Abstract Details

Title Capturing Parkinson’s disease heterogeneity with quantitative mobility measures

Topic Movement Disorders

Presentation(s) S10 - Biomarkers in Movement Disorders (4:25 PM-4:36 PM)

Poster/Presentation
Number 006

Background There is substantial heterogeneity in PD motor and non-motor features. At least two major subtypes have been recognized, tremor dominant (TD) and postural instability gait difficulty (PIGD), with potential implications for progression and overall disability. Compared to standard clinical rating scales, instrumented motor testing may offer more sensitive and robust characterization of PD motor and non-motor features.

Objective To evaluate clinic-based, quantitative mobility measures using a wearable sensor in comparison with standard clinic assessment for characterization of Parkinson’s disease (PD) heterogeneity, including motor subtypes, cognition, and disability.

Design/Methods Subjects with PD completed a 10-minute motor protocol, including a 32-foot walk, Timed Up and Go (TUG) with turn, and standing posture task, while wearing a sensor device (DynaPort Hybrid, McRoberts BV), and 12 previously-validated mobility measures were computed. Regression analyses evaluated each metric in relation to (i) motor MDS-UPDRS, (ii) motor subtype (TD vs. PIGD), (iii) cognition (Montreal Cognitive Assessment, MoCA), and (iv) disability (Patient-Reported Outcomes Measurement Information System-29). All analyses included age, gender, and disease duration as covariates, and models ii-iv were secondarily adjusted for MDS-UPDRS.

Results We enrolled 100 subjects with PD (65% male, age 67±10, MDS-UPDRS part III 21±10, MoCA 25±3). The majority of mobility measures (10 of 12) were not correlated with MDS-UPDRS, therefore revealing independent features of motor performance. Measures of gait (speed, cadence), TUG (stand to sit transition), and turn (yaw) were each significantly associated with PD motor subtype, cognitive impairment, and disability (all anti-correlated, p<0.05), and these associations were robust to adjustment for motor MDS-UPDRS.

Conclusions Quantitative mobility measures correlate with indices of PD motor and non-motor heterogeneity. Moreover, these metrics capture relevant features of motor performance beyond those obtained using the MDS-UPDRS. Clinic-based, wearable sensors show promise for enhanced phenotyping and dissection of PD heterogeneity.

Authors/Disclosures
Emily J. Hill, MD (University of Cincinnati) PRESENTER	Dr. Hill has nothing to disclose.
Isabel Alfradique-Dunham, MD (Washington University in St. Louis)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Sindhu R. Rao, MBBS (Baylor College of Medicine)	No disclosure on file
	No disclosure on file
Arjun Tarakad, MD (Baylor College of Medicine)	Dr. Tarakad has nothing to disclose.
Joohi Jimenez Shahed, MD (Icahn School of Medicine at Mount Sinai)	Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bracket Global LLC. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medtronic. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpha Omega. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for RegenXBio. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Praxis. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyowa Kirin. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BlueRock Therapeutics. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PhotoPharmics. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Emalex. The institution of Dr. Jimenez Shahed has received research support from Michael J Fox Foundation. The institution of Dr. Jimenez Shahed has received research support from Amneal. The institution of Dr. Jimenez Shahed has received research support from Annovis. The institution of Dr. Jimenez Shahed has received research support from SAGE. The institution of Dr. Jimenez Shahed has received research support from Ono Pharmaceuticals. The institution of Dr. Jimenez Shahed has received research support from BlueRock. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with Movement Disorders Society. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with ��ɫ��. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Parkinson Foundation. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant on Research Grant with Florida Atlantic University. Dr. Jimenez Shahed has received personal compensation in the range of $0-$499 for serving as a Speaker with Tourette Association of America. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with NACCME.
Joseph Jankovic, MD, FAAN (Baylor College of Medicine)	Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Revance. Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance, Allergan. The institution of Dr. Jankovic has received research support from Baylor College of Medicine. Dr. Jankovic has received research support from Abbvie. The institution of Dr. Jankovic has received research support from Abbvie.
Aron S. Buchman, MD (Rush Alzheimer's Disease Center)	No disclosure on file
	No disclosure on file
Joshua M. Shulman, MD, PhD, FAAN (Duncan Neurological Research Institute)	Dr. Shulman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Helis Medical Foudation. The institution of Dr. Shulman has received research support from National Institutes of Health.

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