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<p>Identifying digital biomarkers for gait ataxia remains a key research priority in spinocerebellar ataxias (SCAs), given their potential to enhance the monitoring of disease progression.&#xa0;This study aimed to evaluate the progression of digitally measured gait ataxia features in symptomatic SCA2 individuals.&#xa0;Forty-seven clinically manifest SCA2 patients were evaluated over four years with assessments conducted at four time points whereas 39 gender-and age matched controls were studied three time in a similar time span. At each visit, participants completed a 2-minute natural walking test while wearing six body-worn inertial measurement units. Digital metrics, including stride-to-stride mean and standard deviations of gait speed; double support; stride length, stance, elevation at midswing; foot strike angle; toe off angle and toe out angle as well as the lateral step variability. Clinical scales, including the Scale for the Assessment and Rating of Ataxia (SARA) and the Inventory of Non-Ataxia Symptoms (INAS), were also assessed.&#xa0;All digital measures showed significant longitudinal changes over time, except for toe-out angle, lateral step variability, and gait speed variability. After controlling for gait speed, only the means of elevation at midswing, foot strike angle, and toe-off angle, as well as the variability of stride length, elevation at midswing, foot strike angle, and toe-off angle, remained unaffected. The baseline total SARA score was the strongest predictor of longitudinal changes in most gait metrics, while the SARA gait sub-score more accurately predicted changes in the mean values than the variability of these digital measures. Significant correlations were observed between longitudinal changes in SARA scores and changes in several digital measures.&#xa0;Our findings confirm the progressive nature of SCA2 and demonstrate that digitally measured gait metrics are sensitive biomarkers. These metrics complement traditional clinical scales, providing deeper insight into gait impairment dynamics which could improve the evaluation of therapeutic interventions.</p><p>Clinical trial number: Not applicable.</p>

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Progression of Gait Ataxia in Spinocerebellar Ataxia Type 2: Clinical Utility of Digitally Measured Gait Metrics

  • 期刊论文

  • 发表日期：

    2025年11月26日

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  • Roberto Rodríguez-Labrada,
  • Yasmany González-Garcés,
  • Frank J. Carrillo-Rodes,
  • Julio C. Rodríguez-Díaz,
  • Yaimeé Vázquez-Mojena,
  • Ulf Ziemann,
  • Georg Auburger,
  • Fay Horak,
  • Christopher Gomez,
  • Luis Velázquez-Pérez

摘要

Identifying digital biomarkers for gait ataxia remains a key research priority in spinocerebellar ataxias (SCAs), given their potential to enhance the monitoring of disease progression. This study aimed to evaluate the progression of digitally measured gait ataxia features in symptomatic SCA2 individuals. Forty-seven clinically manifest SCA2 patients were evaluated over four years with assessments conducted at four time points whereas 39 gender-and age matched controls were studied three time in a similar time span. At each visit, participants completed a 2-minute natural walking test while wearing six body-worn inertial measurement units. Digital metrics, including stride-to-stride mean and standard deviations of gait speed; double support; stride length, stance, elevation at midswing; foot strike angle; toe off angle and toe out angle as well as the lateral step variability. Clinical scales, including the Scale for the Assessment and Rating of Ataxia (SARA) and the Inventory of Non-Ataxia Symptoms (INAS), were also assessed. All digital measures showed significant longitudinal changes over time, except for toe-out angle, lateral step variability, and gait speed variability. After controlling for gait speed, only the means of elevation at midswing, foot strike angle, and toe-off angle, as well as the variability of stride length, elevation at midswing, foot strike angle, and toe-off angle, remained unaffected. The baseline total SARA score was the strongest predictor of longitudinal changes in most gait metrics, while the SARA gait sub-score more accurately predicted changes in the mean values than the variability of these digital measures. Significant correlations were observed between longitudinal changes in SARA scores and changes in several digital measures. Our findings confirm the progressive nature of SCA2 and demonstrate that digitally measured gait metrics are sensitive biomarkers. These metrics complement traditional clinical scales, providing deeper insight into gait impairment dynamics which could improve the evaluation of therapeutic interventions.

Clinical trial number: Not applicable.