Apple Watch Helps Personalize Parkinson’s Care

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5 Feb. 2021. A new study shows an Apple watch can capture data on tremors experienced by people with Parkinson’s disease to help provide more precise care. Findings from the study done by engineers and medical researchers at Apple Inc. and academic labs appear in the 3 Feb. issue of the journal Science Translational Medicine (paid subscription required).

Parkinson’s disease occurs when the brain produces less of the amino acid dopamine, a neurotransmitter that sends signals from one neuron or nerve cell to another. As the level of dopamine lowers, people with Parkinson’s disease become less able to control their bodily movements and emotions. Among the symptoms encountered by people with Parkinson’s disease are slower than normal movements and fewer automatic movements like blinking, called bradykinesia, and involuntary, erratic, writhing movements of the face, arms, legs, or trunk, known as dyskinesia.

Parkinson’s disease symptoms can be treated with deep-brain stimulation or medications taken over long periods of time. However, say the authors, people with the disorder visit their doctors only every few months to assess their conditions and make any adjustments in treatments. Otherwise, patients need to recall their symptoms after the fact, an error-prone technique. Thus, an easy-to-use method for monitoring the symptoms of people with Parkinson’s disease could offer a fast and reliable way to check on adherence to drugs or adjust medication levels if needed.

A biomedical engineering team from Apple Inc. in Cupertino, California and collaborators at university medical centers devised and tested a technique using Apple’s smartwatch to monitor dyskinesia symptoms in people with Parkinson’s disease. Apple’s watch and similar wearable devices, have motion sensors — accelerometers and gyroscopes — for tracking movement and exercise. The team led by Apple biomedical engineer Adeeti Ullal designed a system called Motor Fluctuations Monitor for Parkinson’s Disease, or MM4PD, to capture minute-by-minute movements with these sensors, and wrote algorithms to interpret these data as indicators of dyskinesia symptoms.

Data collected from participants for six months

Ullal and colleagues wrote the interpretive algorithms in a series of studies with Parkinson’s disease patients, with part of the group wearing an Apple watch and others without a watch for comparison. The researchers then asked 225 individuals with Parkinson’s disease, age 71 on average, to wear an Apple watch for six months and share their data for MM4PD to calculate daily fluctuations in tremors and other dyskinesia symptoms.

The team correlated data from MM4PD with clinical evaluations of participants and found a high correlation of 0.8 between the MM4PD data and expert assessments; 1.0 is a perfect one-to-one correlation. In addition, the researchers found changes in tremors and dyskinesia symptoms experienced by study participants, as measured by MM4PD, match expectations by clinicians 94 percent of the time. The other six percent of cases, say the authors, show opportunities to make changes in patients’ medication strategies where symptom changes may otherwise go unnoticed.

The researchers say wearables like an Apple watch with an MM4PD system can provide a useful supplement to standard clinical care for Parkinson’s disease and provide data for testing new therapies in clinical trials. Apple Inc. is increasing its presence in medical research, as reported by Science & Enterprise over the past few years. Most recently, in August 2020, Apple and UCLA began a study of detecting depression with smartwatch data.

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