Time for a change in the clinical management of Parkinson’s disease
The global burden of PD(opens in new window) has more than doubled over the last generation(opens in new window) in large part due to increasing life expectancy. Along with other neurodegenerative diseases, PD is expected to surpass cancer(opens in new window) as the second most common cause of death by the year 2040. PD is officially a movement disorder(opens in new window) with symptoms including tremor, limb rigidity, gait and balance problems, and difficulty in speaking or writing. Additionally, it is often accompanied by cognitive decline and dementia(opens in new window). All these affect quality of life and ability to maintain employment. The most common treatment is medication. However, in about 20-40 % of patients(opens in new window), the drugs become less effective after 5 years of treatment and increasing dosage can increase the side effects. The Italian SME Biomedical Lab(opens in new window) has developed a wearable device that continuously monitors and assesses movements. A revolution compared to sporadic check-ups and self-reporting(opens in new window), it can help neurologists tailor treatments for improved outcomes. With EU support of the PD-Watch(opens in new window) project, the team conducted a feasibility study to prepare the path to commercialisation.
Sensor detects signs of PD
PD-Watch integrates a sensor to detect movements and sophisticated software to distinguish normal from PD-related ones. It has been designed and tested to be worn on the wrist, but it could also be worn on other parts of the body. Luigi Battista, chief engineer at Biomedical Lab and project coordinator, explains: “The PD-Watch evaluates the frequency content of sensor data and also identifies specific movements(opens in new window) typically associated with PD. For example, hand tremors in PD usually occur between 3 and 7 Hz with a supination-pronation impairment(opens in new window).” Since the PD-Watch monitors and quantifies the therapeutic effects of the established treatment plan on a 24-h basis, it can help a neurologist modify treatment to minimise PD motor symptoms. In collaboration with neurologist Antonietta Romaniello at the San Carlo Hospital of Potenza(opens in new window) (site in Italian), a clinical trial was conducted on a patient with PD demonstrating that tremors were reduced by 64 %(opens in new window) from one day to the next with a new therapeutic plan. Battista adds: “PD-Watch results correlate well with selected items of the Unified Parkinson’s Disease Rating Scale(opens in new window), which is part of the current gold standard for evaluating normal and impaired motor performance.”
Steadily marching forward
Data are recorded, processed and reported, showing trends and results. The solution is cloud based to enhance clinician access and evaluation. “During the project, many patients reported seeing a clinician only about 20-30 min once or twice per year. They felt it was difficult for a neurologist to completely evaluate their conditions in such limited examinations because motor symptoms can vary considerably throughout the day and from one day to the next. Patients and physicians were excited to know that the PD-Watch enables continuous monitoring,” reports Battista. The software provides a competitive advantage over other wearable devices due to the improved ability to distinguish between normal movements and PD-associated pathological motor behaviour. The PD Watch should benefit clinical trials, routine clinical practice and, most importantly, the growing number of patients with PD.
