A Prospective Longitudinal Assessment of PD Functional Impairment and Disability Via Mobile Health Technology

Study Overview
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Brief Summary
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The purpose of this study is to compare data from a battery of novel mobile health technologies to standard-of-care validated patient questionnaires and clinician rating scales in Parkinson's disease patients.

Detailed Description
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Mobile health technologies include the wearable sensor technologies that are body-worn and passively collect information and mobile devices like smartphones that can be frequently used by patients to actively or passively collect information. However, there has been limited comparison of different wearable technologies to validated clinical rating scales to allow us to come to a consensus about their utility in both clinical practice and research trials. Data from mobile health technologies in Parkinson's Disease (PD) have not been validated to use in the place of clinician rating scales. It is also not clear if the information obtained with the devices consistently correlates with change on the clinician scales and longitudinal motor decline. Technological challenges, such as the feasibility (safety, compliance) of use devices in patients with neurodegenerative disease, change in equipment and algorithms over time, collaboration with companies who may own patents, and other issues may also limit their use in healthcare and research. The purpose of this study is to compare data from a battery of novel mobile health technologies to standard-of-care validated patient questionnaires and clinician rating scales in PD patients. The hypothesis is that there will be an association between data from mobile health technologies and data obtained from validated questionnaires/scales, indicating that these technologies are a reliable means of monitoring motor symptomatology and functional impairment and disability over time. The primary aims of the study are to compare information on continuously-measured patient-reported PD-related functional impairment and disability changes from traditional validated questionnaires to continuously-measured health-related data from a battery of novel mobile health technologies, and to assess the feasibility (compliance, safety, satisfaction) of PD patients to use a battery of novel mobile health technologies.

Official Title
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A Prospective Longitudinal Assessment of Parkinson's Disease Functional Impairment and Disability Via Mobile Health Technology

Conditions
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Parkinson Disease

Intervention / Treatment
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* Device: Personal Kinetigraph, Kinesia 360


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: PD as defined by the UK Brain Bank Criteria Disease duration between 2-13 years Aged 35-68 years Hoehn & Yahr stage 3 or less when in the levodopa-ON state Exclusion Criteria: Atypical parkinsonism including 18F-dopa PET patterns consistent with this MMSE score of < 24 or evidence for dementia using DSM-IV criteria Unable to do normal copying of interlocking pentagons and semantic fluency score <20 over 90 secs Ongoing major medical or psychiatric disorder including depression and psychosis Other concomitant treatment with neuroleptics Significant drug induced dyskinesias (>2 for any body part on the AIMS scale) Previous neurosurgery Unable to be imaged using MRI

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 68 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Parkinson Disease patients<br>To examine the relationship between in-home continuous measures of tremor, bradykinesia, mobility, and dyskinesia acquired over a 7-day period, from 2 mobile health technologies (Personal Kinetigraph, Kinesia 360) with one-time in-clinic measures of motor functional ability pertaining to the same 7-day period as assessed by Part 2 of the MDS-UPDRS, Part 4 of the MDS-UPDRS, Neuro-QOL, and PDQ-39. This will be examined in n=20 patients (10 patients assigned to each technology with a crossover at 3 months for a total of 20 patients over 6 months, 6 timepoints with data collected every 2 weeks). Patients will then be following for an observational period of an additional 6 months. | Device: Personal Kinetigraph, Kinesia 360<br>* 10 patients will be assigned to each technology with a crossover at 3 months for a total of 20 patients over 6 months, 6 timepoints with data collected every 2 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Personal Kinetigraph | Watch containing accelerometer and gyroscope for measurement of motor symptoms of PD | 3 months | 
| Kinesia 360 | 2 sensor straps to wrist and ankle containing accelerometer and gyroscope for measurement of motor symptoms of PD. | 3 months | 
| MDS-UPDRS | Part I assesses the non-motor aspects of experiences of daily living in the week prior to the visit. Part II assesses the motor aspects of experiences of daily living in the week prior to the visit. Part III assesses motor disabilities of a subject at the time of the visit and Part IV assesses motor complications in the week prior to the visit. A total of 46 items are included in Parts I, II and III. Each item will receive a score ranging from 0 to 4 where 0 represents the absence of impairment and 4 represents the highest degree of impairment. | 6 months |