Why measuring Parkinson’s symptoms matters
Parkinson’s disease is a progressive neurodegenerative disorder. No disease-modifying therapies have been approved so far, but a variety of medications and treatments are available to manage symptoms. A detailed understanding of the patient’s symptoms is essential for adjusting medication timing and doses, weighing add-on therapies, and deciding when to escalate to advanced treatments.
Today, the existence and progression of Parkinson’s disease are mainly determined through in-person clinical evaluation during time-restricted appointments and patient-reported information. However, this approach has inherent limitations, often leading to an incomplete evaluation of symptoms and disease progression.
The measurement of Parkinson’s symptoms is intended to complement the clinical assessment and help clinicians get a more holistic view of a patient’s condition by collecting symptom data over an extended period of time and at home. Adding longitudinal, real-world symptom data can improve clinical evaluations and support more informed therapy decisions.
Detailed symptom data for personalized treatment planning
Measurement allows to capture symptom data unobtrusively during the patient’s daily life. By measuring in a familiar in-home environment, the patient’s day-to-day condition is best captured.
Many patients also have difficulty describing their symptoms and might over- or underestimate the severity of their self-perceived motor symptoms. In addition, cognitive impairment and difficulty with attention and concentration may affect a patient’s ability to recall the experienced symptoms and report them during the clinic appointment.
Measurement can help fill the gap and provide detailed symptom data beyond the clinical evaluation. This enables the detection of critical periods and supports the development of highly personalized treatment plans for symptom control.
Detection of fluctuations
Patients on levodopa often experience treatment-related complications, such as fluctuations and dyskinesia. Early data indicate that, for each year of exposure to levodopa, about 10% of people with Parkinson's disease develop motor fluctuations (Aradi et al. 2020). In the management of Parkinson’s disease, fluctuations represent one of the most challenging complications.
With measurement, it is possible to receive more detailed information about when symptoms fluctuate, quickly identify the problematic periods, and adjust medication to best control symptoms while keeping medication-related complications to a minimum.
Treatment optimization
Detailed visibility of the patient’s symptoms is crucial for optimal symptom control and the avoidance of motor fluctuations, particularly in the later stages of the disease.
Measurement supports the clinical goal of treatment optimization by detecting symptoms and showing their course and change over time.
The objective measurement in Parkinson's disease management can contribute to more effective treatment interventions and improved motor disability (Antonini et al. 2023, Woodrow et al. 2020).
Evaluation of treatment effectiveness
Regular assessment of the patient’s symptoms through wearable technology has shown to provide more reliable insights into symptom progression and treatment effectiveness (Adams et al. 2024). It makes symptoms more observable and comparable across visits and allows clinicians to identify symptom patterns and trends. In addition, regular measurement helps clinicians to objectively monitor the treatment's effectiveness and maintain a better care balance for the patient.
Studies show that continuous monitoring plays a crucial role in the treatment quality a patient receives, allowing medical professionals to better understand disease progression and adjust medication.
Despite the availability of innovative technologies for detecting and quantifying symptoms and their fluctuations, interpretation and clinical contextualization remain tasks performed by the clinician responsible for the patient’s care (Müller et al. 2024).
Sources:
Adams, J.L., Kangarloo, T., Gong, Y., Khachadourian, V., Tracey, B., Volfson, D., Latzman, R.D., Cosman, J., Edgerton, J., Anderson, D., et al., Using a Smartwatch and Smartphone to Assess Early Parkinson’s Disease in the WATCH-PD Study over 12 Months, npj Park. Dis., 2024, 10, 112.
Antonini, A., Reichmann, H., Gentile, G., Garon, M., Tedesco, C., Frank, A., Falkenburger, B., Konitsiotis, S., Tsamis, K., Rigas, G., Kostikis, N., Ntanis, A., Pattichis, C., Toward objective monitoring of Parkinson's disease motor symptoms using a wearable device: wearability and performance evaluation of PDMonitor®, Frontiers in Neurology, Volume 14, 2023, https://doi.org/10.3389/fneur.2023.1080752.
Aradi, S.D., Hauser, R. A., Medical Management and Prevention of Motor Complications in Parkinson's Disease, Neurotherapeutics, Volume 17, Issue 4, 2020, Pages 1339–1365, https://doi.org/10.1007/s13311-020-00889-4.
Müller, T., Buhmann, C., Delf, M., Klostermann, F., Kupsch, A., Lipp, A., Müngersdorf, M., von Pannwitz, W., Südmeyer, M., Clinicians’ viewpoints on current paradigms of care and research in Parkinson’s disease, J Neural Transm 131, Pages 1455–1462, 2024, https://doi.org/10.1007/s00702-024-02822-x.
Woodrow, H., Horne, M.K., Fernando, C.V., Kotschet, K.E. et al., A blinded, controlled trial of objective measurement in Parkinson’s disease, npj Parkinsons Dis. 6, 35, 2020, https://doi.org/10.1038/s41531-020-00136-9.