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Sunday, December 2, 2018

PKG™ Data Can Inform Treatment Decisions in Parkinson Disease

Neurology Advisor Contributing Writer December 1, 2018

PKG™ quantifies the kinematics of movement disorder symptoms in patients with Parkinson disease.


Objective data obtained with the wearable Personal KinetiGraph™ (PKG™) Movement Recording System resulted in a 33% alteration in care for patients with Parkinson disease, according to a study published in the Journal of Parkinson's Disease. PKG™ quantifies the kinematics of movement disorder symptoms in patients with Parkinson disease, providing information beyond what can be obtained during clinical consultation.

In a prospective physician survey study conducted from December 2015 through July 2016, a total of 143 PKG™s were ordered on 89 patients with Parkinson disease. A total of 112 physician surveys were completed in 81 patients for the final analysis. Patients were grouped in categories: initial patient visit in clinic, patients with Parkinson disease symptom fluctuations, patients with indeterminate history, and patients using or considering deep brain stimulation or Duopa. 

Patients often wore the PKG™ for 2 to 3 weeks on their right or left wrist prior to a routine clinical visit. PKG™ recorded daily and summary scores for bradykinesia and dyskinesia as well as fluctuations, data on tremor, immobility, movement during daytime, somnolence, and sleep. Physician survey questions focused on whether the PKG™ provided additional information in comparison with physician observation and patient-reported history and whether the clinical management plan subsequently changed in regard to Parkinson disease medication type, dosage, frequency, or amount.

Of the total cohort, 32% (n=36) of surveys resulted in an alteration to patient care; 50% of these cases (n=18) produced new and precise information recorded in daily OFF time. The Parkinson disease symptom fluctuation group had the most surveys at 58% (n=21), the initial patient visit in clinic group had 22% (n=8), the indeterminate history patient group had 14% (n=5), and the group of patients using or considering deep brain stimulation or Duopa had 6% (n=2). Case studies reveal better outcomes for patients with Parkinson disease with therapeutic adjustments based on data obtained by PKG™.

Limitations inherent in the study design prevent investigators from expounding further on the results, as detailed data collection and research-driven visit schedules were not employed. Nevertheless, PKG™ has a valuable role in the routine care of patients with Parkinson disease at tertiary care clinics and telemedicine and may change the manner in which motor symptoms of Parkinson disease are monitored.

This study was supported by Global Kinetics Corporation. 

Reference
Santiago A, Langston JW, Gandhy R, et al. Qualitative evaluation of the Personal KinetiGraphTM Movement Recording System in a Parkinson's clinic [published online November 8, 2018]. J Parkinsons Dis. doi:10.3233/jpd-181373

https://www.neurologyadvisor.com/movement-disorders-advisor/kinetigraph-movement-recording-evaluation-parkinsons/article/817668/

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