title: Sensor-based evaluation and treatment of nocturnal hypokinesia in Parkinson's disease: An evidence-based review.
abstract: The manifestations of nocturnal movements in Parkinson's disease (PD) are protean, with major disabilities related to nocturnal hypokinesia. While it can be assessed by clinical interviews and screening instruments, these are often inaccurate and prone to recall bias. In light of advances in sensor technology, we explored the use of sensors in the study of nocturnal hypokinesia, by performing a systematic review of the professional literature on this topic. Evidence suggests that nocturnal hypokinesia exists even in patients in the early stages, and PD patients turned significantly less and with much slower speed and acceleration than controls, partly related to low nocturnal dopamine level. We conducted another systematic review to evaluate the evidence of the efficacy of dopaminergic agents in the treatment of nocturnal hypokinesia. Several lines of evidence support the use of long-acting drugs or by continuous administration of short-acting agents to control symptoms. Sensor parameters could be considered as one of the important objective outcomes in future clinical trials investigating potential drugs to treat nocturnal hypokinesia. Physicians should be aware of this technology as it can aid the clinical assessment of nocturnal hypokinesia and enhance the quality of patient care. In addition, the use of sensors currently is being considered for various aspects of research on early diagnosis, treatment, and rehabilitation of PD patients.
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org.
authors.forename: Roongroj
authors.initials: R
authors.lastname: Bhidayasiri
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
authors.forename: Jirada
authors.initials: J
authors.lastname: Sringean
authors.affiliation: Biomedical Signal Processing Laboratory, National Electronics and Computer Technology Center (NECTEC) and National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand.
authors.forename: Chusak
authors.initials: C
authors.lastname: Thanawattano
mesh_terms: D061725:Accelerometry / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D000818:Animals; D002986:Clinical Trials as Topic / Q000379:methods; D015259:Dopamine Agents / Q000494:pharmacology / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods* / Q000639:trends; D006801:Humans; D018476:Hypokinesia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D009068:Movement / Q000187:drug effects / Q000502:physiology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D015259:Dopamine Agents
keywords: Continuous dopaminergic delivery; Dopaminergic agents; Nocturnal akinesia; Nocturnal hypokinesia; Parkinson's disease; Sensors; Turning in bed