Objective: To evaluate the ability of DHT derived features from remotely collected active tests to measure disease progression in individuals with early Parkinson’s disease (PD) under stable dopaminergic treatment.

Background: Features derived from daily assessments with DHTs have demonstrated high test-retest reliability, clinical validity and sensitivity to disease progression in de-novo diagnosed and dopaminergic treatment-naive early PD participants [1] [2]. However, it is unknown whether the same holds true for individuals with PD who are on stable dopaminergic treatment and who perform daily assessments in the ON-state.

Method: Up to one-year longitudinal data from 53 individuals with PD in their second to sixth year after diagnosis and on stable dopaminergic treatment (avg. age 64.1, 68% male, avg. MDS-UPDRS Total (1-4)  41.2) were analyzed. As this study is ongoing, updated results from a later data cut-off will be presented at MDS.  Participants performed daily active tests at home with the Roche PD Mobile Application v2. Digital features were computed and aggregated over two-week periods (minimum 3 feature values per test per fortnight). Sensitivity to disease progression for digital features, corresponding MDS-UPDRS items, and MDS-UPDRS Part III scores (all collected in the ON state) was assessed with linear mixed effect models fitted on change from baseline to year 1 with age and gender as covariates. 

This was an exploratory, proof-of-concept analysis, with significance level alpha=.2, and no multiple comparisons correction.

Results: Digital features across different core motor symptom domains of Parkinson’s disease demonstrated nominally significant change (e.g. hand turning amplitude from Hand Turning test, turn speed from U-turn test, loudness of speech from Free Speech test). By contrast, MDS-UPDRS Part III total ON scores did not change over one year; and only one MDS-UPDRS item score (3.6 Pronation/Supination corresponding to the Hand Turning test) showed progression.

Conclusion: Digital features derived from remotely collected motor tasks with the Roche PD Mobile Application v2 may sensitively measure progression of Parkinson’s disease in individuals with PD under stable dopaminergic treatment, even while no progression was observed in MDS-UPDRS scores.

References: [1] Lipsmeier, F., Taylor, K.I., Postuma, R.B. et al. Reliability and validity of the Roche PD Mobile Application for remote monitoring of early Parkinson’s disease. Sci Rep 12, 12081 (2022).
[2] K. Taylor, F. Lipsmeier, E. Volkova-Volkmar, M. Scelsi, L. Essioux, A. Monnet, B. van Lier, H. Svoboda, T. Kustermann, W. Zago, T. Nikolcheva, R. Postuma, G. Pagano, M. Lindemann. Exploratory analysis of the effect of delayed-start prasinezumab on motor sign progression measured with the Roche PD Mobile Application v2: PASADENA Phase II Parts 1 and 2 [abstract]. Mov Disord. 2022; 37 (suppl 2).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/digital-health-technology-dht-derived-features-as-sensitive-measures-of-disease-progression-in-early-parkinsons-disease-under-stable-dopaminergic-treatment/