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Fig. 1 | Journal of NeuroEngineering and Rehabilitation

Fig. 1

From: A method for measuring time spent in bradykinesia and dyskinesia in people with Parkinson’s disease using an ambulatory monitor

Fig. 1

The Levodopa Response and Categorization of Fluctuators. In panels a and b, the X axis shows time (t) of day between the first and second dose (red vertical lines) and the Y axis shows bradykinesia increasing in severity toward the bottom of the graph. The target range for bradykinesia is shown by orange shading. a. depicts a case where the severity of early morning bradykinesia at the time of the first dose (DT) is above the target range. The levodopa response is the difference in bradykinesia severity (Δ1) at time of peak levodopa effect (PTE: 46–90 min after the first dose) and at DT. Two examples of subsequent clinical responses to the first dose are shown. The full green line (A) shows a case with “wearing-off” which occurred when the Severity Level increased by “1” (Δ2) between 165 and 210 min after the first dose time (depending on time of peak levodopa effect latency). The green dotted line (B) shows a persisting response without significant decline from the best levodopa response. Blue lines (t1 and t2) immediately under the target range indicate when Line “A” is above target and conceptually, PTB is the time represented by this line (t1 + t2) as a percentage of total time (t). b represents 6 fluctuator categories (defined at the right of each curve) that are described in the Methods. c is a flow diagram of the fluctuator classification and the naming convention

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