Research ArticleBiosensors

Smartwatch inertial sensors continuously monitor real-world motor fluctuations in Parkinson’s disease

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Science Translational Medicine  03 Feb 2021:
Vol. 13, Issue 579, eabd7865
DOI: 10.1126/scitranslmed.abd7865

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Keeping a watch on Parkinson’s disease

Smartwatches can capture continuous motor activity and physiologic metrics and could be useful for remote patient monitoring. Powers et al. developed a smartwatch-based ambulatory monitoring system to track dyskinesia and resting tremor in patients with Parkinson’s disease. Smartwatch-detected tremor and dyskinesia matched clinician-reported evaluations seen during in-clinic visits. The smartwatch-based system could identify changes in symptoms resulting from better adherence to medication or deep brain stimulation treatment, as well as subclinical symptoms, suggesting a need for alternative treatment or medication titration. This study demonstrates the potential utility of smartwatch-based remote monitoring for Parkinson’s disease.

Abstract

Longitudinal, remote monitoring of motor symptoms in Parkinson’s disease (PD) could enable more precise treatment decisions. We developed the Motor fluctuations Monitor for Parkinson’s Disease (MM4PD), an ambulatory monitoring system that used smartwatch inertial sensors to continuously track fluctuations in resting tremor and dyskinesia. We designed and validated MM4PD in 343 participants with PD, including a longitudinal study of up to 6 months in a 225-subject cohort. MM4PD measurements correlated to clinical evaluations of tremor severity (ρ = 0.80) and mapped to expert ratings of dyskinesia presence (P < 0.001) during in-clinic tasks. MM4PD captured symptom changes in response to treatment that matched the clinician’s expectations in 94% of evaluated subjects. In the remaining 6% of cases, symptom data from MM4PD identified opportunities to make improvements in pharmacologic strategy. These results demonstrate the promise of MM4PD as a tool to support patient-clinician communication, medication titration, and clinical trial design.

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