Technology-based assessment of motor and nonmotor phenomena in Parkinson disease

ABSTRACT

Introduction: The increasing development and availability of portable and wearable technologies is rapidly expanding the field of technology-based objective measures (TOMs) in neurological disorders, including Parkinson disease (PD). Substantial challenges remain in the recognition of disease phenomena relevant to patients and clinicians, as well as in the identification of the most appropriate devices to carry out these measurements.

Areas covered: The authors systematically reviewed PubMed for studies employing technology as outcome measures in the assessment of PD-associated motor and nonmotor abnormalities.

Expert commentary: TOMs minimize intra- and inter-rater variability in clinical assessments of motor and nonmotor phenomena in PD, improving the accuracy of clinical endpoints. Critical unmet needs for the integration of TOMs into clinical and research practice are the identification and validation of relevant endpoints for individual patients, the capture of motor and nonmotor activities from an ecologically valid environment, the integration of various sensor data into an open-access, common-language platforms, and the definition of a regulatory pathway for approval of TOMs. The current lack of multidomain, multisensor, smart technologies to measure in real time a wide scope of relevant changes remain a significant limitation for the integration of technology into the assessment of PD motor and nonmotor functional disability.

KEYWORDS:

• Biomarker
• Parkinson
• technology
• motor symptoms
• nonmotor symptoms
• trial

Declaration of interest

A Merola is supported by the NIH (KL2 TR001426), has received speaker honoraria from CSL Behring and Cynapsus Therapeutics, and has received grant support from Lundbeck. A Fasano has received grants/research support from MJ Fox Foundation, University of Toronto, McLaughlin Centre; has received honoraria or consultation fees from AbbVie, Boston Scientific, Chiesi Farmaceutici, Ipsen, Medtronic, Novartis, TEVA Canada, UCB Pharma; and has participated in sponsored advisory boards for AbbVie, Boston Scientific, and Ipsen. AJ Espay is supported by the NIH, has received grant support from CleveMed/Great Lakes Neurotechnologies, Davis Phinney Foundation, and MJ Fox Foundation; was an investigator in Chelsea-sponsored studies, has acted as a scientific advisor to Lundbeck, and is marketer for Droxidopa but has no financial interest in either company. They have received personal compensation as a consultant/advisory board member for Solvay, Abbott, Chelsea Therapeutics, TEVA, Impax, Merz, Lundbeck, and Eli Lilly; has received honoraria from TEVA, UCB, the AAN, and the Movement Disorder Society; and publishing royalties from Lippincott Williams & Wilkins, Cambridge University Press, and Springer. The authors have no further conflicts of interest to declare.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.