Patients with Parkinson disease experience a complex array of both motor and nonmotor symptoms. The traditional motor hallmarks of Parkinson disease include rigidity, bradykinesia, resting tremor, postural instability, and freezing of gait. As the disease progresses, treatment-related motor response fluctuations and involuntary movements appear. In addition, cognitive disturbances, disautonomia, affective difficulties, and sleep disturbances are also common and further challenge the assessment and treatment of the progressive course of Parkinson disease. Treatment in Parkinson disease is traditionally based on periodic clinical evaluation, reporting of symptoms during the office visit, home-based diaries, and clinical scales assessing motor state, activities of daily living, cognitive and affective state and quality of life. These methods are able to track long-term changes, however, they generally have limitations related to recall bias, subjective reporting, and accuracy. These tools are also insensitive to subtle changes in motor and nonmotor function and the common daily and weekly fluctuations. Better tools are needed to accurately and objectively track disease symptoms, fluctuations, progression, and the effect of treatments.
This JAMA article calls for wider use of body-fixed sensors (small, lightweight measuring devices attached to the body) to track symptom progression in Parkinson's disease and to more accurately diagnose the severity of the disease. They may even be used to deliver therapy to a Parkinson's sufferer, by providing real-time feedback and assist with improving their mobility.