Defrosting Parkinson's Disease
With our ageing population becoming ever larger, progressive neurological conditions that affect the brain (neurodegenerative diseases) are going to become an increasing challenge for clinicians and society. These neurodegenerative diseases have a variety of presentations and often encompass physical, cognitive and psychiatric symptoms.
Parkinson's disease (PD) is one of the most common of these conditions, affecting 1 in 1000 people over the age of 65. It is characterised by physical symptoms but is also known to significantly affect memory and mood. One of the striking features of the disease is its impact on walking, or gait. Patients are slow and shuffling and may also experience a particular symptom known as Freezing of Gait, where they become unable to walk for no apparent reason. This symptom is highly disabling and also increases the risk of falling with subsequent injury in those individuals it affects.
Using the Virtual Gait Laboratory we are attempting to understand the cause for these symptoms of Freezing, which we hope will lead to clinical advances that will benefit patients and 'Defrost Parkinson's Disease'.
Virtual Gait Laboratory
Participants in the research programme are asked to use a simple two-button input device to control the movement of a character in a simulated three-dimensional environment, visualised from the first-person perspective.
Each left or right button press corresponds to the character taking a step forward using the respective leg. Visual and audible cues are presented to instruct the participant to either walk or stop. An example session can be seen in this sample video (wmv, 13.8MB).
While the simulation is running data points are recorded to a file; including the cues given to the participant, their actions using the button box and various environmental events. The simulation allows for test paradigms of varying complexity to be combined with a selection of virtual environments, providing fine control over the cognitive load placed on the participant.
Software
The virtual environment is constructed using the idTech4 technology from id Software (Texas, USA). This is achieved by creating a modification ("mod") based on the game Quake 4, the source code for which id Software make freely available for non-commercial use.
Dr Simon Lewis MBBCh BSc MRCP MD
Dr Simon Lewis read Medicine at the University of Wales, College of Medicine where he developed an interest in research and also undertook an integrated BSc in Human Anatomy. On graduating from medical school he trained in General Medicine and after becoming a Member of the Royal College of Physicians UK he embarked upon Neuroscience research at the University of Cambridge. His research focussed on the cognitive deficits found in Parkinson's disease and he has published a number of scientific papers in addition to completing an MD in this field.
Having concluded his specialist training in Neurology he is now working at the Royal Prince Alfred Hospital in Sydney where he is developing his research interests in neurodegenerative conditions. One of his particular areas of interest relates to the gait disorders found in these diseases. He is hoping to be able to model these disabilities and therefore gain a greater understanding of them, by utilising the 3-d environments afforded by first-person video game engine technology.
Selected publications:
- Lewis SJG, Foltynie T, Blackwell A, Robbins TW, Owen AM, Barker RA. Heterogeneity of Parkinson's disease in the early clinical stages using a data-driven approach. J Neurol Neurosurgery Psychiatry 2005; 76: 343-348.
- Lewis SJG, Dove A, Robbins TW, Barker RA, Owen AM. Dopaminergic basis for deficits in working memory but not attentional set-shifting in Parkinson's disease. Neuropsychologia 2005; 43: 823-832.
- Lewis SJG, Dove A, Robbins TW, Barker RA, Owen AM. Striatal contributions to working memory: a functional magnetic resonance imaging study in humans. Eur J Neurosci 2004; 19: 755-760.
- Lewis SJG, Dove A, Robbins TW, Barker RA, Owen AM. Cognitive impairments in early Parkinson's disease are accompanied by reductions in activity in frontostriatal neural circuitry. J Neurosci 2003;23:6351-6356.
- Lewis SJG, Cools R, Robbins TW, Dove A, Barker RA, Owen AM. Using executive heterogeneity to explore the nature of working memory deficits in Parkinson's disease. Neuropsychologia 2003;41:645-654.
- Lewis SJG, Caldwell M, Barker RA. Modern therapeutic approaches in Parkinson's disease. Expert Rev Mol Med 2003; 3: 1-20.
Simon Wadsworth BSc
In the early to mid 1980s Simon had several commercial games published for the popular Sinclair 'ZX' range of home computers, having taught himself BASIC and Z80 machine code programming.
To advance beyond the status of self-taught programmer he studied Computer Science at City University, London.
Subsequent to graduation he has held positions in several software companies providing bespoke software solutions, predominantly in the Financial Services sector.
He is presently a freelance software development consultant.
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