Academic Journal

Gait Analysis for Identifying Normal Cognition, Subjective Cognitive Decline, and Mild Cognitive Impairment in Parkinson Disease: Diagnostic Study.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Gait Analysis for Identifying Normal Cognition, Subjective Cognitive Decline, and Mild Cognitive Impairment in Parkinson Disease: Diagnostic Study.
Συγγραφείς: Huang J; Department of Neurology, The First affiliated Hospital of Nanhua University, Hengyang, China., Wu L; GYENNO Science Co., Ltd., Shenzhen, China.; HUST-GYENNO CNS Intelligent Digital Medicine Technology Center, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, Hubei, China.; Guangdong Provincial Engineering Technology Research Center for Medical Artificial Intelligence in Neurological Disease, Shenzhen, Guangdong, China., Wang H; Department of Neurology, Jiangxi Medical College, Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China., Chen L; Department of Neurology, Jiangxi Medical College, Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China., Hu B; Department of Neurology, Jiangxi Medical College, Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China., Zhang F; GYENNO Science Co., Ltd., Shenzhen, China.; HUST-GYENNO CNS Intelligent Digital Medicine Technology Center, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, Hubei, China.; Guangdong Provincial Engineering Technology Research Center for Medical Artificial Intelligence in Neurological Disease, Shenzhen, Guangdong, China., Ren K; GYENNO Science Co., Ltd., Shenzhen, China.; HUST-GYENNO CNS Intelligent Digital Medicine Technology Center, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, Hubei, China.; Guangdong Provincial Engineering Technology Research Center for Medical Artificial Intelligence in Neurological Disease, Shenzhen, Guangdong, China., Ling Y; GYENNO Science Co., Ltd., Shenzhen, China.; HUST-GYENNO CNS Intelligent Digital Medicine Technology Center, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, Hubei, China.; Guangdong Provincial Engineering Technology Research Center for Medical Artificial Intelligence in Neurological Disease, Shenzhen, Guangdong, China., Chen Z; GYENNO Science Co., Ltd., Shenzhen, China.; HUST-GYENNO CNS Intelligent Digital Medicine Technology Center, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, Hubei, China.; Guangdong Provincial Engineering Technology Research Center for Medical Artificial Intelligence in Neurological Disease, Shenzhen, Guangdong, China., Huang W; Department of Neurology, Jiangxi Medical College, Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Πηγή: JMIR mHealth and uHealth [JMIR Mhealth Uhealth] 2026 Jun 24; Vol. 14, pp. e69273. Date of Electronic Publication: 2026 Jun 24.
Τύπος έκδοσης: Journal Article; Research Support, Non-U.S. Gov't
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: JMIR Publications Inc Country of Publication: Canada NLM ID: 101624439 Publication Model: Electronic Cited Medium: Internet ISSN: 2291-5222 (Electronic) Linking ISSN: 22915222 NLM ISO Abbreviation: JMIR Mhealth Uhealth Subsets: MEDLINE
Imprint Name(s): Original Publication: Toronto: JMIR Publications Inc., [2013]-
Ιατρικοί όροι (MeSH): Parkinson Disease*/complications , Parkinson Disease*/psychology , Parkinson Disease*/physiopathology , Parkinson Disease*/diagnosis , Cognitive Dysfunction*/diagnosis , Cognitive Dysfunction*/psychology , Cognitive Dysfunction*/classification , Cognitive Dysfunction*/physiopathology , Gait Analysis*/methods , Gait Analysis*/instrumentation , Gait Analysis*/statistics & numerical data , Gait Analysis*/standards , Cognition*/physiology , Cognition*/classification, Humans ; Female ; Male ; Aged ; Middle Aged ; Machine Learning ; Dual-Task Tests
Περίληψη: Background: Patients with Parkinson disease (PD) along with subjective cognitive decline (PD-SCD) are considered an intermediate status between those with normal cognition (PD-NC) and those with mild cognitive impairment (PD-MCI). Wearable digital monitoring technologies and machine learning models offer significant potential for assessing cognitive impairment in patients with PD.
Objective: We aimed to evaluate the utility of wearable technology and machine learning for identifying ordinal cognitive stages (OCS) in PD based on timed up and go (TUG) tests (including single-task TUG [TUGst] and dual-task TUG [TUGdt]).
Methods: Patients with PD along with SCD, MCI, and NC were recruited in a movement disorder clinic. Patients performed TUGst and TUGdt gait trials wearing a motor function and motor symptom quantitative assessment system. In total, 209 kinematic parameters were synthesized for individual TUG to illustrate patients' motion profiles. We constructed dual-task cost parameters (DTC), describing the magnitude of the effect of the cognitive challenge on motion performance. Covariate-adjusted ordered logistic regression was used to compare parameter differences among 3 groups. Multiple machine learning models were used to classify the participants into 3 cognitive impairment levels, with features being selected based on P values from intergroup statistical tests. The total population was randomly divided into a training set and an independent validation set in a 7:3 ratio, and 10-fold cross-validation was used in the training set. Furthermore, this study used permutation importance and Shapley Additive Explanations (SHAP) analysis (including summary plots, bar plots, and waterfall plots) to explain the feature importance of the final model.
Results: The study included 65 age-matched patients (PD-NC: PD-SCD: PD-MCI= 14:21:30). Forty-five kinematic parameters were significantly different (P<.05) among the 3 groups, distributed across TUGst (n=25), TUGdt (n=12), and DTC (n=8) paradigms. Gait phase analysis revealed 35 parameters from walking phases, 9 from stand-to-sit transitions, and 1 from sit-to-stand transitions. Feature type distribution demonstrated predominance of variability features (n=20), followed by pace (n=12) and axial (n=8) characteristics. TUGdt paradigm analysis revealed pronounced movement differences between PD-MCI and both PD-NC and PD-SCD groups, particularly in variability, amplitude, pace, and axial domains. Cross-paradigm analysis identified consistent significant differences in specific features. These findings provide objective kinematic biomarkers for early cognitive state identification in Parkinson disease, with TUGdt parameters demonstrating superior discriminative capacity.
Conclusions: This suggests patients with PD-SCD could have early kinetic signs of cognitive impairment, positioning them between PD-NC and PD-MCI, and our multiclass support vector machine classification model with kinematic parameters achieved a recall rate above 0.70 in both training and validation datasets. The feature importance analysis revealed that DTC_Trunk-Right Rotation Max, DTC_Trunk-Max Transverse Angular Velocity, and dTUG_Lumbar-Right Sway Max Std were the most critical features for distinguishing cognitive states, providing scientific evidence for cognitive function screening based on kinematic parameters.
(©Juan Huang, Lingyu Wu, Hui Wang, Lin Chen, Binbin Hu, Fei Zhang, Kang Ren, Yun Ling, Zhonglue Chen, Wei Huang. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 24.06.2026.)
References: Ageing Res Rev. 2022 Feb;74:101508. (PMID: 34740867)
JAMA Neurol. 2017 Jul 1;74(7):857-865. (PMID: 28505243)
Neurol Sci. 2022 May;43(5):3153-3163. (PMID: 34820745)
Dement Neurocogn Disord. 2018 Jun;17(2):57-65. (PMID: 30906393)
Front Neurol. 2024 Jul 11;15:1354092. (PMID: 39055321)
Int J Geriatr Psychiatry. 2009 Aug;24(8):865-74. (PMID: 19259973)
Front Aging Neurosci. 2022 Mar 01;14:781480. (PMID: 35299943)
Ann Clin Transl Neurol. 2021 Oct;8(10):2096-2104. (PMID: 34595848)
Mov Disord. 2019 Aug;34(8):1164-1173. (PMID: 31091347)
J Gerontol A Biol Sci Med Sci. 2023 Aug 2;78(8):1348-1354. (PMID: 37067827)
Alzheimers Dement. 2014 Nov;10(6):844-52. (PMID: 24798886)
Front Aging Neurosci. 2023 May 26;15:1117068. (PMID: 37304074)
Nat Mach Intell. 2020 Jan;2(1):56-67. (PMID: 32607472)
Neuroscience. 2014 Apr 18;265:83-94. (PMID: 24508154)
J Gerontol A Biol Sci Med Sci. 2008 Dec;63(12):1380-8. (PMID: 19126852)
Appl Neuropsychol Adult. 2015;22(4):287-92. (PMID: 25495957)
J Neurol. 2023 Apr;270(4):2283-2301. (PMID: 36725698)
Cereb Cortex. 2008 Jun;18(6):1374-83. (PMID: 17928332)
Neural Regen Res. 2025 Feb 1;20(2):485-486. (PMID: 38819059)
Neurology. 2023 Jul 4;101(1):e12-e19. (PMID: 37188539)
PLoS One. 2024 May 16;19(5):e0303644. (PMID: 38753740)
Funct Neurol. 2017 Jan/Mar;32(1):28-34. (PMID: 28380321)
Disabil Rehabil. 2008;30(16):1213-21. (PMID: 18608374)
Parkinsonism Relat Disord. 2022 Jan;94:104-110. (PMID: 34906915)
J Clin Exp Neuropsychol. 2006 Oct;28(7):1127-44. (PMID: 16840240)
Front Psychol. 2020 Jul 29;11:1256. (PMID: 32903649)
Parkinsonism Relat Disord. 2020 Nov;80:127-132. (PMID: 32987359)
Parkinsonism Relat Disord. 2019 May;62:28-35. (PMID: 30594454)
J Neurol. 2012 Aug;259(8):1706-12. (PMID: 22289965)
Parkinsonism Relat Disord. 2020 Jan;70:15-19. (PMID: 31786424)
Mov Disord. 2008 Nov 15;23(15):2129-70. (PMID: 19025984)
Cortex. 2013 Nov-Dec;49(10):2845-52. (PMID: 24079917)
Mov Disord. 2012 Oct;27(12):1536-43. (PMID: 23032876)
J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62. (PMID: 14399272)
Front Aging Neurosci. 2021 Dec 24;13:769462. (PMID: 35002676)
Hum Brain Mapp. 2015 Apr;36(4):1484-93. (PMID: 25504964)
Sensors (Basel). 2023 Feb 10;23(4):. (PMID: 36850582)
Neuroscience. 2016 Jan 28;313:99-109. (PMID: 26608123)
J Am Geriatr Soc. 2005 Apr;53(4):695-9. (PMID: 15817019)
J Neurol. 2021 Jan;268(1):337-345. (PMID: 32804281)
J Neurol Neurosurg Psychiatry. 2008 Jul;79(7):760-6. (PMID: 18006652)
Gait Posture. 2013 Sep;38(4):555-62. (PMID: 23489950)
J Neural Transm (Vienna). 2016 May;123(5):495-501. (PMID: 27032775)
Mov Disord. 2020 Aug;35(8):1396-1405. (PMID: 32369660)
Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2019 Jul;26(4):521-530. (PMID: 29985737)
J Int Neuropsychol Soc. 2021 May;27(5):439-449. (PMID: 33292885)
Front Aging Neurosci. 2017 Dec 21;9:423. (PMID: 29311906)
Neurosci Biobehav Rev. 2016 May;64:326-45. (PMID: 26915926)
Eur J Neurol. 2021 Dec;28(12):4022-4030. (PMID: 34478599)
Br J Med Psychol. 1959;32(1):50-5. (PMID: 13638508)
J Am Geriatr Soc. 2012 Nov;60(11):2127-36. (PMID: 23110433)
Funct Neurol. 2014 Apr-Jun;29(2):99-105. (PMID: 25306119)
J Alzheimers Dis. 2018;63(3):1015-1024. (PMID: 29710711)
JAMA Netw Open. 2022 May 2;5(5):e2214647. (PMID: 35639376)
Parkinsons Dis. 2010 Jun 30;2010:. (PMID: 20948888)
Arch Gen Psychiatry. 2011 Aug;68(8):845-52. (PMID: 21810648)
J Alzheimers Dis. 2019;71(s1):S65-S73. (PMID: 30814353)
Parkinsonism Relat Disord. 2016 Dec;33:107-114. (PMID: 27733275)
Alzheimers Dement. 2021 Aug;17(8):1317-1328. (PMID: 33590967)
Eur J Neurol. 2014 Oct;21(10):1276-84, e77. (PMID: 24909761)
Front Neurol. 2021 Nov 23;12:749471. (PMID: 34887827)
N Engl J Med. 2000 Aug 17;343(7):450-6. (PMID: 10944562)
Nat Rev Dis Primers. 2021 Jul 1;7(1):47. (PMID: 34210995)
Maturitas. 2016 Nov;93:73-77. (PMID: 27240713)
Neuropsychology. 2006 Mar;20(2):215-23. (PMID: 16594782)
J Neurol. 2012 Sep;259(9):1808-13. (PMID: 22310940)
Am J Manag Care. 2017 Apr;23(5 Suppl):S83-S92. (PMID: 28715903)
Contributed Indexing: Keywords: Parkinson disease; kinematic parameters; machine learning; mild cognitive impairment; subjective cognitive decline; wearable sensor
Entry Date(s): Date Created: 20260624 Date Completed: 20260624 Latest Revision: 20260911
Update Code: 20260911
PubMed Central ID: PMC13347079
DOI: 10.2196/69273
PMID: 42341295
Βάση Δεδομένων: MEDLINE