Objective measurement versus clinician-based assessment for Parkinson’s disease

ABSTRACT

Introduction

Although clinician-based assessment through standardized clinical rating scales is currently the gold standard for quantifying motor impairment in Parkinson’s disease (PD), it is not without limitations, including intra- and inter-rater variability and a degree of approximation. There is increasing evidence supporting the use of objective motion analyses to complement clinician-based assessment. Objective measurement tools hold significant potential for improving the accuracy of clinical and research-based evaluations of patients.

Areas covered

The authors provide several examples from the literature demonstrating how different motion measurement tools, including optoelectronics, contactless and wearable systems allow for both the objective quantification and monitoring of key motor symptoms (such as bradykinesia, rigidity, tremor, and gait disturbances), and the identification of motor fluctuations in PD patients. Furthermore, they discuss how, from a clinician’s perspective, objective measurements can help in various stages of PD management.

Expert opinion

In our opinion, sufficient evidence supports the assertion that objective monitoring systems enable accurate evaluation of motor symptoms and complications in PD. A range of devices can be utilized not only to support diagnosis but also to monitor motor symptom during the disease progression and can become relevant in the therapeutic decision-making process.

KEYWORDS:

• kinematic
• monitoring
• objective measures
• Parkinson’s disease
• wearing off
• sensors
• technology

Declaration of interest

A Antonini has received compensation for consultancy and speaker-related activities from UCB, Boehringer Ingelheim, Ever Pharma, General Electric, Britannia, AbbVie, Kyowa Kirin, Zambon, Bial, Theravance Biopharma, Jazz Pharmaceuticals, Roche, and Medscape. He has also received research support from Bial, Lundbeck, Roche and Angelini Pharmaceuticals as well as through Horizon 2020 Grants 825785 and 101016902, through a Ministry of Education University and Research Grant ARS01_01081, via the Cariparo Foundation, and via the Movement Disorders Society for NMS Scale validation. He has also served as consultant for Boehringer Ingelheim for legal cases on pathological gambling. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

One reviewer is affiliated with the International Parkinson and Movement Disorder Society. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.