Apple Inc., Cupertino, CA 95014, USA.
Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Sci Transl Med. 2021 Feb 3;13(579). doi: 10.1126/scitranslmed.abd7865.
Longitudinal, remote monitoring of motor symptoms in Parkinson's disease (PD) could enable more precise treatment decisions. We developed the Motor fluctuations Monitor for Parkinson's Disease (MM4PD), an ambulatory monitoring system that used smartwatch inertial sensors to continuously track fluctuations in resting tremor and dyskinesia. We designed and validated MM4PD in 343 participants with PD, including a longitudinal study of up to 6 months in a 225-subject cohort. MM4PD measurements correlated to clinical evaluations of tremor severity (ρ = 0.80) and mapped to expert ratings of dyskinesia presence ( < 0.001) during in-clinic tasks. MM4PD captured symptom changes in response to treatment that matched the clinician's expectations in 94% of evaluated subjects. In the remaining 6% of cases, symptom data from MM4PD identified opportunities to make improvements in pharmacologic strategy. These results demonstrate the promise of MM4PD as a tool to support patient-clinician communication, medication titration, and clinical trial design.
帕金森病（PD）的运动症状的纵向、远程监测可以实现更精确的治疗决策。我们开发了帕金森病运动波动监测仪（MM4PD），这是一种使用智能手表惯性传感器来连续跟踪静止性震颤和运动障碍波动的可移动监测系统。我们在 343 名 PD 参与者中设计并验证了 MM4PD，包括在 225 名受试者队列中长达 6 个月的纵向研究。MM4PD 的测量结果与震颤严重程度的临床评估（ρ=0.80）相关，并在门诊任务中映射到运动障碍存在的专家评分（<0.001）。MM4PD 能够捕捉到对治疗的反应引起的症状变化，在 94%的评估对象中符合临床医生的预期。在剩下的 6%的情况下，来自 MM4PD 的症状数据为改进药物治疗策略提供了机会。这些结果表明，MM4PD 有望成为支持医患沟通、药物滴定和临床试验设计的工具。
