当前位置: X-MOL 学术npj Digit. Med. › 论文详情
mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease
npj Digital Medicine Pub Date : 2020-01-17 , DOI: 10.1038/s41746-019-0214-x
M. Kelley Erb; Daniel R. Karlin; Bryan K. Ho; Kevin C. Thomas; Federico Parisi; Gloria P. Vergara-Diaz; Jean-Francois Daneault; Paul W. Wacnik; Hao Zhang; Tairmae Kangarloo; Charmaine Demanuele; Chris R. Brooks; Craig N. Detheridge; Nina Shaafi Kabiri; Jaspreet S. Bhangu; Paolo Bonato

Accurately monitoring motor and non-motor symptoms as well as complications in people with Parkinson’s disease (PD) is a major challenge, both during clinical management and when conducting clinical trials investigating new treatments. A variety of strategies have been relied upon including questionnaires, motor diaries, and the serial administration of structured clinical exams like part III of the MDS-UPDRS. To evaluate the potential use of mobile and wearable technologies in clinical trials of new pharmacotherapies targeting PD symptoms, we carried out a project (project BlueSky) encompassing four clinical studies, in which 60 healthy volunteers (aged 23–69; 33 females) and 95 people with PD (aged 42–80; 37 females; years since diagnosis 1–24 years; Hoehn and Yahr 1–3) participated and were monitored in either a laboratory environment, a simulated apartment, or at home and in the community. In this paper, we investigated (i) the utility and reliability of self-reports for describing motor fluctuations; (ii) the agreement between participants and clinical raters on the presence of motor complications; (iii) the ability of video raters to accurately assess motor symptoms, and (iv) the dynamics of tremor, dyskinesia, and bradykinesia as they evolve over the medication cycle. Future papers will explore methods for estimating symptom severity based on sensor data. We found that 38% of participants who were asked to complete an electronic motor diary at home missed ~25% of total possible entries and otherwise made entries with an average delay of >4 h. During clinical evaluations by PD specialists, self-reports of dyskinesia were marked by ~35% false negatives and 15% false positives. Compared with live evaluation, the video evaluation of part III of the MDS-UPDRS significantly underestimated the subtle features of tremor and extremity bradykinesia, suggesting that these aspects of the disease may be underappreciated during remote assessments. On the other hand, live and video raters agreed on aspects of postural instability and gait. Our results highlight the significant opportunity for objective, high-resolution, continuous monitoring afforded by wearable technology to improve upon the monitoring of PD symptoms.
更新日期:2020-01-17

 

全部期刊列表>>
化学/材料学中国作者研究精选
ACS材料视界
南京大学
自然科研论文编辑服务
剑桥大学-
中国科学院大学化学科学学院
南开大学化学院周其林
课题组网站
X-MOL
北京大学分子工程苏南研究院
华东师范大学分子机器及功能材料
中山大学化学工程与技术学院
试剂库存
天合科研
down
wechat
bug