A Prospective Longitudinal Assessment of PD Functional Impairment and Disability Via Mobile Health Technology

A Prospective Longitudinal Assessment of Parkinson's Disease Functional Impairment and Disability Via Mobile Health Technology

The purpose of this study is to compare data from a battery of novel mobile health technologies to standard-of-care validated patient questionnaires and clinician rating scales in Parkinson's disease patients.

Mobile health technologies include the wearable sensor technologies that are body-worn and passively collect information and mobile devices like smartphones that can be frequently used by patients to actively or passively collect information. However, there has been limited comparison of different wearable technologies to validated clinical rating scales to allow us to come to a consensus about their utility in both clinical practice and research trials. Data from mobile health technologies in Parkinson's Disease (PD) have not been validated to use in the place of clinician rating scales. It is also not clear if the information obtained with the devices consistently correlates with change on the clinician scales and longitudinal motor decline. Technological challenges, such as the feasibility (safety, compliance) of use devices in patients with neurodegenerative disease, change in equipment and algorithms over time, collaboration with companies who may own patents, and other issues may also limit their use in healthcare and research. The purpose of this study is to compare data from a battery of novel mobile health technologies to standard-of-care validated patient questionnaires and clinician rating scales in PD patients. The hypothesis is that there will be an association between data from mobile health technologies and data obtained from validated questionnaires/scales, indicating that these technologies are a reliable means of monitoring motor symptomatology and functional impairment and disability over time. The primary aims of the study are to compare information on continuously-measured patient-reported PD-related functional impairment and disability changes from traditional validated questionnaires to continuously-measured health-related data from a battery of novel mobile health technologies, and to assess the feasibility (compliance, safety, satisfaction) of PD patients to use a battery of novel mobile health technologies.

Inclusion Criteria:

• PD as defined by the UK Brain Bank Criteria
• Disease duration between 2-13 years
• Aged 35-68 years
• Hoehn & Yahr stage 3 or less when in the levodopa-"ON" state

Exclusion Criteria:

• Atypical parkinsonism including 18F-dopa PET patterns consistent with this
• MMSE score of < 24 or evidence for dementia using DSM-IV criteria
• Unable to do normal copying of interlocking pentagons and semantic fluency score <20 over 90 secs
• Ongoing major medical or psychiatric disorder including depression and psychosis
• Other concomitant treatment with neuroleptics
• Significant drug induced dyskinesias (>2 for any body part on the AIMS scale)
• Previous neurosurgery Unable to be imaged using MRI