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Capturing Parkinson’s disease heterogeneity with quantitative mobility measures (S10.006)

2019; Lippincott Williams & Wilkins; Volume: 92; Issue: 15_supplement Linguagem: Inglês

10.1212/wnl.92.15_supplement.s10.006

1526-632X

Emily J. Hill, Isabel Alfradique‐Dunham, Carl Grant Mangleburg, Brittany Ripperger, Amanda Stillwell, Sindhu Rao, Hiba Saade, Arjun Tarakad, Joohi Jimenez‐Shahed, Joseph Jankovic, Aron S. Buchman, Robert J. Dawe, Joshua Shulman,

Cerebral Palsy and Movement Disorders

Objective: To evaluate clinic-based, quantitative mobility measures using a wearable sensor in comparison with standard clinic assessment for characterization of Parkinson’s disease (PD) heterogeneity, including motor subtypes, cognition, and disability. Background: There is substantial heterogeneity in PD motor and non-motor features. At least two major subtypes have been recognized, tremor dominant (TD) and postural instability gait difficulty (PIGD), with potential implications for progression and overall disability. Compared to standard clinical rating scales, instrumented motor testing may offer more sensitive and robust characterization of PD motor and non-motor features. Design/Methods: Subjects with PD completed a 10-minute motor protocol, including a 32-foot walk, Timed Up and Go (TUG) with turn, and standing posture task, while wearing a sensor device (DynaPort Hybrid, McRoberts BV), and 12 previously-validated mobility measures were computed. Regression analyses evaluated each metric in relation to (i) motor MDS-UPDRS, (ii) motor subtype (TD vs. PIGD), (iii) cognition (Montreal Cognitive Assessment, MoCA), and (iv) disability (Patient-Reported Outcomes Measurement Information System-29). All analyses included age, gender, and disease duration as covariates, and models ii-iv were secondarily adjusted for MDS-UPDRS. Results: We enrolled 100 subjects with PD (65% male, age 67±10, MDS-UPDRS part III 21±10, MoCA 25±3). The majority of mobility measures (10 of 12) were not correlated with MDS-UPDRS, therefore revealing independent features of motor performance. Measures of gait (speed, cadence), TUG (stand to sit transition), and turn (yaw) were each significantly associated with PD motor subtype, cognitive impairment, and disability (all anti-correlated, p Conclusions: Quantitative mobility measures correlate with indices of PD motor and non-motor heterogeneity. Moreover, these metrics capture relevant features of motor performance beyond those obtained using the MDS-UPDRS. Clinic-based, wearable sensors show promise for enhanced phenotyping and dissection of PD heterogeneity. Disclosure: Dr. Hill has nothing to disclose. Dr. Alfradique-Dunham has nothing to disclose. Dr. Mangleburg has nothing to disclose. Dr. Ripperger has nothing to disclose. Dr. Stillwell has nothing to disclose. Dr. Rao has nothing to disclose. Dr. Saade has nothing to disclose. Dr. Tarakad has nothing to disclose. Dr. Jimenez Shahed has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with St. Jude Medical/Abbott, Medtronic, Teva, Bracket, Nuvelution, Sunovion,. Dr. Jimenez Shahed has received research support from Biotie/Accorda, Medtronic, St. Jude Medical/Abbott, Eli Lilly & Company, Wilsons Therapeutics. Dr. Jankovic has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Neurocrine Biosciences, Nuvelution, Teva Pharmaceutical Industries Ltd., US WorldMeds. Dr. Buchman has nothing to disclose. Dr. Dawe has nothing to disclose. Dr. Shulman has nothing to disclose.