Digital technology is changing Parkinson’s research, clinical care

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Digital health technology, which ranges from telephone applications to telemedicine, is advancing Parkinson’s disease research and clinical care, according to various review studies.

“Digital health technologies are an important and promising area that is starting to have a real and tangible impact on people with [Parkinson’s disease]”, said Anat Mirelman, PhD, specialist in neurology at Tel Aviv University in Israel, in a press release.

Several journals on the state of digital health in Parkinson’s disease were featured in a special issue of the Parkinson’s Disease Journal, and underlined in the editorial article, “Using technology to reshape clinical care and research in Parkinson’s disease.

Parkinson’s disease is characterized by a progressive loss of coordination and movement, which has a huge impact on the lives of people with the disease, as well as those of their families and caregivers.

Digital technology is now part of many aspects of society, including healthcare and research, and its role in current clinical practice and research in Parkinson’s disease is expanding. Digital health technology refers to a wide range of applications, such as wearable and contactless sensors, smartphone applications, and telemedicine for remote interactions.

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Mirelman, working with researchers in the United States and the Netherlands, examined the practice of using digital health technologies to advance the care and treatment of people with Parkinson’s disease.

“This special supplement includes a series of succinct reviews that cover many practical and relevant aspects, such as digital surveillance, telemedicine, digital therapy, virtual clinical trials, and digital progression biomarkers for clinical trials,” said said Mirelman. “All opinions offer both a view of the current state of the art and insightful perspectives on future directions. “

In recent years, researchers have examined the use of objective measures based on technology with mixed results. There are differences in the measurement of mobility in a home environment, where movement is self-initiated and goal-directed, compared to a more controlled clinical setting. But the use of digital in clinical practice is still limited.

“Despite the accumulation of evidence to support the feasibility, utility, and benefits of various digital technology approaches, the use of digital technology in clinical practice has long remained rare,” said Bastiaan Bloem, MD, PhD, author of a study at Radboud University. Nijmegen Medical Center in the Netherlands.

With the limits imposed by the ongoing coronavirus pandemic (COVID-19), digital health technology has increased, rapidly transforming neurological care and research.

“It took contagion for patients, doctors and insurers to pay more attention,” Bloem said. “Specifically, the limits on our ability to travel imposed by the ongoing coronavirus pandemic have led to a dramatic increase in the use of digital platforms in a matter of months. “

This “unprecedented” change “has been identified as one of the few silver liners of the pandemic,” he added.

With patients wearing sensors at home, clinicians can monitor their motor symptoms in real time and better understand behavioral changes and the impact of social distancing on non-motor symptoms.

For example, the assessment of sleep problems, a common non-motor symptom of Parkinson’s disease, is usually done in a sleep lab, which is an artificial setting. Sleep monitoring can now be done regularly at home, in a more passive setting, the study notes, which may also shed light on sleep disturbances in the early stages of the disease.

Digital tools can also expose features of the disease that are largely hidden, including social difficulties and voice disturbances, and provide real-time measurement of tremors, uncontrolled movements and falls, as well as ” objectively assess the effects of therapies. This can lead to a better understanding of the variable disease processes over time and provide more precise results that can be measured in a real context.

As more and more evaluations are conducted at home using mobile devices, clinical trials can also be more decentralized. In addition, digital measurement may support the expansion of digital therapies such as deep brain stimulation and new treatment approaches such as music for walking disorders, cognitive behavioral therapy for anxiety, and speech therapy. delivered at home rather than in a clinic.

Still, “significant challenges remain,” noted Mirelman. “These include the digital divide, the issue of privacy and security, and reimbursement, which forces health insurance companies and other payers to be convinced of the merits of technology. “

The pandemic has also exposed the limits of telemedicine and disease surveillance practices. In particular, there remains a need for in-person clinical visits, especially for new patients, which can help build relationships with healthcare providers.

“The COVID-19 pandemic has highlighted some of the shortcomings of telemedicine or surveillance approaches, such as the unabated need for in-person visits, especially for new patients,” Bloem said. “These gaps raise another question as to how well digital health technologies will survive when our lives return to a new normal after this pandemic is resolved. “

One thing is certain, however, that “the digital revolution has indeed started. We can be almost equally certain that this is just the beginning, ”he added. “The future of digital medicine will likely benefit both patients and healthcare in ways that are currently difficult to predict. “


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