Objective: To evaluate the feasibility of using a wearable device to objectively quantify the motor improvement of a Parkinson Disease patient with a therapy modification from oral to continuous intrajejunal levodopa infusion therapy (LCIG) [1,2].

Background: Current methods to evaluate the effect of therapy adjustment or clinical changes are based on questionnaires and diaries. These methods are subjective and depends on the patient’s perspective. The use of new wearables might provide an objective medical perception to physicians.

Method: A patient diagnosed with Parkinson’s disease who was prescribed for levodopa carbidopa infusion gel therapy based on current evaluation, was assessed with STAT-ON™, a wearable medical device  to objective measure differences in motor symptoms (motor fluctuations, bradykinesia, dyskinesia and freezing of gait (FoG)), before and after therapeutic intervention.

Results: The bradykinesia index (BI) which correlates with UPDRS subscales [3], considers a patient in a suboptimal state in indexes below 6.5 and in optimal state when scores are above 8.5. The BI improved from 6.3 to 7.9. On and Off time were the same pre and post treatment, but the BI showed that the Off quality was milder.

Dyskinesia was reduced from 27.9% to 16.2% and the FoG, which is practically insignificant, was reduced from 1.8 episodes to 0.2 episodes per day. No significant changes in walking minutes per day were observed (125.8 before surgery vs 126.4 after surgery). The improvement registered by STAT-ON™ agreed with patient’s medical history.

Conclusion: LCIG therapy has been shown to be a good therapy in advanced Parkinson patients. Traditional methods to assess motor improvement are subjective and not always reliable. In our patient, STAT-ON™ was consistent to determine several PD motor symptoms compared with current evaluation methods and with the patient opinion. STAT-ON ™  device has shown to be a good tool to quantify these improvements.

References: [1] Antonini A, Isaias IU, Canesi M, Zibetti M, Mancini F, Manfredi L, et al. Duodenal levodopa infusion for advanced Parkinson’s disease: 12-month treatment outcome. Mov Disord. 2007;22:1145—9.

[2] Nyholm D, Lewander T, Johansson A, Lewitt PA, Lundqvist C, Aquilonius SM. Enteral levodopa/carbidopa infusion in advanced Parkinson disease: long-term exposure. Clin Neuropharmacol. 2008;31:63—73.

[3] Rodríguez-Molinero A, et al. Analysis of correlation between an accelerometer-Based algorithm for Detecting Parkinsonian gait and UPDRS subscales. Front Neurol 2017;8:3–8. https://doi.org/10.3389/fneur.2017.00431.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantification-motor-improvement-from-levodopa-carbidopa-infusion-gel-therapy-in-patients-with-parkinsons-disease-using-a-wearable-device/