% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@ARTICLE{Hermle:282538,
author = {Hermle, Dominik and Schubert, Robin and Barallon, Pascal
and Ilg, Winfried and Schüle, Rebecca and Reilmann, Ralf
and Synofzik, Matthis and Traschütz, Andreas},
title = {{D}igital {O}utcomes of {U}pper {L}imb {A}taxia {C}apture
{M}eaningful {L}ongitudinal {C}hange and {T}reatment
{R}esponse},
journal = {Movement disorders},
volume = {40},
number = {11},
issn = {0885-3185},
address = {New York, NY},
publisher = {Wiley},
reportid = {DZNE-2025-01301},
pages = {2486 - 2496},
year = {2025},
abstract = {BackgroundDigital-motor outcomes promise better
responsiveness than clinician-reported outcomes in ataxia
trials. However, their patient meaningfulness and
sensitivity to change remain to be demonstrated,
particularly in the upper limb domain.ObjectivesValidation
of quantitative motor (Q-Motor) assessment for upper limb
ataxia against patient-reported outcomes and regarding
sensitivity to both longitudinal and treatment-induced
change, the latter in n-of-1 treatment
settings.MethodsSingle-center longitudinal assessment of
finger tapping, diadochokinesia, grip-lift, spiral drawing,
and target reaching in (1) 36 cross-genotype ataxia patients
and 20 controls, validating digital measures for
correlations with patient-reported outcome measure
(PROM)-ataxia, 2-weeks test–retest reliability, and
sensitivity to change within a trial-relevant 1-year
follow-up, anchored in Patient Global Impression of Change
(PGI-C); and (2) two patients with spinocerebellar ataxia
type 27B (SCA27B) on versus off treatment with
4-aminopyridine.ResultsTwenty-four digital measures
correlated with the PROM-ataxia upper-limb composite
(|ρ| = 0.4–0.7) and had excellent test–retest
reliability (ICC = 0.91–0.99). Correlations to
individual PROM-ataxia items were specific for functional
impairment the respective measure was hypothesized to
capture. Speed of finger tapping and diadochokinesia, and
smoothness of target reaching (spectral arc length of
movement in three dimensions [SPARC3D]) captured 1-year
progression in ataxia patients (|rprb| = 0.38–0.51),
and specifically in patients with worsening PGI-C. Estimated
sample sizes to detect longitudinal change were lower for
digital than clinical outcomes (SPARC3D: n = 33, Scale
for the Assessment and Rating of Ataxia (SARA): n = 79,
nine-hole peg-test: n = 214). Speed of diadochokinesia,
stability of grip-lift, and variability of target reaching
captured treatment responses to 4-aminopyridine in SCA27B,
exceeding minimal detectable and minimal important
change.ConclusionDigital upper limb measures capture
patient-meaningful 1-year longitudinal and treatment-induced
change, and are therefore promising outcomes for upcoming
ataxia trials. © 2025 The Author(s). Movement Disorders
published by Wiley Periodicals LLC on behalf of
International Parkinson and Movement Disorder Society.},
cin = {AG Gasser},
ddc = {610},
cid = {I:(DE-2719)1210000},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
doi = {10.1002/mds.70012},
url = {https://pub.dzne.de/record/282538},
}