Session Title: Phenomenology and Clinical Assessment of Movement Disorders
Session Time: 1:15pm-2:45pm
Location: Les Muses Terrace, Level 3
Objective: To monitor the motor symptoms in patients with device-assisted therapy (DAT, defined as deep brain stimulation or infusion with apomorphine or levodopa) before and after the start of DAT to evaluate changes in bradykinesia, tremor, dyskinesia and fluctuations.
Background: In Sweden (population of approximately 10 million inhabitants), around 200 new patients are yearly started on DAT, corresponding to around 10% of the incidence of PD. However, there are few published evaluations of the patient situation after initial titrations of patients in clinical routine, and no governmental requirements to report results. Because the DAT treatments are healthcare demanding and give possibilities for individual fine tuning, it would be important to follow patients over time to achieve optimal efficacy of the treatment and improve quality of life for the individual patient.
Method: This retrospective study of motor symptoms for patients that have received DAT was carried out at Karolinska University Hospital and Uppsala University Hospital in Sweden. The inclusion criteria were that the patient should have made a movement recording of their motor symptoms before and after DAT initiation. In total, 25 patients were included in this study up to date. Evaluation of symptoms was made by using a Parkinson Kinetigraph, further patients will be included in the interim phase and presented on poster.
Results: The initial movement recording revealed that 36 % of the patients displayed severe dyskinesia (DKS>9). 44 % of those patients reduced their amount of dyskinesia after DAT initiation (DKS <9). However, this came with increased bradykinetic symptoms (BKS>25) in 75 % of the patients. 32 % of the patients displayed severe symptoms of bradykinesia (BKS <25) during their initial movement recording. 13 % of these reduced their bradykinesia score after DAT treatment (BKS<25). Fluctuation-dyskinesia scores, time with tremor and time immobile are currently analyzed.
Conclusion: The wrist sensor clearly detects motor differences before and after start of DAT and can be used as an adjunct to monitor the effects of DAT. In our cohort, dyskinetic symptoms were reduced upon initiation of DAT but bradykinesia scores deteriorated in the majority of patients, revealing the need for health care to follow and titrate stimulation and medication of the patients after initiating DAT.
To cite this abstract in AMA style:A. Johansson, M. Lundgren, M. öthman, D. Nyholm. Evaluation of Device-Assisted Treatment using a wearable accelerometry wrist sensor [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/evaluation-of-device-assisted-treatment-using-a-wearable-accelerometry-wrist-sensor/. Accessed December 5, 2023.
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