mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease

Abstract Accurately monitoring motor and non-motor symptoms as well as complications in people with Parkinson’s disease (PD) is a major challenge, both during clinical management and when conducting clinical trials investigating new treatments. A variety of strategies have been relied upon including...

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Autores principales:	M. Kelley Erb, Daniel R. Karlin, Bryan K. Ho, Kevin C. Thomas, Federico Parisi, Gloria P. Vergara-Diaz, Jean-Francois Daneault, Paul W. Wacnik, Hao Zhang, Tairmae Kangarloo, Charmaine Demanuele, Chris R. Brooks, Craig N. Detheridge, Nina Shaafi Kabiri, Jaspreet S. Bhangu, Paolo Bonato
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/0dd58e5b67224d71adf3be1ff21cbc66
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spelling	oai:doaj.org-article:0dd58e5b67224d71adf3be1ff21cbc662021-12-02T14:29:12ZmHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease10.1038/s41746-019-0214-x2398-6352https://doaj.org/article/0dd58e5b67224d71adf3be1ff21cbc662020-01-01T00:00:00Zhttps://doi.org/10.1038/s41746-019-0214-xhttps://doaj.org/toc/2398-6352Abstract Accurately monitoring motor and non-motor symptoms as well as complications in people with Parkinson’s disease (PD) is a major challenge, both during clinical management and when conducting clinical trials investigating new treatments. A variety of strategies have been relied upon including questionnaires, motor diaries, and the serial administration of structured clinical exams like part III of the MDS-UPDRS. To evaluate the potential use of mobile and wearable technologies in clinical trials of new pharmacotherapies targeting PD symptoms, we carried out a project (project BlueSky) encompassing four clinical studies, in which 60 healthy volunteers (aged 23–69; 33 females) and 95 people with PD (aged 42–80; 37 females; years since diagnosis 1–24 years; Hoehn and Yahr 1–3) participated and were monitored in either a laboratory environment, a simulated apartment, or at home and in the community. In this paper, we investigated (i) the utility and reliability of self-reports for describing motor fluctuations; (ii) the agreement between participants and clinical raters on the presence of motor complications; (iii) the ability of video raters to accurately assess motor symptoms, and (iv) the dynamics of tremor, dyskinesia, and bradykinesia as they evolve over the medication cycle. Future papers will explore methods for estimating symptom severity based on sensor data. We found that 38% of participants who were asked to complete an electronic motor diary at home missed ~25% of total possible entries and otherwise made entries with an average delay of >4 h. During clinical evaluations by PD specialists, self-reports of dyskinesia were marked by ~35% false negatives and 15% false positives. Compared with live evaluation, the video evaluation of part III of the MDS-UPDRS significantly underestimated the subtle features of tremor and extremity bradykinesia, suggesting that these aspects of the disease may be underappreciated during remote assessments. On the other hand, live and video raters agreed on aspects of postural instability and gait. Our results highlight the significant opportunity for objective, high-resolution, continuous monitoring afforded by wearable technology to improve upon the monitoring of PD symptoms.M. Kelley ErbDaniel R. KarlinBryan K. HoKevin C. ThomasFederico ParisiGloria P. Vergara-DiazJean-Francois DaneaultPaul W. WacnikHao ZhangTairmae KangarlooCharmaine DemanueleChris R. BrooksCraig N. DetheridgeNina Shaafi KabiriJaspreet S. BhanguPaolo BonatoNature PortfolioarticleComputer applications to medicine. Medical informaticsR858-859.7ENnpj Digital Medicine, Vol 3, Iss 1, Pp 1-10 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Computer applications to medicine. Medical informatics R858-859.7 M. Kelley Erb Daniel R. Karlin Bryan K. Ho Kevin C. Thomas Federico Parisi Gloria P. Vergara-Diaz Jean-Francois Daneault Paul W. Wacnik Hao Zhang Tairmae Kangarloo Charmaine Demanuele Chris R. Brooks Craig N. Detheridge Nina Shaafi Kabiri Jaspreet S. Bhangu Paolo Bonato mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease
description	Abstract Accurately monitoring motor and non-motor symptoms as well as complications in people with Parkinson’s disease (PD) is a major challenge, both during clinical management and when conducting clinical trials investigating new treatments. A variety of strategies have been relied upon including questionnaires, motor diaries, and the serial administration of structured clinical exams like part III of the MDS-UPDRS. To evaluate the potential use of mobile and wearable technologies in clinical trials of new pharmacotherapies targeting PD symptoms, we carried out a project (project BlueSky) encompassing four clinical studies, in which 60 healthy volunteers (aged 23–69; 33 females) and 95 people with PD (aged 42–80; 37 females; years since diagnosis 1–24 years; Hoehn and Yahr 1–3) participated and were monitored in either a laboratory environment, a simulated apartment, or at home and in the community. In this paper, we investigated (i) the utility and reliability of self-reports for describing motor fluctuations; (ii) the agreement between participants and clinical raters on the presence of motor complications; (iii) the ability of video raters to accurately assess motor symptoms, and (iv) the dynamics of tremor, dyskinesia, and bradykinesia as they evolve over the medication cycle. Future papers will explore methods for estimating symptom severity based on sensor data. We found that 38% of participants who were asked to complete an electronic motor diary at home missed ~25% of total possible entries and otherwise made entries with an average delay of >4 h. During clinical evaluations by PD specialists, self-reports of dyskinesia were marked by ~35% false negatives and 15% false positives. Compared with live evaluation, the video evaluation of part III of the MDS-UPDRS significantly underestimated the subtle features of tremor and extremity bradykinesia, suggesting that these aspects of the disease may be underappreciated during remote assessments. On the other hand, live and video raters agreed on aspects of postural instability and gait. Our results highlight the significant opportunity for objective, high-resolution, continuous monitoring afforded by wearable technology to improve upon the monitoring of PD symptoms.
format	article
author	M. Kelley Erb Daniel R. Karlin Bryan K. Ho Kevin C. Thomas Federico Parisi Gloria P. Vergara-Diaz Jean-Francois Daneault Paul W. Wacnik Hao Zhang Tairmae Kangarloo Charmaine Demanuele Chris R. Brooks Craig N. Detheridge Nina Shaafi Kabiri Jaspreet S. Bhangu Paolo Bonato
author_facet	M. Kelley Erb Daniel R. Karlin Bryan K. Ho Kevin C. Thomas Federico Parisi Gloria P. Vergara-Diaz Jean-Francois Daneault Paul W. Wacnik Hao Zhang Tairmae Kangarloo Charmaine Demanuele Chris R. Brooks Craig N. Detheridge Nina Shaafi Kabiri Jaspreet S. Bhangu Paolo Bonato
author_sort	M. Kelley Erb
title	mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease
title_short	mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease
title_full	mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease
title_fullStr	mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease
title_full_unstemmed	mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease
title_sort	mhealth and wearable technology should replace motor diaries to track motor fluctuations in parkinson’s disease
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/0dd58e5b67224d71adf3be1ff21cbc66
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mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease

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