Real-Life Turning Movements Capture Subtle Longitudinal and Preataxic Changes in Cerebellar Ataxia

Area of Science:

• Biomedical Engineering
• Neurology
• Movement Science

Background:

• Degenerative ataxias require ecologically valid endpoints for treatment acceptance.
• Real-life movement analysis can capture disease progression and treatment effects.

Purpose of the Study:

• To identify quantitative motor biomarkers in real-life turning movements for degenerative ataxias.
• To assess sensitivity to longitudinal changes and preataxic stages.

Main Methods:

• Combined cross-sectional and longitudinal observational study.
• Included 30 degenerative ataxia patients (8 preataxic) and 23 controls.
• Assessed turning using body-worn inertial sensors in lab and real-life settings.

Main Results:

• Lateral velocity change (LVC) differentiated ataxic from healthy subjects (δ=0.68) and preataxic from healthy subjects (δ=0.53).
• LVC correlated strongly with clinical ataxia severity (SARA, ρ=0.79) and balance confidence (ABC, ρ=0.66).
• LVC detected significant 1-year longitudinal changes (r_prb=0.66), unlike SARA or general turning measures.

Conclusions:

• Turning measures provide sensitive, ecologically valid biomarkers for degenerative ataxias.
• These biomarkers are effective even in early, preataxic stages.
• Promising for clinical trials targeting degenerative cerebellar disease.