Gait characteristics track biological disease stages in Parkinson’s disease
Gait characteristics track biological disease stages in Parkinson’s disease
Publication status: preprint
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Original abstract
Abstract Parkinson’s disease (PD) exhibits a heterogeneous course, posing challenges for accurate trajectory prediction. The Neuronal Alpha-Synuclein Disease-Integrated Staging System (NSD-ISS) provides a biological framework for staging from at risk to advanced disease. Within this framework, gait characteristics hold promise as quantitative digital markers, as they are sensitive to motor severity. However, their role within the NSD-ISS remains unclear. Using data from the ICICLE-GAIT study, we investigated whether quantitative gait characteristics derived from an instrumented walkway and an accelerometer-based body-worn monitor (BWM) during laboratory assessment differ between stages of the clinically manifest component of the NSD-ISS. Participants with PD were classified as Stage 3 (walkway: n = 40; BWM: n = 35) or Stage 4 (walkway: n = 36; BWM: n = 28). Significant (p < 0.05) differences between stages were observed in gait characteristics across the domains of pace, rhythm, and variability for both systems, whereas postural control differed significantly only for the instrumented walkway. These findings provide proof of concept for the potential role of gait characteristics as objective digital measures within the clinically manifest component of the NSD-ISS. Further research is needed to evaluate the full NSD-ISS and to validate these findings longitudinally and in real-world settings.