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Powers R, Etezadi-Amoli M, Arnold EM, Kianian S, Mance I, Gibiansky M, Trietsch D, Alvarado AS, Kretlow JD, Herrington TM, Brillman S, Huang N, Lin PT, Pham HA, Ullal AV. Smartwatch inertial sensors continuously monitor real-world motor fluctuations in Parkinson's disease. Sci Transl Med. 2021 Feb 3;13(579) PubMed.
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Washington University
There are several highlights of the study that are noteworthy. In the non-PD control group, it was impressive that dyskinesia false-positive rates were so low (~2 percent overall) since these movements are more heterogeneous and can mimic normal functions. In the PD patient cohort, there was near-perfect correspondence between clinical rating and smartphone symptom profiles. Clinicians provided with very little information used the smartphone symptom profiles to accurately (87.5 percent) classify before/after medication treatment status. Finally, and most intriguing to me, was the ability to contemporaneously measure individual medication response—this is a potential breakthrough for symptomatic treatments in PD.
There are several highlights of the study that are noteworthy. In the non-PD control group, it was impressive that dyskinesia false-positive rates were so low (~2 percent overall) since these movements are more heterogeneous and can mimic normal functions. In the PD patient cohort, there was near-perfect correspondence between clinical rating and smartphone symptom profiles. Clinicians provided with very little information used the smartphone symptom profiles to accurately (87.5 percent) classify before/after medication treatment status. Finally, and most intriguing to me, was the ability to contemporaneously measure individual medication response—this is a potential breakthrough for symptomatic treatments in PD.
Of course, this approach may not work for all cases. There were unacceptably high dyskinesia FP rates for musical instrument playing, cycling, and, oddly, “riding a bus,” but with some tweaks and perhaps some individual customization or careful screening, these problems should be easily surmountable. Since inertial sensor technology is now widely available and very inexpensive, it would benefit the field to see if similar data could be captured by devices from different manufacturers—and especially from devices with a more economical price point than the Apple Watch.
However, the authors have shared the data, and more importantly, made the code used to create daily tremor and dyskinesia profiles freely available, and thus should be commended on their commitment to open science. I look forward to seeing more data from this team and especially work in sub-clinical detection in at-risk PD populations.
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