Abstract
The effective management and therapies for Parkinson’s disease (PD) require appropriate clinical evaluation. The Parkinson’s KinetiGraph (PKG) is a wearable sensor system that can monitor the motion characteristics of PD objectively and continuously. This study was aimed to assess the correlations between PKG data and clinical scores of bradykinesia, rigidity, tremor, and fluctuation. It also aims to explore the application value of identifying early motor symptoms. An observational study of 100 PD patients wearing the PKG for ≥ 6 days was performed. It provides a series of data, such as the bradykinesia score (BKS), percent time tremor (PTT), dyskinesia score (DKS), and fluctuation and dyskinesia score (FDS). PKG data and UPDRS scores were analyzed, including UPDRS III total scores, UPDRS III-bradykinesia scores (UPDRS III-B: items 23–26, 31), UPDRS III-rigidity scores (UPDRS III-R: item 22), and scores from the Wearing-off Questionnaire (WOQ-9). This study shows that there was significant correlation between BKS and UPDRS III scores, including UPDRS III total scores, UPDRS III-B, and UPDRS III-R scores (r = 0.479–0.588, p ≤ 0.001), especially in the early-stage group (r = 0.682, p < 0.001). Furthermore, we found that BKS in patients with left-sided onset (33.57 ± 5.14, n = 37) is more serious than in patients with right-sided onset (29.87 ± 6.86, n = 26). Our findings support the feasibility of using the PKG to detect abnormal movements, especially bradykinesia in PD. It is suitable for the early detection, remote monitoring, and timely treatment of PD symptoms.
Highlights
Parkinson’s disease (PD) is the second most common progressive neurodegenerative disease; it is characterized by motor function and non-motor symptoms (Gronek et al, 2020) and affects approximately 1% of the population aged over 60 years old (Pringsheim et al, 2014)
Compared with the early-stage group, the middle-late-stage group had significantly higher mean scores on the Unified Parkinson’s Disease Rating Scale (UPDRS) I, UPDRS II, UPDRS III, and Non-motor Symptoms Scale (NMSS), and it is opposite for Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores
There were no significant differences in the dyskinesia score (DKS), bradykinesia score (BKS), percent time tremor (PTT) scores, Percent Time Immobile (PTI) scores, or Wearing-off Questionnaire-9 (WOQ-9) scores between the two groups
Summary
Parkinson’s disease (PD) is the second most common progressive neurodegenerative disease; it is characterized by motor function and non-motor symptoms (Gronek et al, 2020) and affects approximately 1% of the population aged over 60 years old (Pringsheim et al, 2014). Dopaminergic motor symptoms, including bradykinesia, rigidity, and tremor, are the core features of clinical PD (Grayson, 2016). After 5 years of levodopa treatment, 50% of PD patients develop “wearing off ” symptoms, motor fluctuations, and dyskinesia (McColl et al, 2002; Stacy et al, 2005; Rosqvist et al, 2018). The effective management and development of new therapeutic strategies require clinical evaluation, such as PD home diaries and clinical rating scales (e.g., the UPDRS). The Unified Parkinson’s Disease Rating Scale (UPDRS) assesses motor performance on a scale of 0 to 4. The effect of treatment is assessed by a rating scale (such as the UPDRS), but there is no established level corresponding to the treatment goal (Richards et al, 1994; Goetz et al, 2007; Odin et al, 2018). There is a great need to assess the effectiveness of therapeutic interventions in clinical trials and routine clinical care
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