Objective: To evaluate if PKG data influences neurologists´ treatment decisions in routine clinical care of patients with Parkinson´s disease.

Background: The PKG movement recording system is a wrist worn device carried for 6-10 consecutive days. It collects data on motor function in patients’ normal environment. Besides motor patterns (bradykinesia, dyskinesia and tremor) it registers data on immobility, medication adherence and tendency to impulsiveness.

Method: A prospective observational cohort study of patients (n=100) attending the Neuro Department at the Karolinska University Hospital in Stockholm, Sweden. A clinical assessment with the Parkinson´s Disease Composite Scale (PDCS) and a H&Y staging is performed by the study nurse at the inclusion visit approximately 10 days before the planned visit. Number of positive items in the Non-Motor Symptom Questionnaire (NMSQ) and an assessment of health-related QoL with the Parkinson´s Disease Questionnaire-8 (PDQ-8) are collected. Exclusion criteria include severe dementia, use of wheelchair and having had a PKG recording or a visit to the neurologist the last 3 months. Patients wear the PKG for 6 days. Five neurologists with varying level of PKG experience participate in the study. The PKG information is not available to the treating neurologist until the end of the visit. Before reviewing the PKG results, the neurologist answer a pre-defined set of questions and formulate a recommendation regarding treatment. Immediately after this, the neurologist is able to review the PKG and answer (Yes or No) whether the PKG information changed the treatment recommendation. A second PKG recording at 3-6 months is performed. Secondary outcomes include change in PDCS, NMSQ, PDQ-8 and PKG scores.

Results: Preliminary data has been analyzed (n=37). 19 patients (51%) were male and mean age was 69 years (range 48 – 86). Mean disease duration was 7 years (1.5 – 17.5) and the majority was H&Y stage 2 (59%). Mean PDCS score was 16.1 (2 – 38). Patients reported an average of 8.4 (1 – 17) non-motor symptoms in the NMSQ and mean PDQ-8 score was 7.5 (0 – 15). Inspection of the PKG changed the treatment decision for 13 (35%) of the patients.

Conclusion: Based on the preliminary results, PKG information influences clinical treatment decisions in a substantial number of patients. PKG recordings may provide valuable information in routine clinical care of patients with Parkinson´s disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-information-from-the-personal-kinetigraph-pkg-influence-neurologists-treatment-decisions/