Objective: We aim to establish a robust, continuous method for monitoring hypomimia in Parkinson’s disease (PD), bridging the gap between sporadic clinical evaluations and real-life facial expressivity fluctuations.

Background: Hypomimia, a reduction in facial muscle movement, frequently goes unrecognized in early-stage PD despite its significant impact on social interaction. Individuals vary in baseline facial expressivity, making it challenging to identify subtle disease-related changes in standard clinical assessments. While continuous facial monitoring could clarify these nuances, clinicians typically capture only brief, face-focused impressions or videos that remain underutilized for quantitative analysis [1]. Our newly developed sensor-fitted cap addresses this gap by enabling consistent, real-time tracking of facial movements, potentially revealing bradykinesia patterns and supporting more accurate disease evaluation.

Method: We designed a removable sensor brim that attaches to any standard cap. An ultra-wide camera runs real-time landmark detection, capturing only anonymized geometric coordinates of facial features rather than storing raw video, thereby safeguarding patient privacy. In an ongoing trial, participants first undergo a three-hour MDS-UPDRS assessment while wearing the device. They subsequently continue to wear it for a minimum of five hours per day during a two-week inpatient period. Patient feedback, obtained via the System Usability Scale [2] at discharge, informs iterative improvements. To account for intraindividual fluctuations in facial expressivity, clinical experts rate hypomimia severity each morning and evening throughout the study.

Results: Preliminary observations confirm that the cap consistently captures data suitable for detecting fluctuations in facial expressivity, while early usability evaluations indicate broad acceptance during hospital stays. Furthermore, the modular design streamlines rapid prototyping and supports future integration into clinical workflows.

Conclusion: These findings demonstrate the feasibility of continuous, sensor-based hypomimia monitoring in PD and underscore the value of uninterrupted data collection over single-timepoint assessments. This approach may enable earlier detection of subtle bradykinesia, ultimately guiding more precise and personalized therapeutic interventions for patients with Parkinson’s disease.

References: [1] Novotny M, Tykalova T, Ruzickova H, Ruzicka E, Dusek P, Rusz J. Automated video-based assessment of facial bradykinesia in de-novo Parkinson’s disease. npj Digit Med. 2022;5(1):1–8. doi: 10.1038/s41746-022-00642-5.
[2] Bangor A, Kortum PT, Miller JT. An Empirical Evaluation of the System Usability Scale. Int J Hum-Comput Interact. 2008;24(6):574–94. doi: 10.1080/10447310802205776.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/advancing-hypomimia-assessment-in-parkinsons-disease-by-integrating-a-continuous-monitoring-device-into-clinical-practice/