Noninvasive Device Monitors Parkinson’s Patients, Informs Treatment Decisions

An innovative new companion monitoring tool worn like a wristwatch could help provide more effective therapy for patients with Parkinson's disease and other disorders that affect movement by better informing the decisions of physicians who treat them.

A Cedars-Sinai (Los Angeles, CA, USA) research team is one of the first in the nation to test the Personal KinetiGraph (PKG) data logger, which tracks the movements of Parkinson's patients every 2 minutes over a period of 6–10 days. The information enables neurologists to generate reports showing the fluctuations of Parkinson's symptoms throughout the day and the timing of when patients take their medication.

Michele Tagliati, MD, Cedars-Sinai, said the device could be a game-changer for treatment of patients with advanced Parkinson's disease by providing an objective record of movement fluctuations. Such information can enhance doctors' understanding of the nature and progression of the brain disorder. The device also vibrates to remind patients to press a button indicating that they have taken their medication.

"This technology could help us as physicians better inform our patients of treatment options, such as when to have an aggressive therapy like deep brain stimulation," said Dr. Tagliati, "A more refined approach to treating the symptoms of the disease will ultimately lead to a better quality of life for our patients."

Currently, one of the biggest challenges neurologists face when managing Parkinson's patients is making treatment decisions based on relatively brief patient interactions and subjective patient reports about symptoms. "It's virtually impossible to make a well-informed treatment plan based on how patients feel they have been doing in the last three months, because often they don't remember," said Dr. Tagliati, "The PKG device provides a quantitative way to monitor and understand the fluctuations of movements in our patients when they are not in the office."

Dr. Tagliati and colleague Echo Tan, MD, have sought to more fully understand the disease. After the US Food and Drug Administration (FDA) cleared the device in 2014, they launched a 60-patient clinical trial to study its effectiveness. The study includes patients from various stages of Parkinson's disease. Preliminary findings have been valuable. For example, one patient said his medication stopped working after three hours, whereas the report generated by the watch device showed that the drug hadn't worked at all. This information prompted Dr. Tan to change the patient's prescription.

"The watch works great," said a study patient, "It makes it more objective as opposed to subjective. Like the pain scale, for example. They ask you to rate your pain on a scale of 0 to 10, but my 5 might be your 9, or my 5 might be your 1."

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