Objective: The objective of this population study was to update & expand upon previous research [8] done to describe the objective symptom scores from a larger, deidentified PKG database of PD patients.

Background: The Personal KinetiGraph™ (PKG™) Movement Recording System provides continuous, objective, ambulatory movement data during routine daily activities and provides information on medication compliance, motor fluctuations, immobility, and tremor for patients with Parkinson’s Disease (PD). Previous validation studies have correlated PKG objective scores with other standard PD methods of symptom capture (e.g. Unified Parkinson’s Disease Rating Scale [UPDRS], Abnormal Involuntary Movement Scale [AIMS], etc.). Indications for PKG & patient selection vary by physician.[1-7]

Methods: 21,234 complete and deidentified PKGs from Jan 2012 to March 2018 used globally for routine clinical care were included. Incomplete records (e.g. wear time <4 days) were excluded. Median scores for bradykinesia (BKS), dyskinesia (DKS), and fluctuations (FDS) as well as percent time with tremor (PTT) and percent time immobile (PTI) were included and summarized.

Results: The global mean & median BKS were 26.4 and 26.0, respectively. Sixty-five percent of BKS scores were >23 (correlates with UPDRS III of ~21) , 52% of BKS scores were >25 (~27 UPDRS III), and 36% were >29 (~42 UPDRS III). The global mean & median DKS were 4.1 & 1.7, respectively. Seventeen percent of DKS scores were >7 (~7 mAIMS), and 25% were >5 (~5 mAIMS). The median and mean PTI scores were 6.8% and 9.0%, respectively and 32% of PTI scores were above 10%. The median PTT score was 1.2% and the mean 4.2%. Fifty-three percent of PTT scores were above 1%. For those patients with multiple PKGs, we also assessed PKG symptom scores over time.

Conclusions: This analysis describes Parkinson’s symptomology across an even larger number of patients. It continues to suggest that a meaningful proportion of patients exist who have sub-optimal PD motor symptoms including high levels of bradykinesia and daytime immobility. Continuous objective measurement use in routine clinical care of PD enables identification and quantification of PD motor symptoms, which may then be used by clinicians to assess and track symptoms over time and perhaps become part of routine clinical practice.

References: 1. Griffiths R, Kotschet K, Arfon S, et al. Automated assessment of bradykinesia and dyskinesia in Parkinson’s disease. J Parkinsons Dis. 2012;2(1):47-55; 2. Kotschet K., Johnson W, McGregor S, et al. Daytime sleep in Parkinson’s disease measured by episodes of immobility. Parkinsonism Relat Disord. 2014;20(6):578-83; 3. Evans A, Kettlewell J, McGregor S, et al. A conditioned response as a measure of impulsive-compulsive behaviors in Parkinson’s disease. PLoS One. 2014;9(2):e89319; 4. Horne M, McGregor S, Bergquist F. An objective Fluctuation Score for Parkinson’s Disease. PLoS One. 2015;10(4):e0124522; 5. Braybrook M, O’Connor S, Churchward P, et al. An ambulatory tremor score for Parkinson’s Disease. J Parkinsons Dis. 2016; 6(4), 723-731;6. Ossig C, Gandor F, Bosredon C, Fauser M, Reichmann H, Horne MK, et al. Correlation of objective measurement of motor states using a kinetigraph and patient diaries in advanced Parkinson’s disease. PLoS One. 2016 Aug 24;11(8):e0161559. doi: 10.1371/journal.pone.0161559; 7. Horne M, Kotschet K, McGregor S. The clinical validation of objective measurement of movement in Parkinson’s Disease. CNS. 2016;2(1):16-23.; 8. Lynch P, Pahwa R, Bergquist F, Horne M. Objective Data in Parkinson’s Disease: A description of over 10,000 Parkinson’s symptom scores across the world using the Personal KinetiGraph (PKG). Late Breaking Poster presentation IMDS Conference Vancouver June 2017.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/objective-data-in-parkinsons-disease-a-description-of-over-20000-parkinsons-symptom-scores-across-the-world-using-the-personal-kinetigraph-pkg/