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Longitudinal analysis of mimic muscles in patients with Parkinson’s disease
Introduction Anne Heinzl et al. showed with the standardized sonography of mimic muscles of Parkinson's patients significantly reduced muscle cross-sectional areas (difference between contraction and resting value: ♂: 33.1 %, ♀: 36.7 %). This allowed a quantification of the hypomimia for the first time. Based on that, we started a longitudinal analysis of patients with Parkinson’s Disease.
Methods We collect high-resolution ultrasound and 3D facial images of Parkinson’s patients in medical off- and -on state, while these patients are performing voluntary contractions. The sonography data of the muscle dynamics are analyzed by calculating area, diameter and also the max. deflection through speckle tracking. In the 3D facial images, volume difference and skin surface shift between off- and on-state are measured metrically. In addition, mobility impairment is assessed by using the clinical severity score MDS UPDRS III.
Results The quantification of the sonographic video using speckle tracking showed that the muscle mobility was up to 50 % less during the off-state. Using the example of the M. orbicularis oculi, in a patient the deflection of 2.170 mm in on-state changed to 0.892 mm in the off-state. The 3D video recordings show clear intra-individual changes in the skin surface and thus indirectly the muscle tone. Consequently, conclusions about the severity of the disease, but also the effectiveness of drug therapy are possible.
Conclusion Using 3D video and sonography, we can quantify the changes in the muscle dynamics of Parkinson's patients intra-individually for the first time. The previous ultrasound measurements and their quantification by means of speckle tracking, but also the optical 3D videos show clear differences depending on the medication intake.
Article published online:
10 June 2020
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