Objective: To evaluate the utility of the Parkinson’s KinetiGraph (PKG) as a tool in advanced Parkinson’s disease (PD) to determine need for treatment change by comparing data obtained with patient reported scales.

Background: Traditionally the severity of motor fluctuations in PD is assessed by history and a patient’s self-reporting of symptoms, using different diaries and rating scales, but there are well-known limitations with these subjective assessment methods. The PKG addresses these limitations by providing an objective continuous automated quantification of movement disorder symptoms, experienced at home to enable assessment of bradykinesia and dyskinesia severity and their ratio as a function of motor complications.

Methods: 20 patients with PD (14 male) and motor fluctuations were studied. Mean age was 59.5 (SD 18.5) years and the mean disease duration was 20 (SD 13) years. Oral levodopa frequency was ≥ 4 times/day for all. Data from PKG-recordings over six consecutive days were compared with patient diaries, patient derived dyskinesia severity data (UPDRS IV) and patients perception of motor disability, ranging from 1 (absence of fluctuations) to 5 (fluctuations with severe negative functional impact).

Results: By history the mean total daily duration of the OFF time was 3h (30 min-340 min). There was no significant correlation between PKG derived bradykinesia score (BKS) with subjectively reported OFF time (R=0.29, p=0.25) and UPDRS IV part B Fluctuations (R=0.25, p=0.28). 47% of patients, who completed the diary (n=17) reported troublesome dyskinesia with mean duration of 17.85 % (1-34.7%) of the waking day. Correlation between PKG derived dyskinesia score (DKS) and UPDRS IV part A Dyskinesias was approaching significance (R=0.38, p=0.09). A statistically significant association was found between patients perception of disability due to motor fluctuations and fluctuation score (FS) derived from variations in DKS and BKS (p=0.018, R=0.52).

Conclusions: Our data demonstrate that this commercially available system could play a supportive role in assessing motor aspects of more advanced PD, and reassuringly are matched with patient perception. Diaries continue to be unreliable, particularly in the advanced cohort. Further studies in a larger cohort are needed to further assess the validity of these preliminary results.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/automated-assessment-of-advanced-motor-parkinsons-disease-a-pilot-study-of-the-parkinsons-kinetigraph-as-an-objective-tool-for-measurement-of-motor-fluctuations/