Objective: To evaluate whether mobility measures based on ecological momentary assessment (EMAs) capture deep brain stimulation (DBS) motor improvement in Parkinson’s disease (PD) and correlate with clinician-rated motor impairment (UPDRS III) and motor complications (UPDRS IV).

Background: DBS improves motor symptoms in PD, yet conventional gold-standard clinical assessments such as the UPDRS provide only snapshot evaluations, are labor-intensive and dependent on a structured clinical environment, and are subject to recall-bias. These assessments may not fully capture symptom severity and fluctuations in daily life. EMA and continuous home monitoring offer the potential to quantify real-world symptom dynamics and treatment response with higher ecological validity.

Method: Current preliminary analyses were conducted on 15 PD patients undergoing DBS. Data was collected for 14-day consecutive days, both preoperatively and after DBS-optimization three months postoperatively. A PD-specific EMA questionnaire assessing motor and non-motor symptom severity was prompted six times daily at semi-randomized time points. Clinical motor outcomes were defined as changes in UPDRS III and IV. Associations between EMA-derived mobility metrics (mean and variability of a composite score combining general and hand movement performance) and clinical scores were analyzed using linear mixed-effects models accounting for individual patients.

Results: DBS resulted in significant improvements in both clinical motor scores and EMA-based scores. Higher mean EMA-mobility scores were associated with greater improvement in motor function, showing significant correlations with UPDRS III bradykinesia percentage change (β = −16.74, p < 0.001). Lower EMA mobility variability was associated with less motor fluctuations and correlated with UPDRS IV wearing-off scores (β = 25.21, p = 0.004).

Conclusion: EMA-based home monitoring captures clinically meaningful aspects of motor severity and fluctuations in daily life and reflects DBS treatment effects. These findings support the integration of EMA-supported real-world monitoring into clinical workflows to enhance naturalistic outcome assessment and improve personalized therapy optimization.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/ecological-momentary-assessment-monitoring-captures-motor-fluctuation-improvement-after-dbs-in-parkinsons-disease/