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Self-reported symptoms and motor tests via telemetry in a 36-month levodopa-carbidopa intestinal gel infusion trial
School of Technology and Business Studies, Computer Engineering, Dalarna University, Borlänge, Sweden.ORCID iD: 0000-0002-2372-4226
Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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2013 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Objective: To determine if a home environment test battery can be used to measure effects of Parkinson’s disease (PD) treatment intervention and disease progression.

Background: Sixty-five patients diagnosed with advanced PD were recruited in an open longitudinal 36-month study. On inclusion, 35 of them were treated with continuous intraduodenal administration of a levodopa-carbidopa intestinal gel (LCIG) and 30 patients were candidates for switching from conventional oral PD treatment to LCIG. They utilized a test battery, consisting of self-assessments and fine motor tests (tapping and spiral drawings), in their homes. Assessments were performed four times per day during week-long test periods. For the majority of these test periods, UPDRS and PDQ-39 ratings were performed at the start of the period.

Methods: The test battery time series were summarized into scores for representing symptom severities over test periods. Six conceptual dimensions were defined; four subjectively-reported: ‘Walking’, ‘Satisfied’, ‘Dyskinesia’ and ‘Off’, and two objectively-measured: ‘Tapping’ and ‘Spiral’. In addition, an overall test score (OTS) was defined to represent the overall condition of a patient during a test period.

Results: In LCIG-naïve patients, mean OTS improved startingf rom the first test period on LCIG treatment and this improvement remained statistically significant until month 24 (figure). In contrast to objectively-measured dimensions, mean scores of subjectively-reported dimensions improved significantly throughout the study. In LCIG-non-na€ıve patients, there were no significant changes in mean OTS, except at month 36 (p < 0.01). The OTS correlated adequately with total UPDRS (rho 5 0.59) and total PDQ-39 (0.59).

Conclusions: Using the test battery it is possible to monitor PD symptoms over time. The trends of the test scores were strikingly similar to the trends of the clinical rating scores. Correlations between OTS and the rating scales were adequate indicating that the test battery contains important elements of the information of these well-established scales.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013. Vol. 28 Suppl. 1, p. S168-S168, article id 471
Series
Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257
Keywords [en]
Remote monitoring; Telemedicine; Home assessment; Parkinson's disease; Levodopa infusion
National Category
Information Systems, Social aspects Neurology
Identifiers
URN: urn:nbn:se:oru:diva-62598ISI: 000320940502045OAI: oai:DiVA.org:oru-62598DiVA, id: diva2:1157490
Conference
The Movement Disorder Society's 17th International Congress of Parkinson's Disease and Movement Disorders, Sydney, Australia, June 16-20, 2013
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-03-06Bibliographically approved

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Memedi, Mevludin

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