Smartwatches offer window into Parkinson's disease progression

New research appearing today in the journal njp Parkinson's Disease adds to growing evidence that widely used and user-friendly consumer devices, in this instance an Apple Watch paired with an iPhone, can detect changes in Parkinson's symptoms over time in individuals in the early stages of the disease.

"Digital measures hold the promise to provide objective, sensitive, real-world measures of disease progression in Parkinson's disease," said Jamie Adams, MD, an associate professor of Neurology at the University of Rochester Medical Center, the Center for Health + Technology, and lead author of the study. "This study shows that data generated by smartwatches and smartphones can remotely monitor and detect changes in multiple domains of the disease. These digital assessments could help evaluate the efficacy of future therapies."

"On behalf of Critical Path Institute, we are delighted to see the astounding progress of this unique project," said Diane Stephenson, PhD, executive director of Critical Path for Parkinson's consortium and co-author of the study. "The early and often feedback from regulators have shaped this study in ways that now can link the clinical meaningfulness of symptoms measured by digital health technologies to the voice of people with lived experience. By partnering with patients, regulators, industry, and academic experts this project is serving as a precedent for other disease areas to follow."

Parkinson's is a complex disease, and the onset and severity of symptoms and progression varies widely from patient to patient. Traditional tools employed to track the disease are often subjective and collect information episodically during clinic visits. As a result, these tools do not adequately portray the day-to-day experience of individuals with Parkinson's, limitations that have contributed to the slow pace of new therapies.

In contrast, smartwatches and smartphones can passively monitor many of the symptoms of the disease, such as gait and tremor. Additional information can be collected through tasks such as finger tapping and voice recording to measure speech-related symptoms. Adams and her colleagues recently demonstrated the devices could detect differences between individuals with early, untreated Parkson's and age-matched controls.

In the new study, called WATCH-PD, the researchers followed participants with early-stage Parkinson's for 12 months. Over the course of the year, the data collected by the devices showed that participants with early Parkinson's experienced significant declines in measures of gait, an increase in tremor, and modest changes in speech. The smartwatch was able to detect decreases in arm swing, a common clinical feature of the disease, and activity in the form of the number of daily steps. The progression of symptoms in individuals in the study was consistent with other long-term studies of the disease.

The study was designed to replicate a multi-center clinical trial in individuals with early and untreated Parkinson's disease and involved the participation and input from the pharmaceutical industry, regulators, investigators, and individuals with disease. The WATCH-PD study has recently been extended with support from the Michael J. Fox Foundation and will follow participants for an additional 18 months.

"This study brings us closer to having meaningful digital measures for future use in Parkinson's clinical trials, which may speed up therapeutic development and get treatments to our patients faster." said Adams.

Additional authors include Ray Dorsey, Melissa Kostrzebski, Peggy Auinger, Peter Wilmot, Yvonne Pohlson, and Stella Jensen-Roberts with URMC; Tairmae Kangarloo, Yishu Gong, Vahe Khachadourian, Brian Tracey, Dmitri Volfson, and Robert Latzman with Takeda Pharmaceuticals; Martijn Müller with the Critical Path Institute; Joshua Cosman with AbbVie Pharmaceuticals; Jeremy Edgerton with Biogen; David Anderson and Allen Best with Clinical Ink; and the Parkinson Study Group Watch-PD Study investigators and collaborators including Christopher Tarolli from URMC. The research was supported with funding from Biogen, Takeda, and the members of the Critical Path for Parkinson's Consortium.