Improved measurement of disease progression in people living with early Parkinson's disease using digital health technologies

BackgroundDigital health technologies show promise for improving the measurement of Parkinson's disease in clinical research and trials. However, it is not clear whether digital measures demonstrate enhanced sensitivity to disease progression compared to traditional measurement approaches.MethodsTo this end, we develop a wearable sensor-based digital algorithm for deriving features of upper and lower-body bradykinesia and evaluate the sensitivity of digital measures to 1-year longitudinal progression using data from the WATCH-PD study, a multicenter, observational digital assessment study in participants with early, untreated Parkinson's disease. In total, 82 early, untreated Parkinson's disease participants and 50 age-matched controls were recruited and took part in a variety of motor tasks over the course of a 12-month period while wearing body-worn inertial sensors. We establish clinical validity of sensor-based digital measures by investigating convergent validity with appropriate clinical constructs, known groups validity by distinguishing patients from healthy volunteers, and test-retest reliability by comparing measurements between visits.ResultsWe demonstrate clinical validity of the digital measures, and importantly, superior sensitivity of digital measures for distinguishing 1-year longitudinal change in early-stage PD relative to corresponding clinical constructs.ConclusionsOur results demonstrate the potential of digital health technologies to enhance sensitivity to disease progression relative to existing measurement standards and may constitute the basis for use as drug development tools in clinical research. Parkinson's disease can impact a person's ability to move, which can result in slow or rigid movements. Wearable sensors can be used to measure these symptoms and could be particularly useful to detect changes early in the course of the disease when symptoms may be subtle. We developed a wearable sensor-based method to measure movement in people with early Parkinson's disease that uses wrist and foot-worn sensors. Our results demonstrate that our sensor-based measurements can accurately quantify progressive changes in movement function. Such measurements may allow researchers to more accurately evaluate how well treatments designed to slow the course of Parkinson's disease are working in the future. Czech et al. develop and clinically validate a sensor-based approach to measure upper and lower body bradykinesia in an early Parkinson's disease population. Results demonstrate enhanced sensitivity of sensor-based digital measurements to disease progression over one year relative to current clinical measurement standards.