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Research paper
Accelerometer-based quantitative analysis of axial nocturnal movements differentiates patients with Parkinson's disease, but not high-risk individuals, from controls
  1. Maartje Louter1,2,
  2. Walter Maetzler3,
  3. Jos Prinzen4,
  4. Rob C van Lummel4,
  5. Markus Hobert3,
  6. Johan B A M Arends5,6,
  7. Bastiaan R Bloem1,
  8. Johannes Streffer7,
  9. Daniela Berg3,
  10. Sebastiaan Overeem1,2,
  11. Inga Liepelt-Scarfone3
  1. 1Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical centre, Nijmegen, The Netherlands
  2. 2Sleep Medicine Centre Kempenhaeghe, Heeze, The Netherlands
  3. 3Department for Neurodegenerative Diseases, Centre of Neurology, German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
  4. 4McRoberts, Den Haag, The Netherlands
  5. 5Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands
  6. 6Department of Electrical Engineering, University of Technology, Eindhoven, The Netherlands
  7. 7Janssen Research and Development, Janssen-Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
  1. Correspondence to Dr Inga Liepelt-Scarfone, German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Hoppe-Seyler Str. 3, Tuebingen D-72076, Germany; Inga.Liepelt{at}


Introduction There is a need for prodromal markers to diagnose Parkinson’s disease (PD) as early as possible. Knowing that most patients with overt PD have abnormal nocturnal movement patterns, we hypothesised that such changes might occur already in non-PD individuals with a potentially high risk for future development of the disease.

Methods Eleven patients with early PD (Hoehn & Yahr stage ≤2.5), 13 healthy controls and 33 subjects with a high risk of developing PD (HR-PD) were investigated. HR-PD was defined by the occurrence of hyperechogenicity of the substantia nigra in combination with prodromal markers (eg, slight motor signs, olfactory dysfunction). A triaxial accelerometer was used to quantify nocturnal movements during two nights per study participant. Outcome measurements included mean acceleration, and qualitative axial movement parameters, such as duration and speed.

Results Mean acceleration of nocturnal movements was lower in patients with PD compared to controls. Frequency and speed of axial movements did not differ between patients with PD and controls, but mean size and duration were lower in PD. The HR-PD group did not significantly differ from the control group in any of the parameters analysed.

Conclusions Compared with controls, patients with PD had an overall decreased mean acceleration, as well as smaller and shorter nocturnal axial movements. These changes did not occur in our potential HR-PD individuals, suggesting that relevant axial movement alterations during sleep have either not developed or cannot be detected by the means applied in this at-risk cohort.


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