Objective: To study the crude prevalence and age-standardized prevalence of Parkinson’s disease in community-dwelling adults >18 years of age, in an urban setting in North India

Background: Parkinson disease and related parkinsonian disorders are frequently underdiagnosed in community settings, particularly in regions with limited access to specialized neurological services. Availability of reliable screening tools remains a challenge for estimating PD prevalence, as commonly used screening questionnaires show limited sensitivity in community populations. We plan to utilize Spiral Dx along with a validated PD screening questionnaire for door to door screening to estimate PD prevalence.

Method: This population based cross sectional study will be conducted in two urban communities in New Delhi India. Adults aged above 18 years will undergo screening using both the Spiral Dx algorithm, which analyzes free hand spiral drawings, and the modified Tanner questionnaire for PD. Individuals screening positive on either test will undergo secondary evaluation including MDS UPDRS, MoCA, FOG Q and NMSS, along with brain MRI and TRODAT SPECT when indicated. Demographic, socioeconomic and PD risk factor data will also be collected. Final diagnosis of PD will be confirmed by movement disorder specialists according to the MDS clinical diagnostic criteria. Door to door sampling will be performed within an ongoing LoCARPoN cohort and approximately 7000 individuals are expected to be screened.

Results: Data will be collected using a REDCap based electronic data capture platform. Crude and age standardized prevalence of PD will be calculated per 100000 population. Diagnostic performance of Spiral Dx and questionnaire screening will be evaluated using sensitivity, specificity, positive and negative predictive values. The study is approved by the Institutional Ethics Committee, AIIMS-ND [IEC No. A4719]

Conclusion: We expect to generate population based data on PD prevalence in North India and evaluate the real world utility of an artificial intelligence based spiral analysis tool for community screening. The approach may provide a scalable strategy for early detection and referral of movement disorders in settings with limited access to specialist care.

References: 1. Automated analysis of pen-on-paper
spirals for tremor detection,
quantification, and differentiation
Roopa Rajan, Reghu Anandapadmanabhan, Sharmila Nageswaran1,
Vineeth Radhakrishnan2, Arti Saini, Syam Krishnan2, Anu Gupta,
Venugopalan Y. Vishnu, Awadh K. Pandit, Rajesh Kumar Singh,
Divya M Radhakrishnan, Mamta Bhushan Singh, Rohit Bhatia, Achal Srivastava,
Asha Kishore2,3, M V Padma Srivastav

2. Validity of a Modified Parkinson’s Disease Screening
Questionnaire in India: Effects of Literacy of Participants and
Medical Training of Screeners and Implications for Screening
Efforts in Developing Countries
Nagaraja Sarangmath, MBBS,1 Rohini Rattihalli, MBBS,1 Mona Ragothaman, MBBS,1
Gururaj Gopalkrishna, MD,2 Subbakrishna Doddaballapur, PhD,3 Elan D. Louis, MD,4
and Uday B. Muthane, DM1*
1Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
2Departments of Epidemiology, National Institute of Mental Health and Neurosciences, Bangalore, India
3Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India
4Gertrude H. Sergievsky Center and Department of Neurology, College of Physicians and Surgeons,
Columbia University, New York, New York, USA

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MDS Abstracts - https://www.mdsabstracts.org/abstract/spiral-dx-real-world-evaluation-of-an-artificial-intelligence-algorithm-for-tremor-detection-from-hand-drawn-spirals-community-study-protocol-of-a-population-screening-study-for-parkinson-disease/