Parkinson’s Kinetigraph in the Selection of Levodopa-Carbidopa Intestinal Gel for Motor Fluctuations Refractory to Deep Brain Stimulation

Noui, Yassine; Silverdale, Monty; Evans, Julian; Partington-Smith, Lucy; Kobylecki, Christopher

doi:10.14802/jmd.20090

Cited by 2 publications

(1 citation statement)

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“…The PKG provides several metrics that can contribute to patient management in PD and has been described in the literature to benefit both home-based assessments and medication management [46][47][48]. PKG has already been previously suggested as a tool to support patient selection for advanced therapies [20,36,49]. The outcome measures obtained from the PKG measurements are not directly comparable to the traditional (motor) scores and may be complementary [48,50,51].…”

Section: Discussionmentioning

confidence: 99%

Predicting Motor Outcome and Quality of Life After Subthalamic Deep Brain Stimulation for Parkinson’s Disease: The Role of Standard Screening Measures and Wearable-Data

Geraedts

Vugt

Marinus

et al. 2023

JPD

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Background: Standardized screening for subthalamic deep brain stimulation (STN DBS) in Parkinson’s disease (PD) patients is crucial to determine eligibility, but its utility to predict postoperative outcomes in eligible patients is inconclusive. It is unknown whether wearable data can contribute to this aim. Objective: To evaluate the utility of universal components incorporated in the DBS screening, complemented by a wearable sensor, to predict motor outcomes and Quality of life (QoL) one year after STN DBS surgery. Methods: Consecutive patients were included in the OPTIMIST cohort study from two DBS centers. Standardized assessments included a preoperative Levodopa Challenge Test (LCT), and questionnaires on QoL and non-motor symptoms including cognition, psychiatric symptoms, impulsiveness, autonomic symptoms, and sleeping problems. Moreover, an ambulatory wearable sensor (Parkinson Kinetigraph (PKG)) was used. Postoperative assessments were similar and also included a Stimulation Challenge Test to determine DBS effects on motor function. Results: Eighty-three patients were included (median (interquartile range) age 63 (56–68) years, 36% female). Med-OFF (Stim-OFF) motor severity deteriorated indicating disease progression, but patients significantly improved in terms of Med-ON (Stim-ON) motor function, motor fluctuations, QoL, and most non-motor domains. Motor outcomes were not predicted by preoperative tests, including covariates of either LCT or PKG. Postoperative QoL was predicted by better preoperative QoL, lower age, and more preoperative impulsiveness scores in multivariate models. Conclusion: Data from the DBS screening including wearable data do not predict postoperative motor outcome at one year. Post-DBS QoL appears primarily driven by non-motor symptoms, rather than by motor improvement.

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