Device Rivals Clinicians' Assessment of Parkinson's Disease Symptoms

Caroline Cassels

June 15, 2007

June 15, 2007 (Istanbul) — A promising new device can objectively assess upper-extremity symptoms in Parkinson's disease (PD) patients with more than 80% accuracy, rivaling that of physician assessment with the current gold standard, the Unified Parkinson's Disease Rating Scale (UPDRS).

Preliminary results of a pilot study of Kinesia (Cleveland Medical Devices, Ohio) a lightweight, wireless, movement-disorder monitor, showed good correlation — greater than 80% — between the device's assessment of bradykinesia and tremor in 40 PD subjects and clinician scores.

"Our goal is to produce a system to more consistently quantify symptoms [PD] symptoms with improved resolution using a standard platform so that, instead of just getting a snapshot at a single point in time in a physician's office, we can really capture how a subject is doing over the course of a day or over the course of a week, and these early results suggest this is feasible," the study's principal investigator, Joseph Giuffrida, PhD, from Cleveland Medical Devices, told Medscape.

The results of the study were presented at the 11th International Congress of Parkinson's Disease and Movement Disorders, in Istanbul, Turkey,

Early Findings Promising

Kinesia works through a finger-worn motion sensor, which transmits information to the wrist-worn transceiver, which in turn, wirelessly sends findings to a computer.

The device also has the capacity to store data, allowing it to be worn continuously for 12 hours and then downloaded by the clinician at the next office visit.

During the study, the device collected and quantified data from subjects as they completed a subset of the UPDRS upper-extremity motor exam.

Hands of the study subjects were videotaped while they were completing the exam, and these tapes were then given to clinicians, who scored patients using the UPDRS.

Early findings, comparing the results of the device with clinician scores for the symptoms of tremor and bradykinesia, were well correlated.

Role in Drug Trials?

"We are showing good correlation to tremor and bradykinesia — between 80% to 90%," said Dr. Giuffrida. The research team has plans to test the device in another 20 PD subjects.

Recently approved by the FDA, the device is currently being marketed primarily to the research community. However, said Dr. Giuffrida, if the device proves successful, it could be used to monitor efficacy of PD drugs, initially in clinical trials but ultimately in routine clinical practice.

"If you think about it, an objective, standardized platform should be able to detect subtle differences better than the human eye and remove variability in subjective scores. Kinesia is meant not to replace clinical judgment but to give clinicians another tool to better assess patient outcomes," he said.

Furthermore, added Dr. Giuffrida, Kinesia only assesses upper-extremity symptoms and therefore does not provide a complete clinical picture. Nevertheless, he said, it should provide an accurate assessment of what are common, troubling motor-function symptoms for many PD patients.

11th International Congress of Parkinson's Disease and Movement Disorders: Poster Session I-115. June 3-7, 2007.

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