Emerging wearable technologies for multisystem monitoring and treatment of Parkinson's disease: a narrative review

Abstract

Parkinson's disease (PD) is a chronic movement disorder characterized by a variety of motor and nonmotor comorbidities, including cognitive impairment, gastrointestinal (GI) dysfunction, and autonomic/sleep disturbances. Symptoms typically fluctuate with different settings and environmental factors and thus need to be consistently monitored. Current methods, however, rely on infrequent rating scales performed in clinic. The advent of wearable technologies presents a new avenue to track objective measures of PD comorbidities longitudinally and more frequently. This narrative review discusses and proposes emerging wearable technologies that can monitor manifestations of motor, cognitive, GI, and autonomic/sleep comorbidities throughout the daily lives of PD individuals. This can provide more wholistic insight into real-time physiological versus pathological function with the potential to better assess treatments during clinical trials and allow physicians to optimize treatment regimens. Additionally, this narrative review briefly examines novel applications of wearables as therapy for PD patients.

Keywords: Parkinson’s disease; autonomic; cognition; gastrointestinal; monitoring; motor; sleep; wearable technologies.

FIGURE 1

Motor System: IMUs built into a smartphone can monitor personalized kinematics of PD motor symptoms such as tremor. Cognitive System: One can frequently track cognitive and psychomotor functioning by measuring ERPs using in-ear EEG. GI System: It is now possible to assess one’s GI function and diagnose GI conditions using EGG sensors placed on the abdomen. Autonomic/Sleep Systems: Wearable technologies, including a wristwatch embedded with BP monitoring, can measure real-time autonomic state of PD individuals.