Supervised versus unsupervised technology-based levodopa monitoring in Parkinson’s disease: an intrasubject comparison

Giovanna Lopane, Sabato Mellone, Mattia Corzani, Lorenzo Chiari, Pietro Cortelli, Giovanna Calandra-Buonaura, Manuela Contin

Research output: Contribution to journalArticlepeer-review

Abstract

We aimed to assess the intrasubject reproducibility of a technology-based levodopa (LD) therapeutic monitoring protocol administered in supervised versus unsupervised conditions in patients with Parkinson’s disease (PD). The study design was pilot, intrasubject, single center, open and prospective. Twenty patients were recruited. Patients performed a standardized monitoring protocol instrumented by an ad hoc embedded platform after their usual first morning LD dose in two different randomized ambulatory sessions: one under a physician’s supervision, the other self-administered. The protocol is made up of serial motor and non-motor tests, including alternate finger tapping, Timed Up and Go test, and measurement of blood pressure. Primary motor outcomes included comparisons of intrasubject LD subacute motor response patterns over the 3-h test in the two experimental conditions. Secondary outcomes were the number of intrasession serial test repetitions due to technical or handling errors and patients’ satisfaction with the unsupervised LD monitoring protocol. Intrasubject LD motor response patterns were concordant between the two study sessions in all patients but one. Platform handling problems averaged 4% of total planned serial tests for both sessions. Ninety-five percent of patients were satisfied with the self-administered LD monitoring protocol. To our knowledge, this study is the first to explore the potential of unsupervised technology-based objective motor and non-motor tasks to monitor subacute LD dosing effects in PD patients. The results are promising for future telemedicine applications.

Original languageEnglish
Pages (from-to)1343-1352
Number of pages10
JournalJournal of Neurology
Volume265
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

Keywords

  • Alternate finger tapping test
  • Information and communication technology
  • Levodopa
  • Parkinson’s disease
  • Therapeutic drug monitoring
  • Timed Up and Go test

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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