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 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.

Motion sensor strategies for automated optimization of deep brain stimulation in Parkinson's disease.

Background: Deep brain stimulation (DBS) is a well-established treatment for Parkinson's disease (PD). Optimization of DBS settings can be a challenge due to the number of variables that must be considered, including presence of multiple motor signs, side effects, and battery life.

Methods: Nine PD subjects visited the clinic for programming at approximately 1, 2, and 4 months post-surgery.

Motion sensor dyskinesia assessment during activities of daily living.

Background: Dyskinesia throughout the levodopa dose cycle has been previously measured in patients with Parkinson's disease (PD) using a wrist-worn motion sensor during the stationary tasks of arms resting and extended. Quantifying dyskinesia during unconstrained activities poses a unique challenge since these involuntary movements are kinematically similar to voluntary movement.

Objective: To determine the feasibility of using motion sensors to measure dyskinesia during activities of daily living.

Objective motion sensor assessment highly correlated with scores of global levodopa-induced dyskinesia in Parkinson's disease.

Background: Chronic use of medication for treating Parkinson's disease (PD) can give rise to peak-dose dyskinesia. Adjustments in medication often sacrifice control of motor symptoms, and thus balancing this trade-off poses a significant challenge for disease management.

Objective: To determine whether a wrist-worn motion sensor unit could be used to ascertain global dyskinesia severity over a levodopa dose cycle and to develop a severity scoring algorithm highly correlated with clinician ratings.

Automated motion sensor quantification of gait and lower extremity bradykinesia.

The objective was to develop and evaluate algorithms for quantifying gait and lower extremity bradykinesia in patients with Parkinson's disease using kinematic data recorded on a heel-worn motion sensor unit. Subjects were evaluated by three movement disorder neurologists on four domains taken from the Movement Disorders Society Unified Parkinson's Disease Rating Scale while wearing the motion sensor unit. Multiple linear regression models were developed based on the recorded kinematic data and clinician scores and produced outputs highly correlated to clinician scores with an average correlation coefficient of 0.

Quantitative assessment of levodopa-induced dyskinesia using automated motion sensing technology.

The objective was to capture levodopa-induced dyskinesia (LID) in patients with Parkinson's disease (PD) using body-worn motion sensors. Dopaminergic treatment in PD can induce abnormal involuntary movements, including choreatic dyskinesia (brief, rapid, irregular movements). Adjustments in medication to reduce LID often sacrifice control of motor symptoms, and balancing this tradeoff poses a significant challenge for management of advanced PD.

Quantitative analysis of gait and balance response to deep brain stimulation in Parkinson's disease.

Gait and balance disturbances in Parkinson's disease (PD) can be debilitating and may lead to increased fall risk. Deep brain stimulation (DBS) is a treatment option once therapeutic benefits from medication are limited due to motor fluctuations and dyskinesia. Optimizing DBS parameters for gait and balance can be significantly more challenging than for other PD motor symptoms.

Acute effects of passive leg cycling on upper extremity tremor and bradykinesia in Parkinson's disease.

Background: Previous studies have shown that single bouts of high-rate active cycling (> 80 rpm) improve upper extremity motor function in individuals with Parkinson's disease (PD). It is unknown if passive leg cycling produces a similar effect on upper extremity function. This article examines whether passive leg cycling can promote immediate changes in upper tremor and bradykinesia in PD and if pedaling rates have variable effects.

Feasibility of home-based automated Parkinson's disease motor assessment.

Patients with Parkinson's disease (PD) receive therapies aimed at addressing a diverse range of motor symptoms. Motor complications in the form of symptom fluctuations and dyskinesias that commonly occur with chronic PD medication use may not be effectively captured by Unified Parkinson's Disease Rating Scale (UPDRS) assessments performed in the clinic. Therefore, home monitoring may be a viable adjunct tool to provide insight into PD motor symptom response to treatment.

Objective quantification of arm rigidity in MPTP-treated primates.

Rigidity is a cardinal symptom of Parkinson's disease and is frequently used as an outcome measure in clinical and non-human primate studies examining the effects of medication or surgical intervention. A limitation of current rigidity assessment methods is that they are inherently subjective. To better understand the physiological mechanisms of rigidity and how various therapeutic approaches work, a more objective and quantitative method is needed.