Objective: To assess  the  use of the Parkinson’s  Kinetigraph™ (PKG™) in evaluating the effect of  deep brain stimulation (DBS)  in patients with advanced Parkinson’s disease (PD).

Background: Assessment of the effect of  DBS on bradykinesia and fluctuations is often based on the patients’ own report or diary. The PKG™ allows an objective measurement of PD motor symptoms providing a Bradykinesia Score (BKS), a Dyskinesia Score (DKS), and a Fluctuation Dyskinesia Score (FDS). These  scores have been validated using UPDRS and modified Abnormal Involuntary Movement Scale (mAIMS).  In our study the aim was  to assess DBS effects  with PKG™.

Methods: We performed  six days  PKG™ measurements in  three  patients before DBS operation and 3 months  after DBS operation.  Patients filled out simultaneously paper diaries of their motor fluctuations. The diary data was compared with PKG™ measurements. DBS was programmed 1 and 3 months after operation.

Results: Paper diaries were sparsely filled out and no comprehensive data of motor fluctuations could be obtained.  PKG™ measurements revealed clear changes of daily fluctuations.  Median  scores with standard deviations (SDs)  before DBS were: FDS 13.8±5.4, BKS 22.7 ± 10.2 and DKS 3.0 ± 10.3 (Fig 1. ). After DBS stimulation median scores with SDs were FDS 8.1±2.7, BKS score 26.4.4±6.3 and DKS 0.7±0.4 (Fig 2).

Conclusions: PKG™ measurements revealed reduction of daily fluctuation and dyskinesia after DBS more reliable than diaries. Bradykinesia score was increased which could be due to decreased dyskinesia and postoperative levodopa reduction. PKG™  seems to offer an objective  method to assess DBS effect on  motor symptoms in PD.  Further studies  on the eligibility  of  PKG™ measurement  in  analyzing  the  DBS  effect are warranted.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/ambulatory-movement-measurement-in-evaluating-deep-brain-stimulation-effect-in-patients-with-advanced-parkinsons-disease/