changes in position (x, y, z) and orientation (roll, pitch, yaw) were recorded. These were used to calculate a position index and an orientation index, both depicting the amount of choreatic movement interfering with task performance. Both indices were increased in patients with symptomatic Huntington's disease compared with controls and premanifest gene carriers for both weights, whereas only the position index with 500 g was increased in premanifest gene carriers compared with controls. Correlations were observed with the Disease Burden Score based on CAG‐repeat length and age and with the Unified‐Huntington's Disease Rating Scale. We conclude that quantitative assessment of chorea is feasible in Huntington's disease. The method is safe, noninvasive, and easily applicable and can be used repeatedly in outpatient settings. A use in clinical trials should be further explored in larger cohorts and follow‐up studies. © 2011 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Ralf Reilmann MD</name><affiliations><json:string>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</json:string></affiliations></json:item><json:item><name>Stefan Bohlen MD</name><affiliations><json:string>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</json:string></affiliations></json:item><json:item><name>Florian Kirsten MD</name><affiliations><json:string>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</json:string></affiliations></json:item><json:item><name>E. 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These were used to calculate a position index and an orientation index, both depicting the amount of choreatic movement interfering with task performance. Both indices were increased in patients with symptomatic Huntington's disease compared with controls and premanifest gene carriers for both weights, whereas only the position index with 500 g was increased in premanifest gene carriers compared with controls. Correlations were observed with the Disease Burden Score based on CAG‐repeat length and age and with the Unified‐Huntington's Disease Rating Scale. We conclude that quantitative assessment of chorea is feasible in Huntington's disease. The method is safe, noninvasive, and easily applicable and can be used repeatedly in outpatient settings. 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In Huntington's disease, involuntary choreatic movements are one of the hallmarks of motor dysfunction. Chorea is commonly assessed by subitems of the Unified‐Huntington's Disease Rating Scale. However, clinical rating scales are limited by inter‐ and intrarater variability, subjective error, and categorical design. We hypothesized that assessment of position and orientation changes interfering with a static upper extremity holding task may provide objective and quantitative measures of involuntary movements in patients with Huntington's disease. Subjects with symptomatic Huntington's disease (n = 19), premanifest gene carriers (n = 15; Unified‐Huntington's Disease Rating Scale total motor score ≤ 3), and matched controls (n = 19) were asked to grasp and lift a device (250 and 500 g) equipped with an electromagnetic sensor. While subjects were instructed to hold the device as stable as possible, changes in position (x, y, z) and orientation (roll, pitch, yaw) were recorded. These were used to calculate a position index and an orientation index, both depicting the amount of choreatic movement interfering with task performance. Both indices were increased in patients with symptomatic Huntington's disease compared with controls and premanifest gene carriers for both weights, whereas only the position index with 500 g was increased in premanifest gene carriers compared with controls. Correlations were observed with the Disease Burden Score based on CAG‐repeat length and age and with the Unified‐Huntington's Disease Rating Scale. We conclude that quantitative assessment of chorea is feasible in Huntington's disease. The method is safe, noninvasive, and easily applicable and can be used repeatedly in outpatient settings. A use in clinical trials should be further explored in larger cohorts and follow‐up studies. © 2011 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Huntington's disease</term></item><item><term>chorea</term></item><item><term>clinical trials</term></item><item><term>motor control</term></item><item><term>basal ganglia</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-10-11">Received</change><change when="2011-05-08">Registration</change><change when="2011-10">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/9194B55558E3CEBBB9194983DF3BFC479EFCB6B2/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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Bernd</givenNames><familyName>Ringelstein</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Herwig W.</givenNames><familyName>Lange</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Huntington's disease</keyword><keyword xml:id="kwd2">chorea</keyword><keyword xml:id="kwd3">clinical trials</keyword><keyword xml:id="kwd4">motor control</keyword><keyword xml:id="kwd5">basal ganglia</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Objective measures of motor impairment may improve the sensitivity and reliability of motor end points in clinical trials. In Huntington's disease, involuntary choreatic movements are one of the hallmarks of motor dysfunction. Chorea is commonly assessed by subitems of the Unified‐Huntington's Disease Rating Scale. However, clinical rating scales are limited by inter‐ and intrarater variability, subjective error, and categorical design. We hypothesized that assessment of position and orientation changes interfering with a static upper extremity holding task may provide objective and quantitative measures of involuntary movements in patients with Huntington's disease. Subjects with symptomatic Huntington's disease (n = 19), premanifest gene carriers (n = 15; Unified‐Huntington's Disease Rating Scale total motor score ≤ 3), and matched controls (n = 19) were asked to grasp and lift a device (250 and 500 g) equipped with an electromagnetic sensor. While subjects were instructed to hold the device as stable as possible, changes in position (x, y, z) and orientation (roll, pitch, yaw) were recorded. These were used to calculate a position index and an orientation index, both depicting the amount of choreatic movement interfering with task performance. Both indices were increased in patients with symptomatic Huntington's disease compared with controls and premanifest gene carriers for both weights, whereas only the position index with 500 g was increased in premanifest gene carriers compared with controls. Correlations were observed with the Disease Burden Score based on CAG‐repeat length and age and with the Unified‐Huntington's Disease Rating Scale. We conclude that quantitative assessment of chorea is feasible in Huntington's disease. The method is safe, noninvasive, and easily applicable and can be used repeatedly in outpatient settings. A use in clinical trials should be further explored in larger cohorts and follow‐up studies. © 2011 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn2"><p><b>Relevant conflicts of interest/financial disclosures:</b> Ralf Reilmann was supported by grant RE 1330/1‐1 from the German Research Foundation (DFG) and grant RE‐120225 from the Innovative Medical Research Fund (IMF), Faculty of Medicine, University of Muenster, as well as grants from the European Huntington's Disease Network (<url href="http://www.euro-hd.net">http://www.euro‐hd.net</url>) and the Cure Huntington's Disease Initiative Foundation (<url href="http://www.chdifoundation.org">http://www.chdifoundation.org</url>).</p></note><note xml:id="fn3"><p>Full financial disclosures and author roles may be found in the online version of this article.</p></note><note xml:id="fn1"><p>Ralf Reilmann and Stefan Bohlen contributed equally to this study.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Assessment of involuntary choreatic movements in Huntington's disease—Toward objective and quantitative measures</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Assessment of Chorea in HD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Assessment of involuntary choreatic movements in Huntington's disease—Toward objective and quantitative measures</title></titleInfo><name type="personal"><namePart type="given">Ralf</namePart><namePart type="family">Reilmann</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</affiliation><description>Ralf Reilmann and Stefan Bohlen contributed equally to this study.</description><description>Correspondence: Department of Neurology, University Clinic Muenster (UKM), University of Muenster, Albert Schweitzer Strasse 33, 48149 Muenster, Germany</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefan</namePart><namePart type="family">Bohlen</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</affiliation><description>Ralf Reilmann and Stefan Bohlen contributed equally to this study.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Florian</namePart><namePart type="family">Kirsten</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E. Bernd</namePart><namePart type="family">Ringelstein</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Herwig W.</namePart><namePart type="family">Lange</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Clinic Muenster, Westfaelische Wilhelms University of Muenster, Muenster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-10</dateIssued><dateCaptured encoding="w3cdtf">2010-10-11</dateCaptured><dateValid encoding="w3cdtf">2011-05-08</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">2</extent><extent unit="references">17</extent><extent unit="words">5566</extent></physicalDescription><abstract lang="en">Objective measures of motor impairment may improve the sensitivity and reliability of motor end points in clinical trials. In Huntington's disease, involuntary choreatic movements are one of the hallmarks of motor dysfunction. Chorea is commonly assessed by subitems of the Unified‐Huntington's Disease Rating Scale. However, clinical rating scales are limited by inter‐ and intrarater variability, subjective error, and categorical design. We hypothesized that assessment of position and orientation changes interfering with a static upper extremity holding task may provide objective and quantitative measures of involuntary movements in patients with Huntington's disease. Subjects with symptomatic Huntington's disease (n = 19), premanifest gene carriers (n = 15; Unified‐Huntington's Disease Rating Scale total motor score ≤ 3), and matched controls (n = 19) were asked to grasp and lift a device (250 and 500 g) equipped with an electromagnetic sensor. While subjects were instructed to hold the device as stable as possible, changes in position (x, y, z) and orientation (roll, pitch, yaw) were recorded. These were used to calculate a position index and an orientation index, both depicting the amount of choreatic movement interfering with task performance. Both indices were increased in patients with symptomatic Huntington's disease compared with controls and premanifest gene carriers for both weights, whereas only the position index with 500 g was increased in premanifest gene carriers compared with controls. Correlations were observed with the Disease Burden Score based on CAG‐repeat length and age and with the Unified‐Huntington's Disease Rating Scale. We conclude that quantitative assessment of chorea is feasible in Huntington's disease. The method is safe, noninvasive, and easily applicable and can be used repeatedly in outpatient settings. A use in clinical trials should be further explored in larger cohorts and follow‐up studies. © 2011 Movement Disorder Society</abstract><note type="content">*Relevant conflicts of interest/financial disclosures: Ralf Reilmann was supported by grant RE 1330/1‐1 from the German Research Foundation (DFG) and grant RE‐120225 from the Innovative Medical Research Fund (IMF), Faculty of Medicine, University of Muenster, as well as grants from the European Huntington's Disease Network (http://www.euro‐hd.net) and the Cure Huntington's Disease Initiative Foundation (http://www.chdifoundation.org).</note><note type="content">*Full financial disclosures and author roles may be found in the online version of this article.</note><subject lang="en"><genre>Keywords</genre><topic>Huntington's disease</topic><topic>chorea</topic><topic>clinical trials</topic><topic>motor control</topic><topic>basal ganglia</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>26</number></detail><detail type="issue"><caption>no.</caption><number>12</number></detail><extent unit="pages"><start>2267</start><end>2273</end><total>7</total></extent></part></relatedItem><identifier type="istex">9194B55558E3CEBBB9194983DF3BFC479EFCB6B2</identifier><identifier type="DOI">10.1002/mds.23816</identifier><identifier type="ArticleID">MDS23816</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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