Wearable Device Correctly Identifies Patients With Parkinson for Device-Assisted Therapy

Data collected through a wearable device called the Personal Kinetigraph (PKG) can assist clinicians in recognizing patients with Parkinson disease (PD) who may benefit from deep-brain stimulation (DBS) or other device-assisted therapies (DAT), according to a recent study.

The FDA-approved device is worn on the wrist, like a watch, on the side of the body most affected by the disease and continuously collects data on patients’ movements, such as tremors, involuntary movements, immobility, and motor skill fluctuations. This data helps to provide information on the progression of patients’ motor skills, as well as the effectiveness of therapies available.

Furthermore, the data collected by investigators was also used as a screening tool to recognize patients with PD who could benefit from DBS.

“Although there is broad consensus with respect to the criteria for selecting patients with PD who will benefit from DBS, these symptoms may be difficult for physicians to identify when relying on patient self-report or in-clinic exam findings that may not reflect the spectrum of the individual’s symptoms and result in treatment delays,” Fatta Nahab MD, associate professor of neurosciences at the University of California San Diego, said in a statement.

Over time, the symptomatic benefit of medical therapy tends to wane in patients with PD, referred to as “off” periods. As these therapies become less effective, advanced therapies such as DBS can provide symptomatic improvement in many patients. Despite these potential benefits, nearly 67% of patients referred for DBS may not be suitable candidates for the procedure, and only around 1% of patients with PD receive DBS “despite estimates that as many 20% of patients may be eligible for it,” according to the press release.

The study enrolled 172 patients with PD who underwent assessment for DAT suitability and were then classified according to the presence or absence of “off” periods or dyskinesia that are not adequately addressed by adjustments in available oral medications.

Based on data collected from the PKG device, researchers identified the most useful parameters that allowed the differentiation of patients who were positively selected for DAT from those who were ineligible. Those who qualified for DAT were younger and displayed worse motor symptoms measured by the Unified Parkinson’s Disease Rating Scale.

The PKG-based DAT score was able to correctly identify 87% of patients who were referred for DAT, specifically DBS, in multiple clinical settings. Notably, DAT scores changed when therapeutic interventions were sufficient to resolve motor fluctuations or dyskinesia that would have otherwise required DAT.

“The lack of objective measurements for PD symptoms has been a barrier to optimizing care and outcomes for PD patients across the continuum of the disease. This new study shows that PKG data has significant potential to enable new assessment methods that support the accurate and timely indication of patients who may benefit from advanced therapies,” John Schellhorn, chief executive officer of Global Kinetics Corporation, said in a statement.

Reference

Khodakarami H, Farzanehfar P, Horne M. The use of data from the parkinson’s Kinetigraph to identify potential candidates for device assisted therapies. Sensors (Basel). 2019;19(10):2241. doi: 10.3390/s19102241.