Scope of our Motor Function Research
Motor Function Outcomes for Clinical Research and Care
Motor symptoms like incoordination of movement, gait disturbance or tremor are frequently encountered in CNS disorders and contribute to disease-related disability. Symptom assessment has great relevance for treatment decisions in neuroimmunological disorders like multiple sclerosis or neuromyelitis optica. Further, clinical trials in these disorders use motor endpoints to monitor the efficacy of novel therapeutic agents. Thus, reliable and sensitive motor outcomes will improve diagnostics and improve the validity of trial results.
Visuo-perceptive Computing and Sensor-based Motor Function Assessment
Our research focuses on the development of visuo-perceptive motion capture. We aim to integrate latest technology to provide a quantitative assessment of motor function that may complement clinical or patient-based ratings in both, research settings and at the point-of-care. This includes reliable and valid quantification of well-described motor symptoms that occur in multiple sclerosis as well as research on innovative measures for non-motor symptoms like fatigue or attentional deficits based on quantitative motor testing. Other lines of research include sensor-based gait analysis and long-term assessment of motor function.
Pathology of Motor Dysfunction in Autoimmune Neuroinflammatory Disorders
Symptomatic treatment of motor dysfunction requires understanding how and why symptoms develop. We combine structural and functional MRI with quantitative assessment of motor dysfunction in autoimmune neuroinflammatory disorders like multiple sclerosis or neuromyelitis optica to further understand development of symptoms.
Examples of Recent Research Projects
Perceptive Assessment Battery for MS
The increasing capabilities of consumer sensors are making the way we interact with computing devices more natural, intuitive and immersive. Devices are able to perceive human actions through gestures and motion sensing. This visuo-perceptive computing (VPC) is poised to profoundly alter medical and health applications by allowing reliable and quantitative everywhere-assessment of clinical symptoms.
We research and develop VPC solutions to measure motor function for next generation medicine and clinical research. The Perceptive Assessment Battery for Multiple Sclerosis (PASS-MS) is a set of assessments specifically selected to measure motor dysfunction in Multiple Sclerosis patients. It takes 20 minutes to administer and consists of the following tests:
- POCO: Stance with open and closed Eyes
- POCO-DUAL: Dual Task Stance
- SIP: Stepping In Place
- SCSW: Short Walk with Comfortable Speed
- SMSW: Short Walk with Maximum Speed
- SLW: Short Line Walk
- SAS: Stand up and Sit Down Test
- PDT: Pronator Drift Test
- FNAC: Finger Nose Test
- FTT: Finger Tapping Test
- TTT: Triangular Line Tracking Task
- LTT: Line Tracking Task
- TAT: Truncal Ataxia during Sitting with Open and Closed Eyes
PASS-MS is developed in cooperation with and is available from our technology start-up Motognosis.
Postural Control in Multiple Sclerosis
Multiple sclerosis (MS) patients frequently have postural control impairment, but quantitative posturography is difficult to perform in clinical care. Objective of this project was to evaluate construct validity of visual perceptive computing (VPC) for static posturography and to study postural control in MS patients.
A total of 90 MS patients and 59 healthy controls (HCs) performed three stance tests: open, closed and tandem stance. Static posturography was performed using a VPC system with Microsoft Kinect. Clinical assessments included Expanded Disability Status Scale (EDSS), Timed-25-Foot-Walk, Short-Maximum-Speed-Walk and 12-item MS Walking Scale (MSWS-12) questionnaire. Reliability was assessed with intra-class correlation coefficients at retest.
As a group, MS patients performed worse than HCs in all tests. The closed stance test showed best applicability and reliability. With closed eyes, in 36.7% of patients, the 3D mean angular sway velocity (MSV-3D) was above HCs’ 95th percentile. Higher MSV-3D was associated with decreased walking speed; worse clinical scores, mainly attributable to the cerebellar functional system score; and reflected in self-reported walking disability.
In summary, postural control can be reliably assessed by VPC-based static posturography in patients with MS. Abnormal postural control seems to predominantly reflect involvement of cerebellar circuits with impact on gait and walking disability.
Behrens et al. 2016 (PMID 26814201)
Krüger T, Behrens JR, Grobelny A, Otte K, Mansow-Model S, Kayser B, Bellmann-Strobl J, Brandt AU, Paul F, Schmitz-Hübsch T. Subjective and objective assessment of physical activity in multiple sclerosis and their relation to health-related quality of life. BMC Neurol. 2017 Jan 13;17(1):10. PMID: 28086828
Otte K, Kayser B, Mansow-Model S, Verrel J, Paul F, Brandt AU, Schmitz-Hübsch T. Accuracy and Reliability of the Kinect Version 2 for Clinical Measurement of Motor Function. PLoS One. 2016 Nov 18;11(11):e0166532. PMID: 27861541.
Schmitz-Hübsch T, Brandt AU, Pfueller C, Zange L, Seidel A, Kühn AA, Paul F, Minnerop M, Doss S. Accuracy and repeatability of two methods of gait analysis - GaitRite™ und Mobility Lab™ - in subjects with cerebellar ataxia. Gait Posture. 2016 Jul;48:194-201. PMID: 27289221.
Behrens JR, Mertens S, Krüger T, Grobelny A, Otte K, Mansow-Model S, Gusho E, Paul F, Brandt AU, Schmitz-Hübsch T. Validity of visual perceptive computing for static posturography in patients with multiple sclerosis. Mult Scler. 2016 Oct;22(12):1596-1606. PMID: 26814201.
Hoffmann S, Siedler J, Brandt AU, Piper SK, Kohler S, Sass C, Paul F, Reilmann R, Meisel A. Quantitative motor assessment of muscular weakness in myasthenia gravis: a pilot study. BMC Neurol. 2015 Dec 23;15:265. PMID: 26701600.
Behrens J, Pfüller C, Mansow-Model S, Otte K, Paul F, Brandt AU. Using perceptive computing in multiple sclerosis - the Short Maximum Speed Walk test. J Neuroeng Rehabil. 2014 May 27;11:89. PMID: 24886525.