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. 2023 Apr 17;9(1):64.
doi: 10.1038/s41531-023-00497-x.

Using a smartwatch and smartphone to assess early Parkinson's disease in the WATCH-PD study

Jamie L Adams  1   2 , Tairmae Kangarloo  3 , Brian Tracey  3 , Patricio O'Donnell  3   4 , Dmitri Volfson  3 , Robert D Latzman  3 , Neta Zach  3 , Robert Alexander  3   5 , Peter Bergethon  6 , Joshua Cosman  7 , David Anderson  8 , Allen Best  8 , Joan Severson  8 , Melissa A Kostrzebski  9   10 , Peggy Auinger  9   10 , Peter Wilmot  9 , Yvonne Pohlson  9 , Emma Waddell  9 , Stella Jensen-Roberts  9 , Yishu Gong  3 , Krishna Praneeth Kilambi  11   12 , Teresa Ruiz Herrero  13 , E Ray Dorsey  9   10 ; Parkinson Study Group Watch-PD Study Investigators and Collaborators
Collaborators, Affiliations

Using a smartwatch and smartphone to assess early Parkinson's disease in the WATCH-PD study

Jamie L Adams et al. NPJ Parkinsons Dis. .

Abstract

Digital health technologies can provide continuous monitoring and objective, real-world measures of Parkinson's disease (PD), but have primarily been evaluated in small, single-site studies. In this 12-month, multicenter observational study, we evaluated whether a smartwatch and smartphone application could measure features of early PD. 82 individuals with early, untreated PD and 50 age-matched controls wore research-grade sensors, a smartwatch, and a smartphone while performing standardized assessments in the clinic. At home, participants wore the smartwatch for seven days after each clinic visit and completed motor, speech and cognitive tasks on the smartphone every other week. Features derived from the devices, particularly arm swing, the proportion of time with tremor, and finger tapping, differed significantly between individuals with early PD and age-matched controls and had variable correlation with traditional assessments. Longitudinal assessments will inform the value of these digital measures for use in future clinical trials.

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Conflict of interest statement

Dr. Adams has received compensation for consulting services from VisualDx and the Huntington Study Group; and research support from Biogen, Biosensics, Huntington Study Group, Michael J. Fox Foundation, National Institutes of Health/National Institute of Neurological Disorders and Stroke, NeuroNext Network, and Safra Foundation. Ms. Tairmae Kangarloo, Dr. Brian Tracey, Dr. Dmitri Volfson, Dr. Neta Zach, and Dr. Robert Latzman are employees of and own stock in Takeda Pharmaceuticals, Inc. Dr. Josh Cosman is an employee of and owns stock in AbbVie Pharmaceuticals. Dr. Jeremey Edgerton, Dr. Krishna Praneeth Kilambi, and Katherine Fisher are employees of and own stock in Biogen Inc. Dr. Peter R. Bergethon was an employee of Biogen during a portion of this study. He has no conflicts or interests at the present time. Dr. Dorsey has received compensation for consulting services from Abbott, Abbvie, Acadia, Acorda, Bial-Biotech Investments, Inc., Biogen, Boehringer Ingelheim, California Pacific Medical Center, Caraway Therapeutics, Curasen Therapeutics, Denali Therapeutics, Eli Lilly, Genentech/Roche, Grand Rounds, Huntington Study Group, Informa Pharma Consulting, Karger Publications, LifeSciences Consultants, MCM Education, Mediflix, Medopad, Medrhythms, Merck, Michael J. Fox Foundation, NACCME, Neurocrine, NeuroDerm, NIH, Novartis, Origent Data Sciences, Otsuka, Physician’s Education Resource, Praxis, PRIME Education, Roach, Brown, McCarthy & Gruber, Sanofi, Seminal Healthcare, Spark, Springer Healthcare, Sunovion Pharma, Theravance, Voyager and WebMD; research support from Biosensics, Burroughs Wellcome Fund, CuraSen, Greater Rochester Health Foundation, Huntington Study Group, Michael J. Fox Foundation, National Institutes of Health, Patient-Centered Outcomes Research Institute, Pfizer, PhotoPharmics, Safra Foundation, and Wave Life Sciences; editorial services for Karger Publications; stock in Included Health and in Mediflix, and ownership interests in SemCap. Ms. Kostrzebski holds stock in Apple, Inc. Dr. Espay has received grant support from the NIH and the Michael J Fox Foundation; personal compensation as a consultant/scientific advisory board member for Neuroderm, Neurocrine, Amneal, Acadia, Acorda, Bexion, Kyowa Kirin, Sunovion, Supernus (formerly, USWorldMeds), Avion Pharmaceuticals, and Herantis Pharma; personal compensation as honoraria for speakership for Avion; and publishing royalties from Lippincott Williams & Wilkins, Cambridge University Press, and Springer. He cofounded REGAIN Therapeutics (a biotech start-up developing nonaggregating peptide analogues as replacement therapies for neurodegenerative diseases) and is co-owner of a patent that covers synthetic soluble nonaggregating peptide analogues as replacement treatments in proteinopathies. Dr. Spindler has received compensation for consulting services from Medtronic, and clinical trial funding from Abbvie, Abbott, US WorldMeds, Praxis, and Takeda. Dr. Wyant receives research funding from the National Institutes of Health/National Institute of Neurological Disorders and Stroke NeuroNEXT Network, Eli Lilly, and the Farmer Family Foundation. She also receives royalties from UpToDate. Joan Severson, Allen Best, David Anderson, Michael Merickel, Daniel Jackson Amato, and Brian Severson are employees of Clinical Ink, who acquired the BrainBaseline Platform in 2021 from Digital Artefacts. Joan Severson and Allen Best have financial interests in Clinical Ink.

Figures

Fig. 1
Fig. 1. Comparisons of gait features derived from a smartphone and smartwatch.
Box plots for (panel a) Arm swing (deg), (panel b) Stance (s), (panel c) Cadence (steps/min), (panel d) Double support (s), (panel e) Turn duration (s), and (panel f) Gait speed (m/s) between those with and without Parkinson’s disease and by MDS-UPDRS part III gait item 3.10. MDS-UPDRS Movement Disorder Society-Unified Parkinson’s Disease Rating Scale.
Fig. 2
Fig. 2. Comparisons of psychomotor function derived from a smartphone.
Box plots for (panel a) number of total finger taps and (panel b) number of objects successfully manipulated on a smartphone between those with and without Parkinson’s disease by dominant and non-dominant hand.
Fig. 3
Fig. 3. Comparisons of tremor scores derived from continuous passive tremor data from a smartwatch.
Box plots for passive tremor fraction between (panel a) those with and without Parkinson’s disease and by (panel b) MDS-UPDRS part II tremor, (panel c) MDS-UPDRS part III rest tremor amplitude (right + left), and (panel d) MDS-UPDRS part III rest tremor constancy. MDS-UPDRS Movement Disorder Society-Unified Parkinson’s Disease Rating Scale.
Fig. 4
Fig. 4. Comparisons of speech performance derived from a smartphone.
Box plots for pitch range (in semitones) between (panel a) those with and without Parkinson’s disease and by (panel b) MDS-UPDRS speech item 3.1. MDS-UPDRS Movement Disorder Society-Unified Parkinson’s Disease Rating Scale.
Fig. 5
Fig. 5. Digital devices evaluated in-clinic and at-home during the study.
MDS-UPDRS Movement Disorder Society-Unified Parkinson’s Disease Rating Scale. Copyrighted images of BrainBaseline’s Movement Disorders Mobile Application were reprinted with permission by Clinical ink (Horsham, PA). Copyrighted images of APDM Wearable Technology were reprinted with permission by APDM Wearable Technologies, a Clario Company (Portland, OR).
See this image and copyright information in PMC

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