Objective: To determine the effect of ethnic background on motor scores in people with Parkinson’s disease (PwP) using objective measurement.

Background: Limited evidence has suggested that the motor response to dopaminergic medication in PwP differs across people from different ethnic backgrounds. For example, it has been observed that people of black African descent appear hyporesponsive [1]. Objective measures, overcoming the limitations of scale-based and in-clinic assessments [2, 3], are lacking.

Method: We included PwP with a diagnosis of idiopathic Parkinson’s disease (PD) according to the UK Brain Bank criteria, who were enrolled on the Parkinson’s Kinetigraph^TM Registry (PKG Registry) study at the Parkinson’s Foundation Centre of Excellence at King’s College Hospital London (REC reference: 17/LO/1010, IRAS ID: 215965), and for whom data on ethnic background was available. The PKG watch is a wrist-worn device that provides continuous monitoring of motor symptoms and is worn for a period of six consecutive day. A proprietary algorithm calculates scores for bradykinesia (BKS) and dyskinesia (DKS) [4].

Results: A total of 99 participants were included in the current analysis with 11 from an Asian, 9 from a Black, and 79 from a Caucasian background. Participants from the three groups were well-matched for age, gender, disease duration, levodopa equivalent daily dose, and other baseline characteristics (p≥0.15; table 1), whereas a trend was observed for lower SCales for Outcomes in PD in participants of Asian descent (p=0.08). Using the 75^th of percentile of BK and DK scores we observed significant differences in dyskinesia severity across groups (p=0.024), with highest scores in PwP of Asian and lowest scores PwP of Black descent (figure 1). No differences were observed for bradykinesia, tremor, and immobility scores (p≥0.14).

Conclusion: Despite similar demographic characteristics, including dopaminergic treatment, PwP of Asian descent appear more prone to dyskinesia than PwP of Black or Caucasian descent. In addition, our study underlines the discrepancy between classical motor scale outcomes and objective wearable outcomes in PD. We propose both findings should be taken into account in the clinical management of PwP.

References: [1] Chaudhuri KR, Hu MT, Brooks DJ (2000) Atypical parkinsonism in Afro-Caribbean and Indian origin immigrants to the UK. Mov Disord 15, 18-23. [2] Ossig C, Gandor F, Fauser M, Bosredon C, Churilov L, Reichmann H, Horne MK, Ebersbach G, Storch A (2016) Correlation of Quantitative Motor State Assessment Using a Kinetograph and Patient Diaries in Advanced PD: Data from an Observational Study. PLoS One 11, e0161559. [3] Erb MK, Karlin DR, Ho BK, Thomas KC, Parisi F, Vergara-Diaz GP, Daneault JF, Wacnik PW, Zhang H, Kangarloo T, Demanuele C, Brooks CR, Detheridge CN, Shaafi Kabiri N, Bhangu JS, Bonato P (2020) mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson’s disease. NPJ Digit Med 3, 6. [4] Horne M, McGregor S, Lynch P, Zoellner Y (2015) Objective Data In Parkinson’s Disease Therapy Management – A Retrospective Analysis Of The Parkinson’s Kinetigraph (Pkg) Database. Value Health 18, A685.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/wearable-sensor-motor-outcomes-across-patients-with-parkinsons-disease-from-asian-black-and-caucasian-ethnicity-in-the-united-kingdom/