基于虚拟现实的评估系统对上肢共济失调的定量评估。

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY
Masayuki Sato, Takayuki Abe, Sho Aoki, Setsuki Tsukagoshi, Yasushi Yuminaka, Yoshio Ikeda
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引用次数: 0

摘要

目的:小脑共济失调损害协调性和平衡性,降低生活质量。传统的临床量表,包括共济失调评定量表(SARA)和国际合作共济失调评定量表(ICARS),被广泛用于评估共济失调,但受主观性和量表间可变性的限制。因此,我们旨在开发一种基于虚拟现实的系统来客观定量地评估上肢共济失调。方法:使用头戴式显示器实施“虚拟鼻子-手指测试”,参与者执行重复的伸手任务。测量了6个参数:4个空间参数(减去长度、轨迹比、末端轨迹长度和最大超冲距离)和2个时间参数(所需时间和运动速度)。这些参数在组间进行比较,与临床量表相关,并使用受试者工作特征曲线分析诊断准确性。通过试验参数的变化来评估运动适应性。结果:招募了95名参与者:39名患有小脑性共济失调,30名对照组,26名患有帕金森病。与其他组相比,共济失调的参与者表现出更大的空间偏差和时间变异性。运动轨迹比、所需时间、运动速度变异性系数与临床共济失调评分显著相关。该系统显示出较高的诊断准确性,通过降低运动速度来补偿空间误差,共济失调患者表现出不同的运动适应性。解释:这种基于虚拟现实的系统能够客观、定量、便携和动态独立地评估上肢共济失调,增强其在临床和研究环境中的可行性,以及作为小脑共济失调生物标志物的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quantitative Assessment of Upper Limb Ataxia Using a Virtual Reality-Based Evaluation System.

Objective: Cerebellar ataxia impairs coordination and balance, reducing quality of life. Conventional clinical scales, including the Scale for the Assessment and Rating of Ataxia (SARA) and the International Cooperative Ataxia Rating Scale (ICARS), are widely used to assess ataxia but are limited by subjectivity and inter-rater variability. Therefore, we aimed to develop a virtual reality-based system to objectively and quantitatively assess upper limb ataxia.

Methods: A "virtual nose-finger test" was implemented using a head-mounted display, in which participants performed repetitive reaching tasks. Six parameters were measured: four spatial (subtracted length, trajectory ratio, terminal trajectory length, and maximum overshoot distance) and two temporal (required time and movement speed). These parameters were compared across groups, correlated with clinical scales, and analyzed for diagnostic accuracy using receiver operating characteristic curves. Motor adaptation was assessed using parameter changes across trials.

Results: Ninety-five participants were recruited: 39 with cerebellar ataxia, 30 controls, and 26 with Parkinsonian disorders. Participants with ataxia exhibited significantly greater spatial deviations and temporal variability than other groups did. Trajectory ratio, required time, and movement speed variability coefficient significantly correlated with clinical ataxia scores. The system demonstrated high diagnostic accuracy from the receiver operating characteristic analyses, and participants with ataxia showed different motor adaptations by compensating for spatial errors through reduced movement speed.

Interpretation: This virtual reality-based system enables objective, quantitative, portable, and ambulatory-independent evaluation of upper limb ataxia, enhancing its feasibility in clinical and research settings and its potential as a biomarker for cerebellar ataxia.

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来源期刊
Annals of Clinical and Translational Neurology
Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)
CiteScore
9.10
自引率
1.90%
发文量
218
审稿时长
8 weeks
期刊介绍: Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.
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