An investigation of the auditory brainstem response characteristics of people with Parkinson's disease
Creators: name: Yousefi, Shahriar
Publisher: name: Swinburne
Year: 2024

description: This dissertation is the documentation for a Doctoral research program undertaken at the Industrial Research Institute of the Swinburne University of Technology (IRIS), in collaboration with the School of Biophysical Sciences and Electrical Engineering (BSEE), between the years of 2000 and 2004. The objective of the research work that was undertaken was to study the auditory brainstem response (ABR) characteristics of people with Parkinson's Disease (PD) to determine whether or not these characteristics could form the basis of a tool for determining the presence of PD; the performance of medication, and disease progression. Prior to the commencement of this research, the gold-standard for PD diagnostics was considered to be autopsy, and the only tools available for assessment of living patients were fluoro-deoxyglucose (FDG) / fluoroDopa (FDopa)-based positron emission tomography (PET) or conventional (subjective) clinical testing. The use of PET was costly and impractical for monitoring disease progression. Clinical testing approaches, on the other hand, had a degree of subjectivity, leading to potential misdiagnoses with inadequately trained clinicians. It was therefore postulated that a low-cost technique based on conventional ABR testing equipment, which was readily available within the medical environment, could provide considerable benefits. In order to be useful as a tool, ABR would ultimately need to identify uniquely the presence of PD from other potential disorders, most notably multiple system atrophy (MSA) which was sometimes confused with PD. At the time this research was conducted, the prevailing method of differentiating PD from MSA was based upon magnetic resonance imaging (MRI). This research was only concerned with the first stage of such a research process - that is, determining whether the ABR of PD patients was fundamentally different to that of a control group. In undertaking the investigation, a significant component of the research involved drawing together research literature from a large number of sources in order to present a case that could present a reasonable research path for experimentation. The next stage of the research involved developing an experimentation program that could be used to compare the ABR characteristics of people with PD against a control group and, further, to compare the ABR characteristics of PD participants against their level of impairment, as measured on a conventional mobility test. In summary, the outcomes of the experimental process that was undertaken, and the statistical analysis of the outcomes, suggested that: (1) People with mild manifestations of PD, who were in an unmedicated state, had marked abnormalities in the amplitude of Wave III of their ABR waveform. (2) The amplitude of Wave III of the ABR waveform was sensitive to variations in PD medication levels. (3) The amplitude of Wave V of the ABR waveform was, to a lesser extent than Wave III, affected by the presence of PD and medication levels. (4) The latencies of Waves III and V of the ABR waveforms did not appear to be affected by the presence of PD or by variations in medication levels. This thesis presents the results of the experimental study, together with a statistical analysis of the significance of the outcomes and an evaluation of the limitations of the work that was carried out. The recommendations arising from the research outcomes suggest ways for extending the work that has been completed in this program.