Objective: To evaluate the contribution of a digital biomarker to the identification of motor complications in patients with Parkinson’s disease (PD) being considered for deep brain stimulation (DBS).

Background: Patient selection for DBS is primarily based on clinical evaluation and rating scales. However, objective monitoring of motor fluctuations may provide additional information. STAT-ON is a wearable device that continuously measures motor states in PD, including motor OFF, dyskinesia, and bradykinesia.

Method: Data were collected in the Parkinson’s programme of the Andalusian multicentre personalized medicine study (NeuroRECA: Alianza Andalucía Roche). This is a prospective study evaluating multi-omics biomarker predictors in patients with PD who are candidates for DBS, including digital biomarkers. Patients wore STAT-ON for 5–7 days and underwent standard clinical assessments, including the UPDRS. Three objective criteria derived from STAT-ON were analyzed: motor OFF >2 h/day, dyskinesia >1 h/day, and bradykinesia index <8.5. Agreement between wearable-derived metrics and clinical scales was evaluated.

Results: A total of 66 patients with PD were recruited (mean age 57.5 ± 8.6 years; 62% male). Of these, 39 wore the device and were included in the present analysis. Among them, 11 (28.2%) had >2 h/day of motor OFF, 20 (51.3%) had >1 h/day of dyskinesia, and 12 (30.7%) showed a bradykinesia index <8.5. Overall, 24 patients (61.5%) fulfilled at least one STAT-ON criterion suggestive of advanced motor complications. Agreement with corresponding UPDRS-IV items was 85% for dyskinesia and 82% for motor OFF; concordance was 58% with total UPDRS-III scores and 67% when axial motor items were considered. Among the 15 patients not identified by the device as having advanced disease, 11 had a tremor-dominant phenotype and 3 showed mild axial symptoms based on gait, posture, and postural stability items on the UPDRS-III.

Conclusion: Wearable monitoring with STAT-ON showed high agreement with clinical measures of dyskinesia and motor fluctuations, and moderate agreement with bradykinesia-related clinical measures. These findings suggest that this digital biomarker may provide complementary information to clinical assessment when identifying patients with PD and motor complications who may be eligible for DBS.

References: 1. Rodríguez-Martín D, Cabestany J, Pérez-López C, et al. A New Paradigm in Parkinson’s Disease Evaluation With Wearable Medical Devices: A Review of STAT-ON. Front Neurol. 2022 Jun 2: 13: 912343.

2. Pérez-López C, Hernández-Vara J, Caballol N, et al. Comparison of the Results of a Parkinson’s Holter Monitor With Patient Diaries, in Real Conditions of Use: A Sub-analysis of the MoMoPa-EC Clinical Trial. Front Neurol. 2022 May 16: 13:835249.

3. Rodríguez-Molinero A, Pérez-López C, Samà A, et al. A Kinematic Sensor and Algorithm to Detect Motor Fluctuations in Parkinson Disease: Validation Study Under Real Conditions of Use. JMIR Rehabil Assist Technol. 2018 Apr 25; 5 (1): e8.

4. Samà A, Angulo C, Pardo D, et al. Analyzing human gait and posture by combining feature selection and kernel methods. Neurocomputing. 2011 Sept; 74 (16): 2665-2674.

5. Pérez-López C, Samà A, Rodríguez-Martín D, et al. Assessing Motor Fluctuations in Parkinson’s Disease Patients Based on a Single Inertial Sensor. Sensors 2016; 16(12): 2132.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/monitoring-of-motor-complications-with-wearable-technology-in-parkinsons-patients-considered-for-deep-brain-stimulation/