FM2-2 Exploratory analysis whether wearable sensor data can correlate with aspects of non-motor symptoms in parkinson’s: a real life study with the parkinson’s kinetigraphTM

Abstract

ObjectivesTo determine the association between the range and nature of non-motor symptoms (NMS) in people with Parkinson’s (PwP) and validated Parkinson’s KinetigraphTM (PKG) outcome measures.DesignCross-sectional retrospective study of participants enrolled in the Non-motor Longitudinal International Study (NILS, UKCRN No: 10084) at King’s College Hospital, London.Subjects108 PwP with a PKG recording within 4 months of a NILS assessment were included in the analysis.MethodsPKG is a validated accelerometery-based measure for motor function in PwP, reporting scores for global bradykinesia (BKS) and dyskinesia (DKS). NMS were assessed by the NMS scale (NMSS).ResultsUsing multiple linear regression, BKS was predicted by NMSS domains 6 (gastrointestinal tract; p=0.006) and 8 (sexual function; p=0.003). DKS was predicted by domains 3 (mood/cognition; p=0.016), domain 4 (perceptual problems; p=0.025), domain 6 (gastrointestinal tract; p=0.029) and domain 9 (miscellaneous, p=0.003). In these domains, anxiety, delusions, dysphagia, hyposmia, weight change and hyperhidrosis significantly predicted DKS. In addition, carbidopa dose predicted NMSS total scores (p=0.037), but not total LEDD (p=0.91).ConclusionsIn PwP, measures of BK and DK were mainly associated with gastrointestinal problems, underpinning the importance of gastric absorption of oral medications and constipation and the related motor effects in PwP. Interestingly, carbidopa appears to have a role in non-motor symptoms in PwP, which deserves further investigation.

Should there be less emphasis on levodopa‐induced dyskinesia in Parkinson's disease?

“…Illustrating this are data from an unselected cohort of 200 PD patients being recruited to an international wearable sensor registry study showing that significant dyskinesia is observed among only 18.5% of the moderate‐ to advanced‐stage PD population referred to King's College Hospital (London), a major academic teaching hospital. This is in line with the studies by Scott and colleagues and Bjornestad and colleagues and might even be an overestimation given that our center is a reference center for advanced therapies . An additional factor to consider also is the under‐recognized phenomenon of “levodopaphobia” where patients intentionally avoid or delay taking clinically effective doses of l ‐dopa for the fear of dyskinesia .…”