A Smartphone-Based Tool for Assessing Parkinsonian Hand Tremor

Abstract

The aim of this study is to propose a practical smartphone-based tool to accurately assess upper limb tremor in Parkinson's disease (PD) patients. The tool uses signals from the phone's accelerometer and gyroscope (as the phone is held or mounted on a subject's hand) to compute a set of metrics which can be used to quantify a patient's tremor symptoms. In a small-scale clinical study with 25 PD patients and 20 age-matched healthy volunteers, we combined our metrics with machine learning techniques to correctly classify 82% of the patients and 90% of the healthy volunteers, which is high compared to similar studies. The proposed method could be effective in assisting physicians in the clinic, or to remotely evaluate the patient's condition and communicate the results to the physician. Our tool is low cost, platform independent, noninvasive, and requires no expertise to use. It is also well matched to the standard clinical examination for PD and can keep the patient "connected" to his physician on a daily basis. Finally, it can facilitate the creation of anonymous profiles for PD patients, aiding further research on the effectiveness of medication or other overlooked aspects of patients' lives.

Effect of levodopa-carbidopa intestinal gel on resting tremors in patients with advanced Parkinson’s disease

“…As an alternative to investigator-scored UPDRS Part III Question 20, Kostikis et al . 20 have demonstrated the use of a smartphone-based tool that can measure tremors directly, allowing for more frequent monitoring of PD tremors during a study. Due to the post hoc nature of the analysis reported herein, and the open-label treatment study design, the effect of LCIG on reducing resting tremors in this population of patients with advanced PD needs to be prospectively investigated.…”

The Parkinson's disease e‐diary: Developing a clinical and research tool for the digital age

“…Examples for motor symptoms include spiral drawing, finger tapping, and voice characteristics and for nonmotor symptoms, assessments of visual performance and short-term memory. 20,[22][23][24][25] Passive measures should be obtained in an unsupervised and unobtrusive fashion, 26 recorded preferentially during patients' daily regular activities. One hope is that in the future, passive tracking should capture a subset of relevant MFs and NMFs.…”

“…Active data collection should be tailored for motor and nonmotor symptoms. Examples for motor symptoms include spiral drawing, finger tapping, and voice characteristics and for nonmotor symptoms, assessments of visual performance and short‐term memory . Passive measures should be obtained in an unsupervised and unobtrusive fashion, recorded preferentially during patients' daily regular activities.…”

Targeting KCa1.1 Channels with a Scorpion Venom Peptide for the Therapy of Rat Models of Rheumatoid Arthritis

“…In addition, this technique was effective at quantifying the tremors observed in paxilline-treated rats and at differentiating the presence and absence of tremors, making it a valuable technique to quickly screen whether potential drugs are tremorigenic in vivo. Similar accelerometerbased technologies have also been used to observe tremors in rats and mice (Miyazaki et al, 2014;Shih and Young, 2007) and smart phone-based accelerometry apps have even been used to monitor tremors in patients with Parkinson's disease (Joundi et al, 2011;Kostikis et al, 2015).…”