Objective: To develop and evaluate objective measures of Parkinson’s disease (PD) severity and progression by applying dynamical systems analysis to inertial sensor kinematic data.

Background: The slow progressive nature of PD is a significant challenge for developing PD therapeutics. Disease progression is slow and heterogeneous in early PD, and estimation of disease severity is based on clinical rating scales (e.g. MDS-UPDRS) that are subjective and limited in sensitivity to detect change. Measures derived from wearable sensor data may have improved sensitivity, accuracy, and reproducibility, and may better reflect patients’ own perceptions of PD progression during a clinical trial.

Method: A wearable sensor-based movement monitoring system (Mobility Lab, APDM Inc.) was used to obtain data from 129 participants with PD at the baseline visit in the ongoing SPARK Study (NCT03318523). Data were acquired from 5 synchronized sensors (L5 lumbar, both wrists, both feet) while the participants completed a series of activities including (but not limited to) repeated arm and leg movements, walking, sitting, and standing still. We will refer to this as the Quantitative Movement Assessment (QMA). Comparison data were obtained from healthy volunteers also completing the QMA. Signal features were extracted from both phase plane and time series data derived from the sensors, and were chosen to reflect phenomena of motion that comprise the clinical definition of PD motor signs (e.g. bradykinesia and tremor) and traditionally make up the scoring guidelines for observation during items on part III of the MDS-UPDRS.

Results: Fifty sensor-derived QMA measures have been defined that quantify bradykinesia in each arm and leg, rest tremor in each arm, postural tremor, postural instability, and gait characteristics. QMA measures significantly differentiate between PD and healthy participants. Within the PD participants, QMA measures were strongly related to clinical disease severity as measured by the MDS-UPDRS part III at study entry.

Conclusion: Objective measures from inertial sensors worn during the QMA may provide improved sensitivity and precision compared to conventional clinical rating scales such as the MDS-UPDRS. These analytics will need to be evaluated in longitudinal datasets to determine their suitability to detect changes in the progression of Parkinson’s disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantifying-movement-to-measure-parkinsons-disease-severity-and-progression-in-a-phase-2-study-spark/