Role of the Personal KinetiGraph in the routine clinical assessment of Parkinson’s disease: recommendations from an expert panel

ABSTRACT

Introduction: Evaluation of people with Parkinson’s disease (PD) is often complex due to heterogeneity of symptoms and disease course, including the variability of motor fluctuations and dyskinesia. Routine clinical evaluations may be incomplete, may not accurately capture important symptoms, and may not reflect day-to-day variability. While significant advances have been made in wearable ambulatory continuous objective monitoring (COM) technologies, many clinicians remain uncertain of how to incorporate them in clinical practice, including the value to clinical decision-making. The Personal KinetiGraph™ (PKG) has FDA clearance in the United States, and has recently been used in several clinical studies.

Areas covered: An expert group of movement disorders neurologists convened to discuss the clinical utility of the PKG in the routine assessment of people with PD. Based on their experience, the group identified clinical scenarios where objective information gained from review of PKG reports can provide useful information to improve clinical management.

Expert commentary: PKG provides clinically meaningful data in patients with PD that can aid the clinician in evaluating patients and optimizing their pharmacologic therapy. Early clinical experience and expert opinion suggest that utilization of COM technologies such as the PKG have the potential to improve medical care in people with PD.

KEYWORDS:

• Parkinson’s disease
• bradykinesia
• dyskinesia
• technology
• wearable
• assessment
• ambulatory monitoring
• continuous objective monitoring

Acknowledgments

The authors thank Lisa Day of Global Kinetics Corporation for her help with the face-to-face meeting and figures.

Declaration of interest

R Pahwa reports personal compensation for Abbvie, Acadia, Adamas, Accorda, Global Kinetics

Corporation, Lundberg, Impax, Neurocrine, St Jude Medical, Pexton, Teva Neuroscience, UCB, Sunovion, and US WorldMeds. He has received research grants from Acadia, Adamas, Avid, Accorda, Boston Scientific, Cala Health, Kyowa, Pfizer, NIH/NINDS, NPF, and PSG/University of Rochester. He has also served on the data monitoring committee for Ionis Pharma. He has received personal compensation as the Co-Editor-in-Chief of the International Journal of Neuroscience.

SH Isaacson reports consultancy and/or promotional speaker on behalf of: Acadia, Acorda, Adamas, Allergan, Amarantus, Biotie, Britannia, Cynapsus, GE, Global Kinetics Corporation, Impax, Ipsen, Kyowa, Lundbeck, NeuroDerm, Teva, UCB, US WorldMeds. In addition, he reports research funding from Abbvie, Acadia, Acorda, Adamas, Addex, Allergan, Biotie, Civitas, Eisai, Ipsen, Kyowa, Lilly, Merck, Michael J Fox Foundation, Parkinson Study Group, Pharma2B, Roche, Serono, Teva, UCB Pharma, and US WorldMeds. D Torres-Russotto has been a speaker or consultant for Allergan, AbbVie, Adamas, Ipsen, Global Kinetics Corporation, Lundbeck, and Teva. In addition, he has received research grants from AbbVie, Ipsen, Huntington Study Group, Parkinson Study Group, NIH/NINDS. F Nahab reports funding support from the National Institute of Neurological Disorders and Stroke (1R01NS073683-01A1), International Essential Tremor Foundation, CTSA (1UL1TR000460, UL1TR000100, UL1TR001442), Biotie, Cavion Inc., Michael J. Fox Foundation, and educational funding from Medtronic. He reports serving as a consultant for Cala Health, Global Kinetics Corporation, and Teva Neuroscience. He has also received royalties from Springer Publishing. P Lynch is employed by Global Kinetics Corporation. K Kotschet reports consultancy for Global Kinetics Corporation and a financial interest in Global Kinetics Corporation, and has research grant funding from Ipsen. Medical writing support on this paper was provided by Anita Chada-Patel of ACP Clinical Communications.

Reviewer disclosures

One reviewer is involved in a company that develops a similar device but reviewers had no other relevant financial relationships to disclose.

Additional information

Funding

This paper is the result of a meeting of US and Australian based movement disorder neurologists with expertise in the use of Personal KinetiGraph in clinical assessment. Participation at the meeting (honoraria and expenses) was funded by Global Kinetics Corporation. Medical writing support was funded by Global Kinetics Corporation.