Optimal Time Lags From Causal Prediction Model Help Stratify and Forecast Nervous System Pathology

Authors: Theodoros Bermperidis, Richa Rai, Jihye Ryu, Damiano Zanotto, Sunil K. Agrawal, Anil K. Lalwani, and Elizabeth B. Torres

Summary

Many clinical diagnoses for nervous system disorders come from meeting criteria that are considered observational. While these criteria are standardized, there can still be a lot of variability across individuals with the same diagnosis, which makes finding a treatment challenging. This is true within Fragile X, and researchers are consistently trying to find sub-groups within the larger Fragile X population that may best respond to certain treatments and finding something measurable to help predict how your condition may evolve is important. We know that there is likely not a one-size-fits-all treatment, so this work is very important.

Patients with Fragile-X-associated tremor/ataxia syndrome (FXTAS), patients with Parkinson’s Disease (PD) and patients with autism spectrum disorder (ASD) all have motor issues that can be identified, measured, and tracked by their gait throughout their lifespan. Because there is overlap in the genes involved in these three diagnoses, identifying patterns in gait issues in these disorders may help with earlier diagnosis and treatment.

The study team analyzed how gait and the small movements changed. While gait declines naturally with typical aging, the hip, knee, and ankle joints and the thigh, leg, and foot bones are the first to be impacted. Fragile X premutation carriers shows a lag in connectivity across the body in comparison to individuals without the premutation. Through their novel statistical technique, the team grouped a random sample of the population into different sub-categories of nervous system diagnoses. The easiest group to detect and forecast different gait was the Fragile X premutation participants against the elderly participants undergoing natural aging.

Why This Matters

Early detection is key to early treatment. Being able to identify and diagnose possible nervous system disorders by detecting gait problems 15 to 20 years before their clinical diagnosis could help advance treatment development and quality of life. This could be especially helpful for Fragile X premutation carriers as they age given the possibility of developing FXTAS.

Next Steps

More research needs to be done on this topic to best understand the predictive properties of gait in individuals who carry the Fragile X premutation carriers. This research suggests building screening tools based on walk tests could help with early detection and diagnosis of several nervous system disorders.

Acknowledgements and Funding

We thank all participants in the study. This research was funded by the (New Jersey) Governor’s Council for the Medical Research and Treatments of Autism, grant number CAUT15APL038, and by the Nancy Lurie Marks Family Foundation Career Development Award to Elizabeth B. Torres.

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