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Abstract
Wearable sensors are becoming increasingly more available in Parkinson’s disease and are used to measure motor function. Whether non-motor symptoms (NMS) can also be measured with these wearable sensors remains unclear. We therefore performed a retrospective, exploratory, analysis of 108 patients with a diagnosis of idiopathic Parkinson’s disease enroled in the Non-motor Longitudinal International Study (UKCRN No. 10084) at King’s College Hospital, London, to determine the association between the range and nature of NMS and an accelerometer-based outcome measure of bradykinesia (BKS) and dyskinesia (DKS). NMS were assessed by the validated NMS Scale, and included, e.g., cognition, mood and sleep, and gastrointestinal, urinary and sexual problems. Multiple linear regression modelling was used to identify NMS associated with BKS and DKS. We found that BKS was associated with domains 6 (gastrointestinal tract; p = 0.006) and 8 (sexual function; p = 0.003) of the NMS scale. DKS was associated with domains 3 (mood/cognition; p = 0.016), 4 (perceptual problems; p = 0.025), 6 (gastrointestinal tract; p = 0.029) and 9 (miscellaneous, p = 0.003). In the separate domains, constipation was significantly associated with BKS. Delusions, dysphagia, hyposmia, weight change and hyperhidrosis were identified as significantly associated with DKS. None of the NMSS domains were associated with disease duration (p ≥ 0.08). In conclusion, measures of BKS and DKS were mainly associated with gastrointestinal problems, independent of disease duration, showing the potential for wearable devices to pick up on these symptoms. These exploratory results deserve further exploration, and more research on this topic in the form of comprehensive large-scale studies is needed.
Highlights
There is a clear need for objective monitoring of nonmotor symptoms (NMS) as many of these symptoms are unreported by up to 42.8% of NMS that were undeclared by PD patients in the clinic, which were later identified by the NMS Questionnaire.[5]
We provide wearable sensor monitoring to all patients who are willing to use the Parkinson’s KinetiGraphTM (PKG) watch for six consecutive days
Patients were not selected based on the presence of motor fluctuations, and their baseline non-motor characteristics did not differ from patients participating in the Non-motor Longitudinal International Study (NILS) study who did not receive a PKG (p = 0.91), making a selection bias unlikely
Summary
Current PD management guidelines focus predominantly on treating motor symptoms and evidence for the treatment of nonmotor symptoms (NMS) is lagging behind the treatment of motor symptoms.[1,2] Addressing NMS is crucial as some can present 15–20 years before the onset of motor symptoms and impact greatly on quality of life.[3,4] there is a clear need for objective monitoring of NMS as many of these symptoms are unreported by up to 42.8% of NMS that were undeclared by PD patients in the clinic, which were later identified by the NMS Questionnaire.[5]The Parkinson’s KinetiGraphTM (PKG), developed by Global Kinetics Corporation, is a wrist-worn wearable sensor device that uses an accelerometer to provide continuous ambulatory monitoring of movement.[6]. The device has MHRA and FDA–CEA marking, and is one of the recent objective wearables measuring BKS and DKS in PD.[7,8]
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