Atypical Motor Research Articles

Screening of Cholinoreceptor Agonists in Experimental Model on Daphnia magna Straus

The acute toxicity and the ability of cholinoreceptor agonists to induce atypical motor hyperactivity in zoohydrobionts Daphnia magna Straus, equivalent to a significant seizure state in warm-blooded animals, were evaluated. Determination of this test function may be useful in screening assessment of pharmacological activity of cholinergic substances.

Duropathy as a rare motor neuron disease mimic: from bibrachial amyotrophy to infratentorial superficial siderosis

BackgroundBibrachial amyotrophy associated with an extradural CSF collection and infratentorial superficial siderosis (SS) are rare conditions that may occasionally mimic ALS. Both disorders are assumed to be due to dural tears.Case presentationA 53-year-old man presented with a 7-year history of slowly progressive asymmetric bibrachial amyotrophy. Initially, a diagnosis of atypical motor neuron disease (MND) was made. At re-evaluation 11 years later, upper limb wasting and weakness had further progressed and were accompanied by sensorineural hearing loss. MRI of the brain and spine demonstrated extensive supra- and infratentorial SS (including the surface of the whole spinal cord) as well as a ventral longitudinal intraspinal fluid collection (VLISFC) extending along almost the entire thoracic spine. Osteodegenerative changes were observed at C5-C7 level, with osteophytes protruding posteriorly. The bony spurs at C6-C7 level were hypothesized to have lesioned the dura, causing a CSF leak and thus a VLISFC. Review of the MRI acquired at first evaluation showed that the VLISFC was already present at that time (actually beginning at C7 level), whereas the SS was not. 19 years after the onset of upper limb weakness, the patient additionally developed parkinsonism. Response to levodopa, brain scintigraphy with 123I-ioflupane and brain MRI with nigrosome 1 evaluation were consistent with idiopathic Parkinson’s disease (PD). On the latest follow-up 21 years after symptom onset, the VLISFC was unchanged, as were upper arm weakness and wasting.ConclusionsBased on the long-term follow-up, we could establish that, while the evidence of the VLISFC was concomitant with the clinical presentation of upper limb amyotrophy and weakness, the radiological signs of SS appeared later. This suggests that SS was not per se the cause of the ALS-like clinical picture, but rather a long-term sequela of a dural leak. The latter was instead the causative lesion, giving rise to a VLISFC which compressed the cervical motor roots. Dural tears can actually cause several symptoms, and further studies are needed to elucidate the pathophysiological correlates of “duropathies”. Finally, as iron metabolism has been implicated in PD, the co-occurrence of PD with SS deserves further investigation.

The Targeted Motor Control Screening Tool Is Valid for 4-Year-Old Children.

The objective was to determine the validity of the Targeted Motor Control (TMC) screening tool with the Neurosensory Motor Developmental Assessment (NSMDA) in 4-year-old children. In this single cohort observational study, children (3years 9months to 4years 5months) completed the TMC and the NSMDA in a randomized order 5 to 14days apart. Seventy-six children (mean age = 4years 2months; standard deviation = 2.5months; n = 35 male) completed both assessments. Forty-two children performed within the normal range on the NSMDA. There were significant and positive moderate correlations between the item totals overall and for each area on the NSMDA and the TMC (r = 0.40-0.61), and between the NSMDA functional grade for each area and the corresponding TMC areas (r = 0.47-0.67). However, the correlation between the NSMDA sensorimotor functional grade and the TMC sensory score was significant but low and positive (r = 0.35). The optimal cut-off score for detecting children at risk of atypical development on the TMC was a score of <9 (n = 42) (sensitivity = 82.4%; specificity = 66.7%), with a positive likelihood ratio of 2.47 (95% confidence interval [CI] = 1.57-3.89) and a negative likelihood ratio of 0.26 (95% CI = 0.12-0.56). The TMC is a valid screening tool to identify 4-year-old children at risk of motor delay. Early identification of developmental concerns using a validated screening tool is recommended. The TMC is a valid performance-based screening tool that can be used to identify children at risk of atypical motor development who would benefit from further developmental assessment so that, if indicated, timely intervention can be implemented.

Objective measurement of movement variability using wearable sensors predicts ASD outcomes in infants at high likelihood for ASD and ADHD.

Early motor delays and differences are common among children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Yet, little work has shown whether there are early atypical motor signs that differentiate these groups. Quantitative measures of movement variability hold promise for improving the identification of subtle and specific differences in motor function among infants and toddlers at high likelihood for ASD and ADHD. To this end, we created a novel quantitative measure of movement variability (movement curvature) and conducted a preliminary investigation as to whether this measure improves outcome predictions. We used a wearable triaxial accelerometer to evaluate continuous motion-based activity in infants at high and low likelihood for ASD and ADHD at 12, 18, 24, and 36 months of age. At 36 months, participants were categorized into three outcome groups: ASD (n = 19), ADHD concerns (n = 17), and a comparison group (n = 82). We examined group differences in movement curvature and whether movement curvature is predictive of a later ASD or ADHD concerns classification. We found that movement curvature was significantly lower in infants with later ASD diagnosis at 18, 24, and 36 months of age compared to infants with either ADHD concerns or those in the comparison group. Movement curvature was also a significant predictor of ASD at 18, 24, and 36 months (AUC 0.66-0.71; p = 0.005-0.039) and when adjusting for high ASD likelihood at 18 and 24 months (AUC 0.90, p = 0.05-0.019). These results indicate that lower movement curvature may be a feature of early motor differences in infants with later ASD diagnosis as early as 18 months of age.

Pharmacological Screening of Cholinergic Drugs Using &lt;i&gt;Daphnia magna Straus&lt;/i&gt; Hydrobionts as a Biological Test Object

This work presents the results of primary pharmacological screening of anticholinergic drugs and comparative evaluation of their specific activity in equitoxic concentrations using Daphnia magna Straus hydrobionts as a biological test object. We determine the protective index and the minimum effective concentration in terms of preventing atypical motor hyperactivity of pharmacological substances when poisoning with a reversible acetylcholinesterase inhibitor. On the basis of the results obtained, the list of promising candidates for further research in warm-blooded animals is extended by all of the anticholinergic drugs previously selected in experiments on mammals.

Atypical Impact of Action Effect Delay on Motor Performance in Autism.

Atypical sensory perception and motor impairments are primary features of autism spectrum disorder (ASD) that indicate atypical development and predict social and non-social challenges. However, their link is poorly understood. Sensory perception is often integrated with motor processes when a sensory effect is temporally contiguous with the motor response. Such sensory-motor coupling further improves motor behavior. Previous studies indicate alterations in sensory perception of action-effect temporal contiguity in ASD, which bares the question of how it may impact motor performance.People diagnosed with ASD and typically developed (TD) participants performed a speeded reaction-time task previously established to capture the facilitating impact of action's perceptual effect on motor response selection. The sensitivity of this mechanism to delays in the effect was measured, manipulating the action-effect temporal contiguity in a within-subject design.An immediate action effect (compared to a No-effect condition) facilitated response selection in the TD group. This facilitation effect was evident in the ASD group but did not show the typical sensitivity to the effect delay. While in the TD group, RT was shorter in the short (225ms) compared to the long (675ms) action effect delay condition, this distinguished pattern was absent in the ASD group.The findings provide supporting evidence that atypical motor performance in ASD results, at least in part, from an altered sensory perception of action effect temporal contiguity. We discuss the results in light of the reduced perceptual specialization account in ASD and its potential for undermining adaptive sensorimotor processes.

Concurrent and predictive validity of the Alberta Infant Motor Scale and the Peabody Developmental Motor Scales-2 administered to infants born preterm in Norway

BackgroundThe correlation between the Alberta Infant Motor Scale (AIMS) and the Peabody Developmental Motor Scales-2 (PDMS-2) has not previously been assessed in Norwegian infants. Our purpose was to investigate the concurrent validity of the AIMS and the PDMS-2 in a group of high-risk infants, and to investigate the predictive validity of the two tests for atypical motor function at 24 months post term age (PTA).MethodsThis is a retrospective study of the AIMS and the PDMS-2 administered to infants born preterm with gestational age ≤ 32 weeks (n = 139) who had participated in a randomized controlled trial of early parent-administered physiotherapy. The infants’ motor development had been assessed using the AIMS and the PDMS-2 at 6- and 12-months. The primary outcome was PDMS-2 at 24-months PTA. To explore the correlation between the two tests we used Spearman’s rho. Bland Altman plots were used to detect if there were systematic differences between the measurements. Receiver-operating characteristics curves were used to calculate area under the curve as an estimate of diagnostic accuracy of the AIMS and the PDMS- with respect to motor outcome at 24 months.ResultsThe correlation between the AIMS and the PDMS-2 (total motor and locomotion subscale), at 6 months, was r = 0.44 and r = 0.76, and at 12 months r = 0.56 and r = 0.80 respectively. The predictive validity for atypical motor function at 24 months, assessed using the area under the curve at 6- and at 12- months, was for the AIMS 0.87 and 0.86, respectively, and for the PDMS-2 locomotion subscale 0.82 and 0.76 respectively.ConclusionThe correlation between the AIMS and the PDMS-2 locomotion subscale, at 6- and 12- months PTA, was good to excellent in a group of infants born preterm in Norway. And the AIMS and the locomotion subscale of the PDMS-2 were equally good predictors for atypical motor outcomes at 24 months PTA. These findings indicate that the AIMS and the locomotion subscale of the PDM-2, could be used interchangeable when assessing motor development in infants at 6- or 12 months of age.Trial registrationClinicalTrials.gov NCT01089296.

&lt;i&gt;Daphnia magna Straus&lt;/i&gt; as a Test Object for Screening Cholinergic Pharmacological Substances

Daphnia magna Straus was used as an experimental zoohydrobiont model for primary screening of compounds of the valproic acid aminoether group with anticonvulsant and cholinoblocking activity. On this basis, the most effective compounds for further trials in warm-blooded animals were selected. The selection criterion included their minimum effective concentration for the prevention of atypical motor hyperactivity induced by phenylcarbamate.

Delayed radiation-induced motor neuron syndrome: A case report.

Delayed radiation-induced motor neuron syndrome (DRIMNS) is an atypical motor neuron disorder that develops months or years after radiation therapy. In this study we present a case of DRIMNS that developed forty years after radiotherapy and to discuss differential diagnoses. A 56-year-old male patient was admitted to our clinic with complaints of increasing difficulty in walking for the past year. He had a history of operation and radiotherapy due to testicular tumor. Electroneuromyography (ENMG) and thoracic, lumbosacral, plexus and pelvic magnetic resonance imaging (MRI) were performed considering radiculopathy, plexopathy and motor neuron disease in the differential diagnosis. MRIs revealed no abnormality. Needle EMG of lower extremity and lumbar paraspinal muscles revealed fibrillation and positive sharp waves concomitant with fasciculations and reduced recruitment suggesting anterior horn cell/root involvement. DRIMNS was considered rather than motor neuron disease based on the long duration of symptoms with slow progressive course and history of radiotherapy to the pelvic region. DRIMNS is a rare entity that should be considered in the differential diagnosis of lower extremity muscle weakness in a patient with a history of malignancy and radiotherapy. EMG findings are very valuable in making the diagnosis together with the clinical picture.

Alteration of body representation in typical and atypical motor development.

Developmental coordination disorder (DCD) impacts the quality of life and ability to perform coordinated actions in 5% of school-aged children. The quality of body representations of individuals with DCD has been questioned, but never assessed. We hypothesize that children with DCD have imprecise body representations in the sensory and motor domains. Twenty neurotypical children, seventeen children with DCD (8-12 years old) and twenty neurotypical adults (25-45 years old) performed both sensory and motor body representation tasks: a limb identification and a limb movement task. We observed lower accuracy in the sensory task but not in the motor task. In both tasks, we observe a larger amplitude of errors, or synkinesis, in children with DCD than in neurotypical children. In neurotypical children, accuracy was lower than in neurotypical adults in the motor and sensory task, and the amplitude of sensory errors and synkinesis was higher than in neurotypical adults. Using a linear regression model, we showed that sensory accuracy is a good predictor of synkinesis production, and that synkinesis production is a good predictor of sensory accuracy, as can be expected by the perception-action loop. Results support the hypothesis of an imprecision of body representation in DCD. We suggest that this imprecision arises from noise in the body representation used at the level of internal models of action. Future studies may assess whether slower plasticity of body representations, initial imprecision, or both may account for this observation. At the clinical level, prevention strategies targeting body representation in early childhood are strategically important to limit such impairments. RESEARCH HIGHLIGHTS: Body representation is impaired in children with DCD and has a significant cost in terms of the accuracy of sensory identification of body parts and associated movements. Inaccuracies in the body representation measured in perception and in action (error amplitude and synkinesis) are related in both NT children and adults. In typical development, we provide evidence of a strong link between body schema and body image.

Bursting with Potential: How Sensorimotor Beta Bursts Develop from Infancy to Adulthood.

Beta activity is thought to play a critical role in sensorimotor processes. However, little is known about how activity in this frequency band develops. Here, we investigated the developmental trajectory of sensorimotor beta activity from infancy to adulthood. We recorded EEG from 9-month-old, 12-month-old, and adult humans (male and female) while they observed and executed grasping movements. We analyzed "beta burst" activity using a novel method that combines time-frequency decomposition and principal component analysis. We then examined the changes in burst rate and waveform motifs along the selected principal components. Our results reveal systematic changes in beta activity during action execution across development. We found a decrease in beta burst rate during movement execution in all age groups, with the greatest decrease observed in adults. Additionally, we identified three principal components that defined waveform motifs that systematically changed throughout the trial. We found that bursts with waveform shapes closer to the median waveform were not rate-modulated, whereas those with waveform shapes further from the median were differentially rate-modulated. Interestingly, the decrease in the rate of certain burst motifs occurred earlier during movement and was more lateralized in adults than in infants, suggesting that the rate modulation of specific types of beta bursts becomes increasingly refined with age.SIGNIFICANCE STATEMENT We demonstrate that, like in adults, sensorimotor beta activity in infants during reaching and grasping movements occurs in bursts, not oscillations like thought traditionally. Furthermore, different beta waveform shapes were differentially modulated with age, including more lateralization in adults. Aberrant beta activity characterizes various developmental disorders and motor difficulties linked to early brain injury, so looking at burst waveform shape could provide more sensitivity for early identification and treatment of affected individuals before any behavioral symptoms emerge. More generally, comparison of beta burst activity in typical versus atypical motor development will also be instrumental in teasing apart the mechanistic functional roles of different types of beta bursts.

Improving early detection, diagnosis and intervention for children with autism spectrum disorder: A cross-sectional survey in China

BackgroundDetection and diagnosis of autism spectrum disorder (ASD) are prerequisites for early interventions. However, few studies focused on this topic. AimThis study aims to characterize the timing from symptom detection to intervention in children with ASD and identify predictors of age at ASD diagnosis, presence of intervention, and the time lag between detection and diagnosis. Methods and proceduresA cross-sectional survey was conducted with 303 parents (111 fathers and 192 mothers, 21–54 years) of children with ASD in Guangzhou, China. Outcomes and resultsThe median time from symptom observation to the first doctor visit was 3 months, while the time to ASD diagnosis averaged 6 months. Most children (76.24 %) were diagnosed within one year after detection, and 25.58 % had no intervention after diagnosis. Predictors of earlier ASD diagnosis included ASD-related symptoms identified at an older age, less serious symptoms, and initial symptoms with atypical motor development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with social deficits, sensory anomalies, and without language impairment, primary caregivers other than parents, families with lower income, and less social support utilization increased the odds of a time lag between detection and diagnosis. Children with fathers having lower education were less likely to receive interventions. Conclusions and implicationsEarlier ASD identification and intervention might be facilitated by health education on typical symptoms of ASD for parents with young children and incorporating ASD screening during routine health examinations for children. For children whose primary caregivers are not their parents and from lower-income families, additional support may be required for timely diagnosis after reporting ASD-related symptoms. Moreover, more intervention supports are expected for children whose fathers have lower education levels. Helping families take full advantage of support is also important for early diagnosis and intervention.

Distinct phenotypes in a cohort of anti-CASPR2 associated neurological syndromes

IntroductionAnti-contactin-associated protein-like 2 (CASPR2) is classically associated with limbic encephalitis (LE), Morvan syndrome and peripheral nerve hyperexcitability (PNH). Additional clinical features have been previously recognized. ObjectiveTo describe a cohort of patients with anti-CASPR2-associated neurological syndromes from a tertiary referral centre. MethodsRetrospective analysis of patients with positive serum anti-CASPR2 antibodies in the period between 2014 and 2021. ResultsNineteen patients were identified, 11 (57.9%) male, with a median age at symptom onset of 49.0 (31.3–63.0) years and a median time to diagnosis of 1.0 (0.0–1.8) years. The most common clinical syndromes were LE (7 cases, 36.8%), Morvan syndrome (4, 21.1%) and PNH (2, 10.5%). Six patients presented with atypical phenotypes (31.6%), comprising dysautonomia (orthostatic hypotension and Adie’s Pupil), motor tics/stereotypies, obsessive-compulsive disorder, and brainstem involvement. The most common presenting symptoms were seizures (31.6%), PNH (21.1%) and cognitive dysfunction (15.8%). One LE patient had a disease duration of 2,5 years and was initially diagnosed with dementia. CSF was normal in most cases. Brain MRI showed temporal lobe hyperintensities in 4 LE cases (57.1%). All PNH cases had myokymic discharges of fasciculations in the electromyography. Two patients had associated thymoma and 1 had lung adenocarcinoma. Eight patients (42.1%) received treatment during the acute phase and 26.3% maintenance treatment. Approximately half of the treated cases improved or stabilised, with 4 (21.1%) deaths in the whole cohort. ConclusionAnti-CASPR2-associated neurological disorders may present with isolated atypical phenotypes, a slowly progressive clinical course, and with normal CSF or imaging findings.

Commentary on "Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure".

Commentary on "Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure".

The feasibility of using the Körperkoordinationstest fur Kinder (KTK) in a U.S. elementary physical education setting to assess gross motor skills specific to postural balance.

For the past ten years, falls have been the leading cause of nonfatal injuries for all age groups less than 15 years old. A significant rise in childhood sedentary behavior in schools and limited opportunities to be outside has led to motor coordination deficits which have contributed to fall injuries. A German assessment tool, the Körperkoordinationstest fur Kinder (KTK), which has been used for decades in Western European countries, allows researchers and physical education teachers to evaluate typical and atypical children's motor coordination competencies related to dynamic postural balance successfully. No research has been published on the use of this assessment tool in the United States. If its use were found to be feasible in this country for identifying motor coordination deficits in typical and atypical children, it would close the gap in determining motor coordination. Therefore, this study sought in Phase 1 to determine the feasibility of using the KTK assessment in U.S. children and Phase 2 sought to determine the adaptability of the scoring protocol from use in other countries to the United States. The Phase 1 results revealed the KTK assessment was feasible to administer in U.S. physical education class by addressing three challenges for U.S. schools: 1) KTK implementation, 2) time to assess each skill, and 3) the equipment availability and cost to implement the test in a physical education setting. In Phase 2, the researchers were able to determine the raw scores and motor quotient scores in this population and then were able to show similar scoring trends between U.S. children and Flemish children from a previous study. This assessment tool was deemed feasible and adaptable which is the first step to use the KTK in U.S. physical education elementary school settings.

Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure.

To investigate the association between prenatal opioid exposure (POE) and newborn infants' motor performance to aid in the early identification of developmental delays. Nineteen infants with POE requiring pharmacological treatment, 27 infants with POE without pharmacological treatment, and 25 infants without POE were assessed via the Test of Infant Motor Performance (TIMP). Infants in both groups with POE had lower TIMP scores than infants without POE. There was no difference between the TIMP scores of infants with POE who required pharmacological treatment and infants with POE who did not require pharmacological treatment. The TIMP can detect differences in motor performance of infants with POE. Regardless of whether infants required pharmacological treatment, POE was associated with lower motor performance. Those working in hospital or early intervention settings can use the TIMP to identify early delays in infants with POE and refer for intervention.

The whole-body motor skills of children with autism spectrum disorder taking goal-directed actions in virtual reality.

Many symptoms of the autism spectrum disorder (ASD) are evident in early infancy, but ASD is usually diagnosed much later by procedures lacking objective measurements. It is necessary to anticipate the identification of ASD by improving the objectivity of the procedure and the use of ecological settings. In this context, atypical motor skills are reaching consensus as a promising ASD biomarker, regardless of the level of symptom severity. This study aimed to assess differences in the whole-body motor skills between 20 children with ASD and 20 children with typical development during the execution of three tasks resembling regular activities presented in virtual reality. The virtual tasks asked to perform precise and goal-directed actions with different limbs vary in their degree of freedom of movement. Parametric and non-parametric statistical methods were applied to analyze differences in children's motor skills. The findings endorsed the hypothesis that when particular goal-directed movements are required, the type of action could modulate the presence of motor abnormalities in ASD. In particular, the ASD motor abnormalities emerged in the task requiring to take with the upper limbs goal-directed actions with low degree of freedom. The motor abnormalities covered (1) the body part mainly involved in the action, and (2) further body parts not directly involved in the movement. Findings were discussed against the background of atypical prospective control of movements and visuomotor discoordination in ASD. These findings contribute to advance the understanding of motor skills in ASD while deepening ecological and objective assessment procedures based on VR.

Evaluation of the Training in Early Detection for Early Intervention (TEDEI) e-learning course using Kirkpatrick’s method

BackgroundEarly intervention in cerebral palsy could improve motor outcome but is only possible following early identification of those affected. There is a need for training of healthcare professionals (HCPs) in early detection of atypical motor development. We developed a video-based e-learning course - Training in Early Detection for Early Intervention (TEDEI) - to address this need. We evaluated whether participation in the course improved knowledge and changed behaviour of HCPs.MethodsParticipants were 332 HCPs (38% physiotherapists, 35.8% occupational therapists), predominantly UK-based (83.7%). Analysis of training effects used mixed methods and followed Kirkpatrick’s model, first assessing “Reaction” through a feedback questionnaire involving Likert scale and free text responses (n = 141). “Learning” was assessed through multiple choice questions (MCQs): all 332 HCPs completed a pre-course quiz of 6 MCQs followed by the course, then a 16 item post-course quiz including the 6 pre-course questions. “Behaviour” was assessed through in-depth qualitative interviewing of 23 participants.Results“Reaction”: TEDEI was found to be effective, engaging and well structured. “Learning”: Scores improved significantly between the pre-course and post-course quiz, median improvement 1/6 (z = 5.30, p < 0.001). HCPs also reported a perceived improvement in their knowledge, confidence and ability. “Behaviour”: HCPs could see how TEDEI would improve their clinical practice through having an assessment framework, ways of working better with parents, and developing observational skills useful for tele-health assessments.ConclusionOur brief e-learning course on early detection for early intervention was viewed positively, improved knowledge and showed potential for positive changes in practice. Kirkpatrick’s model provided a useful framework for undertaking this evaluation.

Motor Speech Phenotypes in Children With Epilepsy: Preliminary Findings.

This exploratory study aimed to characterize motor speech impairments in a small sample of children with epilepsy, both with and without a known seizure etiology. A secondary aim was to evaluate the validity of the Profile for Childhood Apraxia of speech and Dysarthria (ProCAD), a newly developed tool for differential diagnosis of childhood apraxia of speech and dysarthria. Thirteen children with seizure disorders completed a comprehensive speech and language assessment. Three expert speech-language pathologists rated the presence of auditory-perceptual features of motor speech impairment using the ProCAD. Motor speech features, diagnoses, and standardized test scores were compared between children with a known seizure etiology and children with idiopathic epilepsy. Nine of the 13 children exhibited motor speech impairment; dysarthria was the most common diagnosis. Most children (11/13) exhibited language impairment. Group comparisons showed that children with a known seizure etiology had more atypical motor speech features and lower language scores than children with idiopathic seizures. These preliminary findings suggest a high rate of motor speech impairment among children with epilepsy.

Neurologic Dysfunction Assessment in Parkinson Disease Based on Fundus Photographs Using Deep Learning

Until now, other than complex neurologic tests, there have been no readily accessible and reliable indicators of neurologic dysfunction among patients with Parkinson disease (PD). This study was conducted to determine the role of fundus photography as a noninvasive and readily available tool for assessing neurologic dysfunction among patients with PD using deep learning methods. To develop an algorithm that can predict Hoehn and Yahr (H-Y) scale and Unified Parkinson's Disease Rating Scale part III (UPDRS-III) score using fundus photography among patients with PD. This was a prospective decision analytical model conducted at a single tertiary-care hospital. The fundus photographs of participants with PD and participants with non-PD atypical motor abnormalities who visited the neurology department of Kangbuk Samsung Hospital from October 7, 2020, to April 30, 2021, were analyzed in this study. A convolutional neural network was developed to predict both the H-Y scale and UPDRS-III score based on fundus photography findings and participants' demographic characteristics. The area under the receiver operating characteristic curve (AUROC) was calculated for sensitivity and specificity analyses for both the internal and external validation data sets. A total of 615 participants were included in the study: 266 had PD (43.3%; mean [SD] age, 70.8 [8.3] years; 134 male individuals [50.4%]), and 349 had non-PD atypical motor abnormalities (56.7%; mean [SD] age, 70.7 [7.9] years; 236 female individuals [67.6%]). For the internal validation data set, the sensitivity was 83.23% (95% CI, 82.07%-84.38%) and 82.61% (95% CI, 81.38%-83.83%) for the H-Y scale and UPDRS-III score, respectively. The specificity was 66.81% (95% CI, 64.97%-68.65%) and 65.75% (95% CI, 62.56%-68.94%) for the H-Y scale and UPDRS-III score, respectively. For the external validation data set, the sensitivity and specificity were 70.73% (95% CI, 66.30%-75.16%) and 66.66% (95% CI, 50.76%-82.25%), respectively. Lastly, the calculated AUROC and accuracy were 0.67 (95% CI, 0.55-0.79) and 70.45% (95% CI, 66.85%-74.04%), respectively. This decision analytical model reveals amalgamative insights into the neurologic dysfunction among PD patients by providing information on how to apply a deep learning method to evaluate the association between the retina and brain. Study data may help clarify recent research findings regarding dopamine pathologic cascades between the retina and brain among patients with PD; however, further research is needed to expand the clinical implication of this algorithm.