Objective: This study aims to provide quantitative markers of prodromal motor symptoms of idiopathic Parkinson’s disease (PD) from circular walking assessment with a single body-fixed-sensor.

Background: There is an urgent need for objective characterization of PD prodromal impairments to facilitate an early diagnosis and potentially support the development of neuroprotective therapies.

Method: We included 102 subjects from a nine-year prospective cohort study (712 participants) in a nested case-control analysis: 16 diagnosed with PD during follow-up (incident PD) and 96 healthy controls, matched by sex, age and education level with a 1:6 ratio. Forty-one gait features were extracted from baseline assessments with accelerometry during single and dual (counting backwards, drawing crosses on a paper sheet) task circular walking. Non-correlated gait features were compared between cohorts with a Cox proportional hazards regression analysis. These test temporal associations of gait features, and their interaction with trial duration (as indicator of gait speed), to the probability of being diagnosed with PD.

Results: We identified associations between time (from baseline measurement) to PD diagnosis for eleven gait features, mostly based on harmonic ratios, step and stride variability, and index of harmonicity, partially in combination with gait speed. Most significant associations indicated that low gait symmetry and low rhythmicity were associated with larger hazard of PD diagnosis. Area under the curve ranged between 0.63 and 0.69.

Conclusion: Despite low sensitivity and specificity, the findings potentially reflect prodromal motor impairments of PD manifested during circular walking, assessed quantitatively with a low-cost and wearable instrument. This will contribute to the characterisation of pre-diagnostic motor symptoms of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-predictive-potential-of-circular-walking-in-prodromal-parkinsons-disease/