Abstract
Parkinson’s disease (PD) is a chronic, progressive neurological disorder and the second most common neurodegenerative condition. Advanced PD is complicated by erratic gastric absorption, delayed gastric emptying in turn causing medication overload, and hence the emergence of motor and non-motor fluctuations and dyskinesia, which is initially predictable and then becomes unpredictable. As the patient progresses to the advanced stage, advanced Parkinson’s disease (APD) is characterized by refractory motor and non motor fluctuations, unpredictable OFF periods, and troublesome dyskinesias. The management of APD is a complex affair. There is growing recognition that GI dysfunction is common in PD, with virtually the entire GI system (the upper and lower GI tracts) causing problems from dribbling to defecation. The management of PD should focus on personalized care addressing both motor and non-motor symptoms, ideally including not only dopamine replacement but also associated non-dopaminergic circuits, particularly focusing on noradrenergic, serotonergic, and cholinergic therapies bypassing the gastrointestinal tract (GIT) by infusion or device-aided therapies (DAT), including levodopa–carbidopa intestinal gel infusion, apomorphine subcutaneous infusion, and deep brain stimulation, which are available in many countries for the management of the advanced stage of Parkinson’s disease (APD). The PKG (KinetiGrap) can be used as a continuous objective monitoring (COM) aid, as a screening tool to help to identify advanced PD (APD) patients suitable for DAT, and can thus improve clinical outcomes.
Highlights
Parkinson’s disease is the second most common neurodegenerative disease, affecting 1–2% of the population over the age of 60 [1,2]
The percent time immobile (PTI) was defined as the percentage of 2-min periods between 9 AM and 6 PM where the movement data recorded by the PKG device were very low and correlated with the daytime sleep measured by polysomnography (PSG) and the Epworth Sleepiness Scale Scores (ESS)
PKG can be used as a continuous objective monitoring (COM) in daily clinical practice
Summary
Parkinson’s disease is the second most common neurodegenerative disease, affecting 1–2% of the population over the age of 60 [1,2]. Med. 2021, 11, 680 device-aided treatments (APO, LCIG, and STN-DBS), was in agreement with previous studies [28,29,30,31,32,33,34,35,36] It showed improvements in motor, non-motor, and quality-of-life outcomes [36]. The Parkinson’s Disease Questionnaire (PDQ-39) [46,47] is a validated disease-specific tool for measuring health-related quality of life in Parkinson’s disease patients It covers eight dimensions—mobility, activities of daily of living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort—and it contains 39 questions. The percent time immobile (PTI) was defined as the percentage of 2-min periods between 9 AM and 6 PM where the movement data recorded by the PKG device were very low and correlated with the daytime sleep measured by polysomnography (PSG) and the Epworth Sleepiness Scale Scores (ESS).
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