Assessment and Rating of Motor Cerebellar Ataxias With the Kinect v2 Depth Sensor: Extending Our Appraisal

Takeru Honda; Hiroshi Mitoma; Hirotaka Yoshida; Kyota Bando; Hiroo Terashi; Takeshi Taguchi; Yohane Miyata; Satoko Kumada; Takashi Hanakawa; Hitoshi Aizawa; Shiro Yano; Toshiyuki Kondo; Hidehiro Mizusawa; Mario Manto; Shinji Kakei

doi:10.3389/fneur.2020.00179

Assessment and Rating of Motor Cerebellar Ataxias With the Kinect v2 Depth Sensor: Extending Our Appraisal

Front Neurol. 2020 Mar 11:11:179. doi: 10.3389/fneur.2020.00179. eCollection 2020.

Authors

Takeru Honda^{1

2}, Hiroshi Mitoma³, Hirotaka Yoshida⁴, Kyota Bando², Hiroo Terashi⁵, Takeshi Taguchi⁵, Yohane Miyata⁶, Satoko Kumada⁶, Takashi Hanakawa², Hitoshi Aizawa⁵, Shiro Yano⁴, Toshiyuki Kondo⁴, Hidehiro Mizusawa⁷, Mario Manto⁸, Shinji Kakei¹

Affiliations

¹ Movement Disorders Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
² Department of Advanced Neuroimaging, Integrative Brain Imaging Center (IBIC), National Center of Neurology and Psychiatry, Tokyo, Japan.
³ Medical Education Promotion Center, Tokyo Medical University, Tokyo, Japan.
⁴ Department of Computer and Information Sciences, Tokyo University of Agriculture and Technology, Tokyo, Japan.
⁵ Department of Neurology, Tokyo Medical University, Tokyo, Japan.
⁶ Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
⁷ National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
⁸ Department of Neurosciences, University of Mons, Mons, Belgium.

Abstract

Current assessment of patients with cerebellar disorders is based on conventional neurological examination that is dependent on subjective judgements. Quantitative measurement of cerebellar ataxias (CAs) is essential for assessment of evidence-based treatments and the monitoring of the progress or recovery of diseases. It may provide us a useful tool to navigate future treatments for ataxia. We developed a Kinect v2. sensor system with a novel algorithm to measure and evaluate movements for two tests of Scale for the Assessment and Rating of Ataxia (SARA): the nose-finger test and gait. For the nose-finger test, we evaluated and compared accuracy, regularities and smoothness in the movements of the index finger and the proximal limbs between cerebellar patients and control subjects. For the task of walking, we evaluated and compared stability between the two groups. The precision of the system for evaluation of movements was smaller than 2 mm. For the nose-finger test, the mildly affected patients tended to show more instability than the control subjects. For a severely affected patient, our system quantified the instability of movements of the index finger using kinematic parameters, such as fluctuations and average speed. The average speed appears to be the most sensitive parameter that contrasts between patients with CAs and control subjects. Furthermore, our system also detected the adventitious movements of more proximal body parts, such as the elbow, shoulder and head. Assessment of walking was possible only in patients with mild CAs. They demonstrated large sways and compensatory wide stances. These parameters appeared to show higher accuracy than SARA. This examiner-independent device measures movements of the points of interest of SARA more accurately than eye and further provides additional information about the ataxic movements (e.g., the adventitious movements of the elbow, shoulder and head in the nose-finger test and the wide-based walking with large oscillation in the gait task), which is out of the scope of SARA. Our new system enables more accurate scoring of SARA and further provides additional information that is not currently evaluated with SARA. Therefore, it provides an easier, more accurate and more systematic description of CAs.

Keywords: ICARS; SARA; ataxia; cerebellar degeneration; depth sensor; motor control.