Non-motor correlates of wrist-worn wearable sensor use in Parkinson’s disease: an exploratory analysis

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.

Characterization of Non‐Motor Fluctuations Using the Movement Disorder Society Non‐Motor Rating Scale

“…In addition, we used wearable sensor outcomes that did not necessarily coincide with the assessment of NMF, and some data was obtained up to 4 months from NMF assessment, reflecting clinical practice of use of wearables and in keeping with other studies. 15 In addition, we only observed weak associations between wearable sensor data and MDS-UPDRS part IV scores which might be perceived as limiting the use of wearable sensor data. However, the lack of strong association between scale-based assessments and objective data has been reported before and highlights the limitations and bias related to scale-based assessments.…”

“…16 We included PKG data if a participant had a PKG recording within 120 days of the MDS-NMS assessment, based on previously used cut-offs. 15 For the wearable sensor outcomes, we compared: (a) dyskinesia severity scores across different disease durations in PD, in line with the MDS-NMS analysis outlined above; (b) differences in recording dyskinesia severity between the wearable sensor and classical motor scales (MDS-UPDRS); and (c) NMF severity in participants with and without early morning "off" periods (EMO) as a marker of motor fluctuations. The first epoch (06:00-09:00) was not used for dyskinesia analysis as some participants may still have been asleep during this time potentially providing unreliable readings.…”

Wearables als unterstützendes Tool für den Paradigmenwechsel in der Versorgung von Parkinson Patienten

“…Sie stellten fest, dass Bradykinese mit Obstipation und Sexualfunktion signifikant korrelierte und Hyperkinesien mit Psychose und Impuls-Kontroll-Störungen. Die Autoren postulieren, dass die Analyse der Bewegungsmuster einen Rückschluss auf die autonomen Funktionen zulässt [4].…”

Wearable and Biodegradable Sensors for Clinical and Environmental Applications

“…The detailed medical analysis of PD patients in their natural environment could minimize the frequency of accidents, through limiting risk activities. , Heijmans and collaborators (Figure D) were concerned to follow the routine of 20 individuals with Parkinson’s using 3 wearable physical sensors, arranged on the skin for 14 consecutive days, collecting data on objective and involuntary movements resulting from the disease. The data obtained through wearable sensors and questionnaires applied to individuals revealed the feasibility of continuous monitoring, suggesting some modifications for prolonged use.…”