More than 200 million Americans now own smartphones, among two billion users worldwide. Some people use them to make and take calls. Other users read email, while many watch videos or play games. When you think about using downloaded apps, people generally think of them to buy coffee, pay for food, get weather and information, or maybe mapping road trips. Did you know that you can also use technology to track Parkinson’s disease (PD) symptoms and measure disease progression?
The role of technology
Recent articles on ParkinsonsDisease.net have discussed the role technology can play in aiding people with PD. There are apps to track symptoms, apps to assist with communication challenges, and apps to do vocal coaching and facilitate tools to improve speech and vocalization. There are apps that track weight, headaches, and disease specific symptoms.
Research on smartphone apps
New reports highlighting studies in the UK and in Rochester, NY describe how smartphone apps can also be used to capture fluctuations in symptoms and aggregate the information so that it is available you and your doctors. It’s like keeping a diary. As published in the American Medical Association’s Journal, Neurology, the studies were designed to create a tool that would provide an objective measure of motor symptoms that vary throughout the day.1 The app creators sought to measure tasks related to voice, finger tapping, gait, balance, and reaction time.2 129 study subjects included people with PD as well as a disease free control group. Including both groups enabled researchers to evaluate the usability and accuracy of this smartphone app. Researchers evaluated over 6,000 discrete events in five study categories.
Apps used in the study were available for both the iOS (mPower) and Android (HopkinsPD). The apps created a mobile Parkinson disease score (mPDS). mPDS is a severity index with a scoring range from 1-100, where the higher the score the more severe the symptom.1 The mPDS reflects changes that happen throughout the day and can be correlated to timing and dosage of dopaminergic medications. The mPDS score, considered a form of machine learning, provides “frequent, objective, real-world assessments” that could potentially improve communication between doctor, and patient, informing clinical care and evaluation of pharmacological options.1
Testing of the apps took place at home and under supervision in the clinic. Researchers were able to evaluate the ease, accuracy and mechanism of app usage. Although the average age of PD onset is over 60 years old, that did not create a barrier for the Parkinson’s population. Smartphones have been in use for 10 years and most users are now comfortable with the technology.
Why technology may be helpful for people with PD
Using technology to track the severity of the Parkinson’s symptoms may lead to better drugs and targeted timing of treatment. One of the contributing reasons is that reporting is more objective, and not subject to the recall of patients in pain, discomfort, or with memory problems. The results gathered from the app were similar to clinical findings observed by the physicians.
Older studies suggested that apps which track and manage symptoms helped people with PD comply with medication timing, and improved communications and reporting with their medical teams.3 In the recent reports, Dr. Christopher Tarolli, a neurologist from the University of Rochester Medical Center, commented, “the ability to remotely monitor patients on a much more frequent basis, more accurately track the symptoms and progression of the disease, and monitor the impact of exercise, sleep, and medications and their side effects holds the potential to transform how we treat Parkinson’s disease.”
Zhan A, Mohan S, Tarolli C, et al. Using Smartphones and Machine Learning to Quantify Parkinson Disease Severity: The Mobile Parkinson Disease Score. JAMA Neurol. Published online March 26, 2018. doi:10.1001/jamaneurol.2018.0809. Accessed online April 4, 2018.
Cone, A. Tracking Parkinson's symptoms with phone app could improve treatment. Published March 26, 2018. https://www.upi.com/Health_News/2018/03/26/Tracking-Parkinsons-symptoms-with-phone-app-could-improve-treatment/6671522083274/. Accessed online April 5, 2018.
Mack, H. NHS study finds mobile app improves management, quality of doctor visits for people with Parkinson's Disease. Published January 19, 2017. http://www.mobihealthnews.com/content/nhs-study-finds-mobile-app-improves-management-quality-doctor-visits-people-parkinsons. Accessed online April 5, 2017.