Objective: Assess the feasibility of people with Parkinson’s (PwP) performing 30 seconds of repetitive alternating finger presses using Quantitative Digitography (QDG) technology every 30 minutes during awake hours over two days alongside completing the Hauser home diary and a visual analog scale (VAS) of their perceived motor state.

Background: Home diary-determined motor state is the preferred FDA outcome for pivotal trials of PD therapeutics but has been shown to be different from observed motor state and not useful for early-stage therapeutic trials. QDG is a comprehensive, point-of-care remote monitoring technology that delivers validated quantitative metrics of all motor signs in PD in real time and is sensitive to early and later stages of PD. To assess whether a digital health technology (DHT) can provide an accurate assessment of motor states at a particular time, the digital monitoring must coincide with clinical assessment. We hypothesize that performing a QDG test concurrently with a diary entry will reflect off or on state and correlate with the patient-reported degree of off-on state.

Method: Inclusion criteria: clinically established PD, motor fluctuations with or without dyskinesia. QDG mobility test: 30 seconds of repetitive alternating finger presses and releases on adjacent tensioned levers on a KeyDuo digitography device.¹ Home Diary: PwP recorded whether they felt off, on without dyskinesias, on with non-troublesome dyskinesias, or on with troublesome dyskinesias. VAS (0-10): PwP rated their perceived off to on state. Participants completed the QDG mobility test with each hand alongside VAS and diary entry every 30 minutes during awake hours for two days.  

Results: Preliminary results in the first two participants demonstrated successful execution of the protocol over the 2-day testing period (26 and 23 QDG mobility tests performed bimanually on the first day of testing, respectively). QDG demonstrated fluctuations in the Mobility Score over the day and response to dopaminergic medication based on participant recorded dose timing. Results over the larger cohort will be presented.

Conclusion: QDG mobility testing alongside home diary completion was feasible for tracking motor fluctuations in PwP over a two-day period. Preliminary results support QDG’s potential as a robust DHT for real-time motor state assessment and utility for clinical trials in all stages of PD.

References: [1] Hoffman, S.L., Schmiedmayer, P., Gala, A.S. et al. Comprehensive real time remote monitoring for Parkinson’s disease using Quantitative DigitoGraphy. npj Parkinsons Dis. 10, 137 (2024). https://doi.org/10.1038/s41531-024-00751-w

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantitative-digitography-and-home-diaries-for-pd-motor-state-evaluation/