New sensory systems such as Parkinson’s KinetiGraph record symptoms as patients get on with their lives – here’s how it works


What is objective measurement and why is it needed?

In every medical condition, treatments are most effective when measurements are available to guide the choice of medication. For example, in diabetes blood sugar levels provide an objective measurement that can be used to guide treatment decisions and to measure the effectiveness of medication.1 In Parkinson’s disease there are no similar objective measurements to guide medical management.

In a single day, people with Parkinson’s disease alternate between slow movements and disability caused by under-treatment and irritating involuntary movements caused by over-treatment.2 However, when talking to doctors, it may be difficult for a person with Parkinson’s disease and their carers to accurately remember the precise frequency and severity of their symptoms and how they impact on their everyday activities.3 What is needed is an objective measurement that can record the daily movement symptoms of people with Parkinson’s disease while they are going about their daily routines.4

What can be measured objectively in Parkinson’s disease?

In untreated Parkinson’s disease, slow movements are referred to by a Greek word termed bradykinesia.5 Excessive involuntary troublesome movements caused by over-treatment with certain medicines are called dyskinesias.6 For a long time these symptoms of Parkinson’s disease were considered to be abnormal movements. However, research from the Florey Neuroscience Research Institute, Melbourne, Australia concluded that bradykinesia and dyskinesia were ‘normal movements’ but made in the wrong context. In addition to measuring symptoms it would be helpful to monitor how medication is affecting these symptoms and to remind people with Parkinson’s disease when to take their medicine so that doctors can determine if the medicine is still working properly.

The researchers from the Florey Institute placed sensors on the wrist to measure and monitor bradykinesia and dyskinesia in people with Parkinson’s disease.4 Using these sensors researchers were able to measure changes in movements made by people with Parkinson’s disease over time. This recording of movement was then developed into a system, Parkinson’s KinetiGraph (PKG™), which could be used in everyday clinical practice for the management of Parkinson’s disease.4

GK KinetiGraph

What is Parkinson’s KinetiGraph™

The PKG™ consists of a small device worn on the wrist for collecting data and provides a report for the doctor that shows how bradykinesia and dyskinesia vary throughout the day and it also reminds people with Parkinson’s disease to take their medication.

Developed specifically for clinical use, the PKG™ meets all the requirements for a medical device, having been cleared in the United States by the Food and Drug Administration and in the EU with a CE (European Conformity) mark.7,8 Therefore, the PKG™ differs from other available devices which capture bioinformatic data, such as smartphone applications, which are developed for personal use and therefore do not meet the criteria of medical devices.

What does the PKG™ measure and why is it important?

Information collected by the PKG™ will guide the doctor to see how people with Parkinson’s disease are functioning at home and to identify any troublesome problems or symptoms. The PKG™ shows the doctor how dyskinesia and bradykinesia vary throughout the day.4 This important information enables the doctor to see how current medication affects dyskinesia and bradykinesia.4 It also allows doctors to decide in conjunction with the person with Parkinson’s disease on whether the amount of medicine needs to be decreased, increased, or changed to another medicine that is more effective in controlling their symptoms.

The PKG™ also reminds people with Parkinson’s disease to take their medicine and registers when the individual acknowledges the medication was taken. This helps achieve and demonstrate compliance in taking medication and provides important information on how movement symptoms are impacted by taking the medication.

Another problem of Parkinson’s disease is daytime sleepiness and night-time disturbances.9 The PKG™ is able to capture this information into an immobile summary, which enables the doctor to see when an individual has been asleep during the day.9 The sleep data provides important information that is a major aid for better management of these problems.9


This article was sponsored by Global KineticsThe information in this article is given for information purposes only and does not represent an endorsement by Parkinson’s Europe of any particular treatments, products or companies. This article is not a substitute for advice from your doctor, pharmacist or other healthcare professional. Parkinson’s Life makes no representations or warranties of any kind, express or implied, about the completeness or accuracy of information provided.

References

  1. Saudek CD, Derr RL, Kalyani RR. Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c. JAMA. Apr 12 2006;295(14):1688-1697.
  2. Ramirez-Zamora A, Molho E. Treatment of motor fluctuations in Parkinson’s disease: recent developments and future directions. Expert Rev Neurother. Jan 2014;14(1):93-103.
  3. Stone AA, Shiffman S, Schwartz JE, Broderick JE, Hufford MR. Patient non-compliance with paper diaries. BMJ. May 18 2002;324(7347):1193-1194.
  4. Griffiths RI, Kotschet K, Arfon S, et al. Automated assessment of bradykinesia and dyskinesia in Parkinson’s disease. J Parkinsons Dis. 2012;2(1):47-55.
  5. Berardelli A, Rothwell JC, Thompson PD, Hallett M. Pathophysiology of bradykinesia in Parkinson’s disease. Brain. Nov 2001;124(Pt 11):2131-2146.
  6. European Parkinson’s Disease Association. Dyskinesia. 2015; available here.
  7. Global Kinetics Corporation. Global Kinetics Corporation Secures Key European Union (EU) Patent for Parkinson’s KinetigraphTM Technology; available here.
  8. Food and Drug Administration. Personal Kinetigraph (PKG) system; available here.
  9. Kotschet K, Johnson W, McGregor S, et al. Daytime sleep in Parkinson’s disease measured by episodes of immobility. Parkinsonism Relat Disord. Jun 2014;20(6):578-583.
  10. Horne MH. Comment: New tool for measuring Parkinson’s disease; available here.