Objective: To investigate the correspondence between subjective data on motor symptoms prospectively collected at home and retrospective, subjective data assessed by structured interview in patients with Parkinson’s Disease (PD).

Background: The fine-tuning of antiparkinsonian treatment relies on subjective report of their motor symptoms by PD patients at clinical consultation. However, retrospective data might be biased by subjects’ recall. Our group developed an app for tablets especially designed for PD named Sleep Fit. It allows ecological momentary assessment of current motor and sleep-related symptoms by repeated, real-time prospective sampling at precise moments of the day.

Methods: Subjective data on motor symptoms were collected in 42 consecutive patients (9 females, 67 ± 9.8 year-old) with mild to moderate idiopathic PD: a) prospectively, at home, in four different moments of the day for 2 weeks, by mean of the Scales for Outcome in Parkinson Assessment Diary Card (SCOPA-DC) and a Visual Analogue Scale assessing global mobility (VAS-motor), both incorporated in Sleep Fit; b) retrospectively at day 14, by mean of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) parts II and IV, at the hospital. The overall agreement between prospectively and retrospectively collected information was calculated per each category and per patient, as the root mean square difference, after normalization. We also investigated the correlation between agreement and demographics.

Results: The agreement within each category was 16.5% (range 0.0-41.7%) for walking, 18.5% (range 0-75%) for changing position, 15.0% (range 0-43.8%) for hand dexterity, 12.2% (range 0-37.5%) for involuntary movements. Overall, it was of 18.3% (range 0-44.5%) for the four categories together. Global mobility estimated by the VAS-motor scale showed better agreement with MDS-UPDRS parts II+IV (10.0%, range 0.3-40.8%). Preliminary analyses suggest possible correlation between agreement and fatigue, sleepiness, disturbed sleep, motor impairment, levodopa equivalent dose and general morbidity.

Conclusions: Although the agreement between prospective and retrospective assessments of subjective motor symptoms was overall good, a subgroup of PD patients seemed not to accurately report their motor symptoms at clinical consultation. Prospective data collection by mean of the app Sleep Fit might be helpful to overcome this pitfall in clinical practice.

References: Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1-32. Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in nursing & health. 1990 Aug;13(4):227-36.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prospective-home-based-assessment-of-motor-symptoms-in-parkinsons-disease-by-mean-of-the-sleep-fit-app-a-potential-new-clinical-approach/