Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
The Smith-Kettlewell Eye Research Institute, San Francisco, CA, USA.
J Parkinsons Dis. 2022;12(6):1979-1990. doi: 10.3233/JPD-223264.
Assessment of motor signs in Parkinson's disease (PD) requires an in-person examination. However, 50% of people with PD do not have access to a neurologist. Wearable sensors can provide remote measures of some motor signs but require continuous monitoring for several days. A major unmet need is reliable metrics of all cardinal motor signs, including rigidity, from a simple short active task that can be performed remotely or in the clinic.
Investigate whether thirty seconds of repetitive alternating finger tapping (RAFT) on a portable quantitative digitography (QDG) device, which measures amplitude and timing, produces reliable metrics of all cardinal motor signs in PD.
Ninety-six individuals with PD and forty-two healthy controls performed a thirty-second QDG-RAFT task and clinical motor assessment. Eighteen individuals were followed longitudinally with repeated assessments for an average of three years and up to six years.
QDG-RAFT metrics showed differences between PD and controls and provided correlated metrics for total motor disability (MDS-UPDRS III) and for rigidity, bradykinesia, tremor, gait impairment, and freezing of gait (FOG). Additionally, QDG-RAFT tracked disease progression over several years off therapy and showed differences between akinetic-rigid and tremor-dominant phenotypes, as well as people with and without FOG.
QDG is a reliable technology, which could be used in the clinic or remotely. This could improve access to care, allow complex remote disease management based on data received in real time, and accurate monitoring of disease progression over time in PD. QDG-RAFT also provides the comprehensive motor metrics needed for therapeutic trials.
帕金森病（PD）运动症状的评估需要进行面对面的检查。然而，50%的 PD 患者无法获得神经科医生的诊治。可穿戴传感器可以提供一些运动症状的远程测量，但需要连续监测几天。目前尚未满足的一个主要需求是，能否通过一种简单的、短时间的主动任务，从远程或诊所环境中获得所有主要运动症状（包括僵硬）的可靠指标，且这种任务无需持续监测。
研究便携式定量数字仪（QDG）上 30 秒的重复交替手指敲击（RAFT），该仪器可测量幅度和时间，能否可靠地测量 PD 患者的所有主要运动症状。
96 名 PD 患者和 42 名健康对照者进行了 30 秒 QDG-RAFT 任务和临床运动评估。18 名患者进行了平均 3 年、最长 6 年的纵向随访，进行了多次重复评估。
QDG-RAFT 指标在 PD 患者和对照组之间存在差异，为总运动障碍（MDS-UPDRS III）以及僵硬、运动迟缓、震颤、步态障碍和冻结步态（FOG）提供了相关的测量指标。此外，QDG-RAFT 在停药后数年的疾病进展中进行了跟踪，并显示了无动性震颤和震颤为主的表型、有无 FOG 患者之间的差异。
QDG 是一种可靠的技术，可在临床或远程环境中使用。这将改善获得护理的机会，允许基于实时接收的数据进行复杂的远程疾病管理，并准确监测 PD 患者随时间的疾病进展。QDG-RAFT 还提供了治疗试验所需的全面运动指标。
