Continuous Assessment of Levodopa Response in Parkinson's Disease Using Wearable Motion Sensors

Objective: Fluctuations in response to levodopa in Parkinson's disease (PD) are difficult to treat as tools to monitor temporal patterns of symptoms are hampered by several challenges. The objective was to use wearable sensors to quantify the dose response of tremor, bradykinesia, and dyskinesi...

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Bibliographic Details
Published in:IEEE transactions on biomedical engineering 2018-01, Vol.65 (1), p.159-164
Main Authors: Pulliam, Christopher L., Heldman, Dustin A., Brokaw, Elizabeth B., Mera, Thomas O., Mari, Zoltan K., Burack, Michelle A.
Format: Article
Language:English
Subjects:
Aged
Algorithm design and analysis
Algorithms
Ankle
Biomechanical Phenomena
Biomedical monitoring
Cohort Studies
Computer simulation
Correlation analysis
Data collection
Diseases
Drug Monitoring - instrumentation
Drug Monitoring - methods
Drugs
Dyskinesia
Dyskinesias - diagnosis
Dyskinesias - physiopathology
Female
Fluctuations
Home environment
Humans
Kinematics
Levodopa
Levodopa - therapeutic use
Male
Middle Aged
Monitoring
Motion sensors
Motors
Movement disorders
Neurodegenerative diseases
Parkinson Disease - drug therapy
Parkinson Disease - physiopathology
Parkinson's disease
Ratings
ROC Curve
Sensors
Signs and symptoms
technology
Tremor
Wearable Electronic Devices
Wearable sensors
Wearable technology
wearble sensors
Wrist
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Summary:Objective: Fluctuations in response to levodopa in Parkinson's disease (PD) are difficult to treat as tools to monitor temporal patterns of symptoms are hampered by several challenges. The objective was to use wearable sensors to quantify the dose response of tremor, bradykinesia, and dyskinesia in individuals with PD. Methods: Thirteen individuals with PD and fluctuating motor benefit were instrumented with wrist and ankle motion sensors and recorded by video. Kinematic data were recorded as subjects completed a series of activities in a simulated home environment through transition from off to on medication. Subjects were evaluated using the unified Parkinson disease rating scale motor exam (UPDRS-III) at the start and end of data collection. Algorithms were applied to the kinematic data to score tremor, bradykinesia, and dyskinesia. A blinded clinician rated severity observed on video. Accuracy of algorithms was evaluated by comparing scores with clinician ratings using a receiver operating characteristic (ROC) analysis. Results: Algorithm scores for tremor, bradykinesia, and dyskinesia agreed with clinician ratings of video recordings (ROC area > 0.8). Summary metrics extracted from time intervals before and after taking medication provided quantitative measures of therapeutic response (p
ISSN:0018-9294
1558-2531
DOI:10.1109/TBME.2017.2697764