Opportunities and Limitations of Wrist-Worn Devices for Dyskinesia Detection in Parkinson's Disease.

During the in-hospital optimization of dopaminergic dosage for Parkinson's disease, drug-induced dyskinesias emerge as a common side effect. Wrist-worn devices present a substantial opportunity for continuous movement recording and the supportive identification of these dyskinesias. To bridge the gap between dyskinesia assessment and machine learning-enabled detection, the recorded information requires meaningful data representations. This study evaluates and compares two distinct representations of sensor data: a task-dependent, semantically grounded approach and automatically extracted large-scale time-series features. Each representation was assessed on public datasets to identify the best-performing machine learning model and subsequently applied to our own collected dataset to assess generalizability. Data representations incorporating semantic knowledge demonstrated comparable or superior performance to reported works, with peak F scores of 0.68. Generalization to our own dataset from clinical practice resulted in an observed F score of 0.53 using both setups. These results highlight the potential of semantic movement data analysis for dyskinesia detection. Dimensionality reduction in accelerometer-based movement data positively impacts performance, and models trained with semantically obtained features avoid overfitting. Expanding cohorts with standardized neurological assessments labeled by medical experts is essential for further improvements.