Objective: To better understand the utility of a wearable wrist sensor in assessing and managing motor fluctuations in a population of patients with advanced Parkinson Disease (PD) treated with Deep Brain Stimulation (DBS).

Background: Traditional motor fluctuation assessment and treatment decisions in PD patients are based on patients’ self-reports and cross-sectional clinic assessments. The Personal Kinetigraph® (PKG®), Global Kinetics Corporation Ltd., is a wristwatch like device, designed to provide continuous, objective, ambulatory data on bradykinesia, dyskinesia and tremor in PD patients.

Method: We conducted a retrospective chart review in a population of patients with advanced PD treated with DBS, derived from the Movement Disorders Clinic at Michigan State University, between 2017 and 2019. Data from serial PKG recordings obtained from these patients were used in the analysis.

Results: 22 patients were included in the analysis (13 men/9 women) with an average age of 64.6 years (range 51-75), a disease duration of 13.8 years (range 7-23), age at implantation 59.6 years (range 39-69) and 9.3 years since diagnosis when DBS was performed (range 4-21).      
At the start of the study, 63.6% of the patients had a BKS score less than or equal to 25 whereas at the end of the study 54.5% of the patients had a score of 25 or less. Dyskinesia scores remained constant throughout the study with 95.5% of patients having a DKS score of nine or lower at the start and end of the study. The PTI% showed an increase from an average of 10.42% at the first visit to an average of 11.05% at the last visit. Likewise, the PTT% showed an increase from an average of 3.02% at the first visit to an average of 3.53% at the last visit.

Conclusion: In our study we focused on a specific PD population treated with DBS. Despite its use most of our patients still had suboptimal motor control as seen on PKG®. Serial measurements did not show any consistent trend towards improvement in any of the metrics used, for a variety of reasons, including the lack of a standard time interval between assessments. Prospective studies with consistent review of the PKG® data prior to each visit at regular intervals will be necessary to better define its value.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/personal-kinetigraph-and-deep-brain-stimulation-with-parkinsons-disease/