More Sensitive Identification for Bradykinesia Compared to Tremors in Parkinson’s Disease Based on Parkinson’s KinetiGraph (PKG)

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.

Non-Contact Hand Movement Analysis for Optimal Configuration of Smart Sensors to Capture Parkinson’s Disease Hand Tremor

“…These findings indicate that the best locations to capture the maximal movement on the right hand are the distal locations of the hand or at the wrist. This validates the locations used for devices such as Kinesia One TM [22], normally placed distally on the index finger, and also the use of watch devices such as the PKG watch [40].…”

A New Paradigm in Parkinson's Disease Evaluation With Wearable Medical Devices: A Review of STAT-ONTM

“…However, the method cannot determine the “ON” state without dyskinesia ( 81 ). Although there are no data that confirm the performance of an algorithm with blind data, the device has been widely tested under clinical conditions and compared to UPDRS ( 82 ) or diaries ( 80 , 81 ). For instance, the work from Santiago et al ( 83 ), determines that PKG™ provides more information to classical routine visits after analyzing 3 user cases.…”

Outcome Assessment in Parkinson Disease Prevention Trials

“…Here, the advantage of quantifying movement using accelerometers and gyroscopes provides a wealth of information on the quality of movement and potential abnormalities. [17][18][19] A growing body of literature also shows the capability of digital technology to objectively quantify typical PD signs such as tremor, bradykinesia, and dyskinesia and the opportunities for real-world assessment, away from the clinic, which may reveal additional aspects into the patient's functioning in their daily lives that so far alluded clinicians. This type of evaluation is indeed promising because it can pave the way for objective assessment of disease progression.…”