Wearable Technology to Detect Motor Fluctuations in Parkinson's Disease Patients: Current State and Challenges

Abstract

Monitoring of motor symptom fluctuations in Parkinson's disease (PD) patients is currently performed through the subjective self-assessment of patients. Clinicians require reliable information about a fluctuation's occurrence to enable a precise treatment rescheduling and dosing adjustment. In this review, we analyzed the utilization of sensors for identifying motor fluctuations in PD patients and the application of machine learning techniques to detect fluctuations. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ten studies were included between January 2010 and March 2021, and their main characteristics and results were assessed and documented. Five studies utilized daily activities to collect the data, four used concrete scenarios executing specific activities to gather the data, and only one utilized a combination of both situations. The accuracy for classification was 83.56-96.77%. In the studies evaluated, it was not possible to find a standard cleaning protocol for the signal captured, and there is significant heterogeneity in the models utilized and in the different features introduced in the models (using spatiotemporal characteristics, frequential characteristics, or both). The two most influential factors in the good performance of the classification problem are the type of features utilized and the type of model.

Keywords: Parkinson´s disease; motor fluctuations; motor symptoms; sensors; treatment.

Figure 1

PRISMA diagram of the bibliographic review conducted.

Figure 2

Plot of the number of selected articles that satisfy each of the items of the checklist used.

Figure 3

Diagram bar with the type of algorithms utilized. Acronyms: SVM—support vector machines; KNN—k-nearest neighbors; DT—decision tree; CNN—convolutional neural network; RF—random forest; LR—linear regression; NB—näive Bayes; HA—hierarchical algorithm; ANN—artificial neural network; CMLA—customized machine learning algorithm.