Objective: To determine the validity of smartphone software for objective monitoring of motor symptoms in patients with Parkinson’s disease (PD).

Background: Although the MDS-Unified Parkinson’s Disease Rating Scale (UPDRS) scale part III remains the most commonly used framework with which to assess motor impairment in Parkinson’s disease in clinical practice and research [1], it remains subjective and is usually performed infrequently due to the clinical effort required to complete it. Markedly confounded by the day-to-day motor fluctuations many patients face, unitary UPDRS scores poorly reflect individual patient symptoms and reduce power in interventional trials. A number of wearable, smartphone and sensor-based solutions have been proposed that allow patients to monitor symptoms either continuously or at high-frequency without the need for clinical input but the validity of these tools remains untested within well-designed prospective clinical trials. In this study, we validate CloudUPDRS smartphone measures [2] against clinical UPDRS assessment.

Method: The CloudUPDRS Smartphone Software in Parkinson’s (CUSSP) study is a pre-registered pilot multi-site, randomised study. Inclusion criteria were: diagnosis of idiopathic Parkinson’s disease according to Brain Bank criteria, age over 18 years, and Montreal Cognitive Assessment score over 20/30. Sixty patients (females, n = 20) were included so far. Each patient underwent a video-recorded MDS-UPDRS part III clinical examination, and a simultaneous range of UPDRS-style smartphone-based assessments. Objective smartphone measures were used to predict the mean clinical UPDRS rating of 3 neurologists based on video assessment, blinded to the patient’s medication state.

Results: Mean (+/- sd) age was 68 (± 9.5) years. Mean disease duration was 5 (± 4.7) years, with mean Hoehn and Yahr stage of 2. The primary outcome was the predictive accuracy of the smartphone score for the blinded MDS-UPDRS rating score at baseline assessment. Comprehensive analyses are ongoing and will be presented.

Conclusion: The current study is ongoing. We suggest that objective smartphone assessments may allow high-frequency at-home assessment of motor symptoms in PD, and that such a granular picture may be empowering to patients and beneficial to their medical teams and clinical researchers alike.

References: 1. Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Movement disorders : official journal of the Movement Disorder Society 2008;23(15):2129-2170. 2. Kassavetis P, Saifee TA, Roussos G, et al. Developing a Tool for Remote Digital Assessment of Parkinson’s Disease. Movement disorders clinical practice 2016;3(1):59-64.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/smartphone-software-for-home-monitoring-of-motor-symptoms-in-parkinsons-disease-the-cloudupdrs-smartphone-software-in-parkinsons-cussp-study/