{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T18:20:42Z","timestamp":1794075642765,"version":"4.8.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"TAU\u2019s new researchers grant"},{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Measuring ataxia severity is primarily conducted in-person using tests such as the Scale for the Assessment and Rating of Ataxia (SARA). However, given the motor and cognitive impairments of people with cerebellar ataxia (PwA), there are major limitations in ensuring the assessment is accessible and scalable. We aimed to develop and validate a novel test, enabling the remote assessment of ataxia severity, SARA-Le (SARA Live e-version).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      SARA-Le is a structured step-by-step test for administering the SARA through video conferencing. In two experiments, we administered SARA-Le to 106 PwA. In Experiment 1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923), we assessed concurrent validity by comparing SARA-Le and in-person SARA scores administered by an independent neurologist. In addition, we evaluated associations between nine gait measures and both SARA and SARA-Le scores. In Experiment 2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200983), we assessed the efficacy, internal consistency, and correlations between SARA-Le and other related measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      First, we found a high correlation (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.89,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) between SARA-Le and in-person SARA scores, supporting convergent validity. Second, SARA-Le and SARA scores were both similarly associated with the nine gait measures, supporting construct validity. Third, SARA-Le\u2019s Cronbach\u2019s alpha was very high (0.831), supporting internal consistency. Fourth, SARA-Le scores exhibited a positive correlation with disease duration (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.44,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and a negative correlation with MoCA scores (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2212\u00a00.27,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007), supporting construct validity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SARA-Le can serve as a remote technology-based protocol, improving the accessibility and scalability of ataxia severity evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-025-13071-7","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T02:28:51Z","timestamp":1744252131000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Scale for the assessment and rating of ataxia: a live e-version"],"prefix":"10.1007","volume":"272","author":[{"given":"Avigail Lithwick","family":"Algon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penina","family":"Ponger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Daniel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"De Picciotto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Gazit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Brozgol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Hausdorff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Saban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"13071_CR1","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.ncl.2014.09.004","volume":"33","author":"U Akbar","year":"2015","unstructured":"Akbar U, Ashizawa T (2015) Ataxia. Neurol Clin 33:225\u2013248. https:\/\/doi.org\/10.1016\/j.ncl.2014.09.004","journal-title":"Neurol Clin"},{"key":"13071_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13023-021-02091-x","volume":"17","author":"G Thomas-Black","year":"2022","unstructured":"Thomas-Black G, Dumitrascu A, Garcia-Moreno H et al (2022) The attitude of patients with progressive ataxias towards clinical trials. Orphanet J Rare Dis 17:1. https:\/\/doi.org\/10.1186\/s13023-021-02091-x","journal-title":"Orphanet J Rare Dis"},{"key":"13071_CR3","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1212\/WNL.0b013e318294b1cf","volume":"81","author":"TM Dall","year":"2013","unstructured":"Dall TM, Storm MV, Chakrabarti R et al (2013) Supply and demand analysis of the current and future US neurology workforce. Neurology 81:470\u2013478. https:\/\/doi.org\/10.1212\/WNL.0b013e318294b1cf","journal-title":"Neurology"},{"key":"13071_CR4","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1007\/S12311-017-0885-2","volume":"17","author":"MS Salman","year":"2018","unstructured":"Salman MS (2018) Epidemiology of cerebellar diseases and therapeutic approaches. Cerebellum 17:4\u201311. https:\/\/doi.org\/10.1007\/S12311-017-0885-2","journal-title":"Cerebellum"},{"key":"13071_CR5","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1212\/01.wnl.0000219042.60538.92","volume":"66","author":"T Schmitz-H\u00fcbsch","year":"2006","unstructured":"Schmitz-H\u00fcbsch T, du Montcel ST, Baliko L et al (2006) Scale for the assessment and rating of ataxia. Neurology 66:1717\u20131720. https:\/\/doi.org\/10.1212\/01.wnl.0000219042.60538.92","journal-title":"Neurology"},{"key":"13071_CR6","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1007\/s12311-011-0316-8","volume":"11","author":"JAM Saute","year":"2012","unstructured":"Saute JAM, Donis KC, Serrano-Munuera C et al (2012) Ataxia rating scales\u2014psychometric profiles, natural history and their application in clinical trials. The Cerebellum 11:488\u2013504. https:\/\/doi.org\/10.1007\/s12311-011-0316-8","journal-title":"The Cerebellum"},{"key":"13071_CR7","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1002\/mds.28313","volume":"36","author":"S Perez-Lloret","year":"2021","unstructured":"Perez-Lloret S, van de Warrenburg B, Rossi M et al (2021) Assessment of ataxia rating scales and cerebellar functional tests: critique and recommendations. Mov Disord 36:283\u2013297. https:\/\/doi.org\/10.1002\/mds.28313","journal-title":"Mov Disord"},{"key":"13071_CR8","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1002\/mdc3.12315","volume":"3","author":"BK Paap","year":"2016","unstructured":"Paap BK, Roeske S, Durr A et al (2016) Standardized assessment of hereditary ataxia patients in clinical studies. Mov Disord Clin Pract 3:230\u2013240. https:\/\/doi.org\/10.1002\/mdc3.12315","journal-title":"Mov Disord Clin Pract"},{"key":"13071_CR9","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1002\/mdc3.13204","volume":"8","author":"G Tai","year":"2021","unstructured":"Tai G, Corben LA, Woodcock IR et al (2021) Determining the validity of conducting rating scales in Friedreich Ataxia through video. Mov Disord Clin Pract 8:688\u2013693. https:\/\/doi.org\/10.1002\/mdc3.13204","journal-title":"Mov Disord Clin Pract"},{"key":"13071_CR10","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1002\/mds.28478","volume":"36","author":"M Grobe-Einsler","year":"2021","unstructured":"Grobe-Einsler M, Taheri Amin A, Faber J et al (2021) Development of SARA home, a new video-based tool for the assessment of ataxia at home. Mov Disord 36:1242\u20131246. https:\/\/doi.org\/10.1002\/mds.28478","journal-title":"Mov Disord"},{"key":"13071_CR11","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzad166","author":"R Reoli","year":"2024","unstructured":"Reoli R, Therrien A, Millar J et al (2024) The scale for assessment and rating of ataxia is reliable and valid in the telehealth setting for patients with cerebellar ataxia. Phys Ther. https:\/\/doi.org\/10.1093\/ptj\/pzad166","journal-title":"Phys Ther"},{"key":"13071_CR12","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","volume":"53","author":"ZS Nasreddine","year":"2005","unstructured":"Nasreddine ZS, Phillips NA, B\u00e9dirian V et al (2005) The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695\u2013699. https:\/\/doi.org\/10.1111\/j.1532-5415.2005.53221.x","journal-title":"J Am Geriatr Soc"},{"key":"13071_CR13","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1212\/WNL.0b013e3181d1a6c9","volume":"74","author":"T Schmitz-H\u00fcbsch","year":"2010","unstructured":"Schmitz-H\u00fcbsch T, Fimmers R, Rakowicz M et al (2010) Responsiveness of different rating instruments in spinocerebellar ataxia patients. Neurology 74:678\u2013684. https:\/\/doi.org\/10.1212\/WNL.0b013e3181d1a6c9","journal-title":"Neurology"},{"key":"13071_CR14","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2023.1325215","author":"S Binoy","year":"2024","unstructured":"Binoy S, Montaser-Kouhsari L, Ponger P, Saban W (2024) Remote assessment of cognition in Parkinson\u2019s disease and cerebellar ataxia: the MoCA test in English and Hebrew. Front Hum Neurosci. https:\/\/doi.org\/10.3389\/fnhum.2023.1325215","journal-title":"Front Hum Neurosci"},{"key":"13071_CR15","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2024.2397835","author":"Y De Picciotto","year":"2024","unstructured":"De Picciotto Y, Lithwick Algon A, Amit I et al (2024) Large-scale evidence for the validity of remote MoCA administration among people with cerebellar ataxia. Clin Neuropsychol. https:\/\/doi.org\/10.1080\/13854046.2024.2397835","journal-title":"Clin Neuropsychol"},{"key":"13071_CR16","doi-asserted-by":"publisher","DOI":"10.2196\/47179","volume":"25","author":"C Harrison","year":"2023","unstructured":"Harrison C, Trickett R, Wormald J et al (2023) remote symptom monitoring with ecological momentary computerized adaptive testing: pilot cohort study of a platform for frequent, low-burden, and personalized patient-reported outcome measures. J Med Internet Res 25:e47179. https:\/\/doi.org\/10.2196\/47179","journal-title":"J Med Internet Res"},{"key":"13071_CR17","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1093\/gerona\/gls255","volume":"68","author":"S Lord","year":"2013","unstructured":"Lord S, Galna B, Verghese J et al (2013) Independent domains of gait in older adults and associated motor and nonmotor attributes: validation of a factor analysis approach. J Gerontol A Biol Sci Med Sci 68:820\u2013827. https:\/\/doi.org\/10.1093\/gerona\/gls255","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"13071_CR18","doi-asserted-by":"publisher","first-page":"2749","DOI":"10.1007\/s00415-020-09815-2","volume":"268","author":"A Diallo","year":"2021","unstructured":"Diallo A, Jacobi H, Tezenas du Montcel S, Klockgether T (2021) Natural history of most common spinocerebellar ataxia: a systematic review and meta-analysis. J Neurol 268:2749\u20132756. https:\/\/doi.org\/10.1007\/s00415-020-09815-2","journal-title":"J Neurol"},{"key":"13071_CR19","doi-asserted-by":"publisher","first-page":"5449","DOI":"10.1007\/s00415-023-11859-z","volume":"270","author":"J Conrad","year":"2023","unstructured":"Conrad J, Huppert A, Ruehl RM et al (2023) Disability in cerebellar ataxia syndromes is linked to cortical degeneration. J Neurol 270:5449\u20135460. https:\/\/doi.org\/10.1007\/s00415-023-11859-z","journal-title":"J Neurol"},{"key":"13071_CR20","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1212\/WNL.0000000000002041","volume":"85","author":"T Bremova","year":"2015","unstructured":"Bremova T, Malinov\u00e1 V, Amraoui Y et al (2015) Acetyl-dl-leucine in niemann-pick type C. Neurology 85:1368\u20131375. https:\/\/doi.org\/10.1212\/WNL.0000000000002041","journal-title":"Neurology"},{"key":"13071_CR21","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s00415-019-09570-z","volume":"267","author":"G Arcuria","year":"2020","unstructured":"Arcuria G, Marcotulli C, Amuso R et al (2020) Developing a smartphone application, triaxial accelerometer-based, to quantify static and dynamic balance deficits in patients with cerebellar ataxias. J Neurol 267:625\u2013639. https:\/\/doi.org\/10.1007\/s00415-019-09570-z","journal-title":"J Neurol"},{"key":"13071_CR22","unstructured":"Jaroensri R, Zhao A, Balakrishnan G, et al (2017) A video-based method for automatically rating ataxia. In: Machine Learning for Healthcare Conference (PMLR). pp 204\u2013216"},{"key":"13071_CR23","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1002\/mds.27915","volume":"35","author":"KZ Gajos","year":"2020","unstructured":"Gajos KZ, Reinecke K, Donovan M et al (2020) Computer mouse use captures ataxia and parkinsonism, enabling accurate measurement and detection. Mov Disord 35:354\u2013358. https:\/\/doi.org\/10.1002\/mds.27915","journal-title":"Mov Disord"},{"key":"13071_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2019.105257","volume":"188","author":"S Summa","year":"2020","unstructured":"Summa S, Schirinzi T, Bernava GM et al (2020) Development of SaraHome: a novel, well-accepted, technology-based assessment tool for patients with ataxia. Comput Methods Programs Biomed 188:105257. https:\/\/doi.org\/10.1016\/j.cmpb.2019.105257","journal-title":"Comput Methods Programs Biomed"},{"key":"13071_CR25","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s12311-023-01543-3","volume":"23","author":"M Grobe-Einsler","year":"2023","unstructured":"Grobe-Einsler M, Amin AT, Faber J et al (2023) scale for the assessment and rating of ataxia (SARA): development of a training tool and certification program. The Cerebellum 23:877\u2013880. https:\/\/doi.org\/10.1007\/s12311-023-01543-3","journal-title":"The Cerebellum"},{"key":"13071_CR26","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-024-01700-2","author":"M Potashman","year":"2024","unstructured":"Potashman M, Rudell K, Pavisic I et al (2024) Content validity of the modified functional scale for the assessment and rating of ataxia (f-SARA) instrument in spinocerebellar ataxia. The Cerebellum. https:\/\/doi.org\/10.1007\/s12311-024-01700-2","journal-title":"The Cerebellum"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-13071-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-025-13071-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-13071-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T08:41:24Z","timestamp":1747644084000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-025-13071-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,10]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["13071"],"URL":"https:\/\/doi.org\/10.1007\/s00415-025-13071-7","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,10]]},"assertion":[{"value":"8 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 April 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This study was approved by Tel Aviv University Institutional Review Board committee. Informed consent was obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}],"article-number":"332"}}