Can we predict who is at risk of facing cognitive issues in PD and address them earlier? These are the questions being pursued by Dr. Goldman of the PDF Research Center at Rush University Medical Center.
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Mobile devices such as smart phones and tablets have become part of daily life. Already there are applications, or “apps”, to help people with Parkinson’s disease (PD) remember to take medications on time or record their symptoms. Last summer, Sarah Ozinga recognized that these devices could also be put to work for another purpose and with support from PDF, she turned the iPad into a tool for measuring balance in people with PD. And she has her eye on using it as a means to help people with PD who have undergone deep brain stimulation (DBS) to achieve the best results from their surgery.
Mrs. Ozinga is pursuing her doctorate in biomedical engineering in a collaborative program with Cleveland State University and Cleveland Clinic, in Ohio. She studied the iPad for Parkinson’s as part of her dissertation research, in the laboratory of her mentor Jay Alberts, Ph.D. The project was launched with support from a PDF Summer Fellowship, a program which last year provided financial support to 15 students who, like Mrs. Ozinga, have ideas for advancing Parkinson’s research.
When Mrs. Ozinga joined the Alberts lab, she found that a group of colleagues were using iPads to measure the symptoms of concussions in athletes. She had worked with people with PD for several years, and she knew that balance difficulties are one of PD’s defining motor symptoms. Yet Mrs. Ozinga also knew that measuring a person’s balance, also called postural stability, is not simple. For one thing, the rating scales that clinicians customarily use to measure balance are often subjective. And while there are tools that offer precise measurements, they are expensive and time-consuming to carry out.
She also knew that the iPad comes with a built-in accelerometer and gyroscope, hardware that can measure movement. This device, she speculated, might have the capacity to sense the ways in which a person sways forward and backward, or side-to-side, while he or she is trying to maintain balance.
She used her PDF Fellowship to test the theory, by designing and testing an app that would enable the iPad to collect and store balance data when the device was strapped to a person’s lower back.
She also considered whether the iPad might be used to help with a set of challenges that are often encountered by people with Parkinson’s following DBS. In this surgical procedure, electrodes are implanted into a part of the brain that helps control the disabling tremors and dyskinesias that can accompany Parkinson’s. After surgery, it takes time for people with PD and their clinicians to find the ideal settings on their DBS programmers, during which time they may experience changes in movement and cognition. Mrs. Ozinga found a way to combine her app for balance, along with the DBS programmer data (for movement and memory), to potentially make it easier to find a person’s optimal level of electrical stimulation.
The initial results of her PDF-funded research show that the two tests together provide an objective means of determining the optimal settings for DBS stimulation, which would help to ease and control a person’s symptoms after surgery. More research will be needed before this tool is made available. In fact, Mrs. Ozinga is now recruiting participants for studies to further evaluate the potential for iPad apps in Parkinson’s.
Eventually, she hopes, “Using this portable product will make it easier for people to know if their DBS settings are working and to send that information automatically to their doctors.”
After she finishes her Ph.D. dissertation, what comes next? She says, “I picture myself staying in research, studying ways to use technology to help solve real-life issues for people with PD.”
Ms. Ozinga’s research was funded via PDF’s Summer Student Fellowships. In FY2014, PDF is investing $40,000 in this program.