Justyna Dutkiewicz

Small intestine dysfunction in Parkinson’s disease

The aim of this study was to assess the small bowel transit time in patients with Parkinson’s disease (PD). Ten patients with PD with no gastrointestinal complaints and ten healthy control subjects were investigated using single photon emission computed tomography fused with computed tomography after swallowing of a specially prepared capsule containing technetium 99m, which allowed visualization of the passage in the intestines. Preliminary results show that the small intestine passage in PD patients was prolonged compared to controls.

Data Mining and Machine Learning on the Basis from Reflexive Eye Movements Can Predict Symptom Development in Individual Parkinson’s Patients

We are still not in a position to understand most of the brain’s deeper computational properties. As a consequence, we also do not know how brain processes are affected by nerve cell deaths in neurodegenerative diseases (ND). We can register symptoms of ND such as motor and/or mental disorders (dementias) and even provide symptomatic relief, though the structural effects of these are in most cases not yet understood. Fortunately, with early diagnosis there are often many years of disease progression with symptoms that, when they are precisely monitored, may result in improved therapies. In the case of Parkinson’s disease, measurements of eye movements can be diagnostic. In order to better understand their relationship to the underlying disease process, we have performed measurements of reflexive eye movements in Parkinson’s disease (PD) patients. We have compared our measurements and algorithmic diagnoses with experts’ diagnoses. The purpose of our work was to find universal rules, using rough set theory, to classify how condition attributes predict the neurologist’s diagnosis. Prediction of individual UPDRS values only from reflexive saccade (RS) latencies was not possible. But for n = 10 patients, the patient’s age, latency, amplitude, and duration of RS gave a global accuracy in individual patients’ UPRDS predictions of about 80%, based on cross-validation. This demonstrates that broadening the spectrum of physical measurements and applying data mining and machine learning (ML) can lead to a powerful biomarker for symptom progression in Parkinson’s.

Data mining using SPECT can predict neurological symptom development in Parkinson's patients

We have compared in Parkinsons diseases patients neurological data with the local cerebral blood flow measured by the Single-Photon Emission Computed Tomography. Most of our patients underwent Deep Brain Stimulation surgery or were qualified for one in relation to the advanced disease progression. Local cerebral blood flow in different areas has correlated to the Unified Parkinsons Disease Rating Scale (UPDRS). We have used two different data mining methods: WEKA and Rough Set Exploration System to explore these correlations. We have demonstrated that cerebral blood flow changes gave good predictions for the UPDRS IV (84 %) that suggest that a general state of Parkinson Disease are stronger related to the cerebral blood flow than to only motor symptoms.

The neuromodulatory impact of subthalamic nucleus deep brain stimulation on gait and postural instability in Parkinson’s disease patients: a prospective case controlled study.

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) has been an established method in improvement of motor disabilities in Parkinsons disease (PD) patients. It has been also claimed to have an impact on balance and gait disorders in PD patients, but the previous results are conflicting. Objective: The aim of this prospective controlled study was to evaluate the impact of STN-DBS on balance disorders in PD patients in comparison with Best-Medical-Therapy (BMT) and Long-term-Post-Operative (POP) group. Methods: DBS-group consisted of 20 PD patients (8F, 12M) who underwent bilateral STN DBS. POP-group consisted of 14 post-DBS patients (6F, 8M) in median 30 months-time after surgery. Control group (BMT-group) consisted of 20 patients (11F, 9M) who did not undergo surgical intervention. UPDRS III scale and balance tests (Up And Go Test, Dual Task- Timed Up And Go Test, Tandem Walk Test) and posturography parameters were measured during 3 visits in 9 ± 2months periods (V1, V2, V3) 4 phases of treatment (BMT-ON/OFF, DBS-ON/OFF). Results: We have observed the slowdown of gait and postural instability progression in first 9 post-operative months followed by co-existent enhancement of balance disorders in next 9-months evaluation (p < 0.05) in balance tests (Up and Go, TWT) and in posturography examination parameters (p < 0.05). The effect was not observed neither in BMT-group nor POP-group (p > 0.05): these groups revealed constant progression of static and dynamic instability (p > 0.05). Conclusions: STN-DBS can have modulatory effect on static and dynamic instability in PD patients: it can temporarily improve balance disorders. mainly during first 9 post-operative months, but with possible following deterioration of the symptoms in next post-operative months.