None listed
Conditions
Brief summary
The prevalence of dementia in Australia is expected to triple by 2051. Over 165,000 Australians are affected by Alzheimer's disease (AD), and it is expected that 500,000 Australians will be diagnosed by 2040. AD is currently incurable. Motor signs of AD include problems with speech/facial expression, rigidity, balance, posture/gait, bradykinesia (slowed ability to start and continue movements), tremor, incoordination, apraxia (inability to perform coordinated movements or manipulate objects) and dysarthria (difficulty articulating words). Current clinical rating scales lack sensitivity, have floor or ceiling effects (task items too challenging or not challenging enough), and require long observation periods to show changes. There are no known currently used quantitative assessments of motor signs in AD. This pioneering study uses four isometric motor tasks as novel objective and quantitative measures for the assessment of observable motor characteristics and dysfunction in AD. Twenty participants diagnosed with mild to moderate AD, both women and men, and 20 cognitively healthy and age-matched control participants will complete these motor tasks, in addition to tasks measuring cognitive performance and level of dementia. The performance of participants with AD will be compared to the healthy control participants. Knowledge of the characteristics of motor signs in AD is important, given their predictive ability for rates of cognitive decline and mortality and their association with increased cost of care. Assessment of the variability of tongue protrusion forces, grip force, and tapping may provide objective and quantitative measures that (1) provides much needed empirical data on the motor symptoms of AD and help elucidate a motor pattern, and (2) correlates with illness severity (thus may be a measure of disease progression). This knowledge, in addition to improvements in the efficiency and precision of objective measurements of disease progression in individuals with AD, could lead to techniques that are better able to assess disease progression and measure effectiveness of therapeutic interventions.
Interventions
This study uses four isometric computerised motor tasks as novel objective and quantitative measures for the assessment of observable motor characteristics and dysfunction in AD.
Assessment of the variability of tongue protrusion forces, grip force, and tapping may provide objective and quantitative measures that (1) provides much needed empirical data on the motor symptoms of AD and help elucidate a motor pattern, and (2) correlates with illness
severity (thus may be a measure of disease p
This study uses four isometric computerised motor tasks as novel objective and quantitative measures for the assessment of observable motor characteristics and dysfunction in AD. Assessment of the variability of tongue protrusion forces, grip force, and tapping may provide objective and quantitative measures that (1) provides much needed empirical data on the motor symptoms of AD and help elucidate a motor pattern, and (2) correlates with illness severity (thus may be a measure of disease progression). Initials, date of birth and medical history will be recorded. For the study, a number of examinations and tests will be completed. The study will take place in Normanby House, Kew in one visit and will take approximately one hour. The visit will involve: a) Tests to measure mental functioning, everyday functioning, and thinking ability (MMSE) b) A neurological examination and a rating of physical/motor function (UPDRS) c) The four motor tasks use a force transducer sensor. All participants complete all four tasks. Task 1.Grip force analysis task. This assesses the coordination of the grip between thumb and index finger. Both hands are tested by lifting and holding 1) a light weight, and 2) a heavy weight. Five trials of 35 seconds duration will be performed with each hand. Duration: 15 minutes. Task 2. Grip force matching task. Participants will try to match grip to the target force on the computer (with visual feedback). Both hands are tested. Duration: 5 minutes. Task 3. Tapping tasks. Using the index finger, participants will tap the sensor in a number of different conditions (speeded tapping, speeded tapping with serial 2s, tone paced tapping, and self-paced tapping). Duration: 5 minutes. Task 4. Tongue force task. With their tongue on the force transducer, participants will need to match and maintain a specified force level for 20 seconds. Duration: 10 minutes. All AD participants will be on stable dosages of AD medication for at least 6 months (any dosage), as we are screening for participants on stable AD therapy. This also limits side effect confounders.
Sponsors
The University of Melbourne, AUPOA
Study design
Allocation
Non-randomised trial
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
20 cognitively healthy and age-matched control participants. Patients with mild-to-moderate Alzheimer’s Disease (MMSE between 10-24), both women and men, who are on stable treatment. Stable treatment means that participants will be on treatment on a stable dose (any dose) for at least six months prior to the Study Day 1 (baseline visit). Treatment can be the cholinesterase inhibitors donezepil, galantamine, rivastigmine, or the NMDA glutamate blocking drug memantine. Only individuals who are clinically free of extrapyramidal signs or parkinsonism to be included.
Exclusion criteria
Control participants will be used, who will be cognitively healthy (inclusion criteria - no diagnosis of dementia) Exclusion criteria: (1) other co-existing chronic neurological diseases, (2) arthritis or orthopedic disorders, (3) active psychosis, (4) upper extremity weakness (5) incapability of following simple verbal instructions, or (6) visual or other impairments that would interfere with completion of the tasks. Rationale for excluding upper extremity weakness – as the experimental tasks involve gripping and tapping with the hands, we wish to exclude those with known pre-existing difficulties that would confound our results. Those with upper extremity weakness include those with weakness due to stroke, peripheral neuropathy, those with orthopaedic diagnoses, spinal cord injuries, or have any condition or reason that, in the opinion of the research team, interferes with the ability of the patient to participate in or complete the trial, which places the patient at undue risk, or complicates the interpretation of data.
Outcome results
None listed