Sridhar P. Arjunan - Techniques for Assessment of Parkinsonism for Diagnosis and Rehabilitation

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Parkinsons disease is a disorder of the central nervous system. It is the second most common neurodegenerative disorder, with over 0.5% of the population having this disease. The median age of people first diagnosed with Parkinsons disease is around 65 years, and thus its prevalence is expected to increase with an aging population. With no blood tests, or easily available imaging tests, the presence of two or more motor symptoms of tremor, bradykinesia, rigidity, or postural impairment are considered as the basis for the diagnosis of the disease. Dopamine transporter scan can be performed using Positron Emission Tomography (PET) as confirmatory evidence, which however are yet only available in few places.

The standard tools for the diagnosis and monitoring of PD uses Movement Disorder Society Unified Parkinsons Disease Rating Scale Part III (MDS-UPDRS-III). However, this requires clinical observations and thus has the limitations of clinician bias and potential of missing some of the early symptoms. This results in a loss of sensitivity and specificity. Early stage diagnostics can be missed, and it is also difficult to monitor the effectiveness of treatment and disease progression.

Parkinsons disease is associated with the loss of habitual activity. Walking, speaking, and writing are three activities of people that are habitual to healthy people and have been found to be impaired among the people with Parkinsons disease. PD patients often have dysarthria, or slurring in voice, and display micrographia or handwriting becoming small in the early stages of their disease. These can occur up to 5 years before the tremor. Thus, the use of gait analysis, handwriting analysis, and speech or voice analysis has been proposed for early diagnosis of the disease. The number of researchers have proposed computer-based techniques that can be used to quantify these symptoms and provide objective measures for the clinicians. This field is fast developing and there is an urgent need for technical solutions to get accurate and objective measures of the symptoms so that the disease can be identified in the early stages, and its progression can be monitored.

Scheme for Promotion of Academic and Research Collaboration (SPARC) with the aim of supporting Indian researchers to solve global challenges, has provided a platform to collaborate with international experts for developing this book. The aim of this book is to provide a review along with expert opinions on this very needed issue. We, the authors have assembled this book with the aim of sharing with you the current state of the art and identified potential research directions that will be useful. We are a team of clinicians, engineers, and scientists, and have provided the width of background and expertise through the book and attempted to provide you with the information regarding a large width of technologies. We do hope that you will find this useful, and we will soon have the methods to help reduce the burden of this disease in our society.