TY - JOUR
T1 - Supervised versus unsupervised technology-based levodopa monitoring in Parkinson’s disease
T2 - an intrasubject comparison
AU - Lopane, Giovanna
AU - Mellone, Sabato
AU - Corzani, Mattia
AU - Chiari, Lorenzo
AU - Cortelli, Pietro
AU - Calandra-Buonaura, Giovanna
AU - Contin, Manuela
N1 - "Ricercatori distaccati presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Cortelli Pietro, Calandra Buonaura Giovanna, Contin Manuela)"
PY - 2018/6/1
Y1 - 2018/6/1
N2 - 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.
AB - 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.
KW - Alternate finger tapping test
KW - Information and communication technology
KW - Levodopa
KW - Parkinson’s disease
KW - Therapeutic drug monitoring
KW - Timed Up and Go test
UR - http://www.scopus.com/inward/record.url?scp=85044519954&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044519954&partnerID=8YFLogxK
U2 - 10.1007/s00415-018-8848-1
DO - 10.1007/s00415-018-8848-1
M3 - Article
C2 - 29600390
AN - SCOPUS:85044519954
VL - 265
SP - 1343
EP - 1352
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
IS - 6
ER -