Objective: To assess the utility of a cognitive and motor battery on a smartphone/smart watch combination in an at-home setting for remote assessment of PD symptoms by evaluating participants’ adherence and the association between outputs of these assessments and relevant subscales of MDS-UPDRS Part III.

Background: The current gold-standard method to assess and monitor motor impairment in PD is MDS-UPDRS Part III which must be administered in person by a trained specialist, limiting the frequency with which it can be utilized and imposing burden to the research participant. The applicability and use of mobile sensors and smartphone applications to objectively assess the clinical features of PD, enabling remote monitoring of symptoms, have gained increasing interest. The use of such technologies may aid in the diagnosis of PD and improve monitoring of disease progression. A comprehensive set of activities were developed in a mobile app (MAP-PD Study) to capture cognitive and motor deficits of PD. Finger Tapping tasks have been used to objectively assess bradykinesia and shown negative associations with UPDRS Part III score.

Method: 22 PD participants (12 female, 64±6.8 years) in HY stage III or below and 22 controls (12 female, 62±7.2 years). Both groups had a score of 26 or greater on the MMSE and were matched for age, education, and sex. Both groups completed the MDS-UPDRS and smartphone based cognitive and motor battery in lab, continued to perform the digital battery at home for 7 days, and repeated the same battery and MDS-UPDRS on day 9(±4) in lab. The digital battery included symptom tracker, DSST, TMTA and B, VSTM, finger tapping, fine motor, walking, balance, and resting tremor assessments.

Results: PD and control participants successfully completed 95.9% and 89.9% at-home digital activities, respectively. In session1, the control group had a higher number of total taps, lower inter-tap interval, and lower tap duration than the PD group, all p<.05; however, there was no significant difference between groups on the total number of tap errors, p>.05. Neither group in session1 showed a significant association between the digital finger tapping total score and MDS-UPDRS Part III score or finger tapping subscore.

Conclusion: Remote administration of motor and cognitive tasks by a smartphone and smart watch application is feasible and may be a useful tool for monitoring PD disease progression outside the clinic.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/utility-of-a-smartphone-app-in-discretely-assessing-and-monitoring-symptoms-of-parkinsons-disease/