The use of wearables for the diagnosis and treatment of Parkinson's disease

Abstract

Parkinson's disease (PD) is the second most common neurodegenerative disorder, with increasing numbers of affected patients. Many patients lack adequate care due to insufficient specialist neurologists/geriatricians, and older patients experience difficulties traveling far distances to reach their treating physicians. A new option for these obstacles would be telemedicine and wearables. During the last decade, the development of wearable sensors has allowed for the continuous monitoring of bradykinesia and dyskinesia. Meanwhile, other systems can also detect tremors, freezing of gait, and gait problems. The most recently developed systems cover both sides of the body and include smartphone apps where the patients have to register their medication intake and well-being. In turn, the physicians receive advice on changing the patient's medication and recommendations for additional supportive therapies such as physiotherapy. The use of smartphone apps may also be adapted to detect PD symptoms such as bradykinesia, tremor, voice abnormalities, or changes in facial expression. Such tools can be used for the general population to detect PD early or for known PD patients to detect deterioration. It is noteworthy that most PD patients can use these digital tools. In modern times, wearable sensors and telemedicine open a new window of opportunity for patients with PD that are easy to use and accessible to most of the population.

Keywords: Digital medicine; Parkinson’s disease; Sensors; Telemedicine; Wearables.

Fig. 1

Facial expression-based model of the iPrognosis app for detection of hypomimia and depression

Fig. 2

Section of a PKG report summarizing the seven day recording from 8AM till 11 PM of a PD patient with severe dyskinesia—peak dose (around 9:30AM, 12:30AM) and end off dose dyskinesia (around 7PM) as shown by the fat green line and mild bradykinesia throughout the day with slight worsening around 5PM and 11 PM as shown by the fat blue line. The red lines present the determined Levodopa intake times and the red quadrats the confirmed medication intake time of the PD patient