title: Technology in Parkinson's disease: Challenges and opportunities.
abstract: The miniaturization, sophistication, proliferation, and accessibility of technologies are enabling the capture of more and previously inaccessible phenomena in Parkinson's disease (PD). However, more information has not translated into a greater understanding of disease complexity to satisfy diagnostic and therapeutic needs. Challenges include noncompatible technology platforms, the need for wide-scale and long-term deployment of sensor technology (among vulnerable elderly patients in particular), and the gap between the "big data" acquired with sensitive measurement technologies and their limited clinical application. Major opportunities could be realized if new technologies are developed as part of open-source and/or open-hardware platforms that enable multichannel data capture sensitive to the broad range of motor and nonmotor problems that characterize PD and are adaptable into self-adjusting, individualized treatment delivery systems. The International Parkinson and Movement Disorders Society Task Force on Technology is entrusted to convene engineers, clinicians, researchers, and patients to promote the development of integrated measurement and closed-loop therapeutic systems with high patient adherence that also serve to (1) encourage the adoption of clinico-pathophysiologic phenotyping and early detection of critical disease milestones, (2) enhance the tailoring of symptomatic therapy, (3) improve subgroup targeting of patients for future testing of disease-modifying treatments, and (4) identify objective biomarkers to improve the longitudinal tracking of impairments in clinical care and research. This article summarizes the work carried out by the task force toward identifying challenges and opportunities in the development of technologies with potential for improving the clinical management and the quality of life of individuals with PD. © 2016 International Parkinson and Movement Disorder Society.
authors.affiliation: James J. and Joan A. Gardner Family Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA. alberto.espay@uc.edu.
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Espay
authors.affiliation: Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonato
authors.affiliation: Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Fatta B
authors.initials: FB
authors.lastname: Nahab
authors.affiliation: Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tübingen, Germany.|DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Maetzler
authors.affiliation: Davis Phinney Foundation for Parkinson's, Boulder, Colorado, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Dean
authors.affiliation: Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Klucken
authors.affiliation: Digital Sports Group, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Bjoern M
authors.initials: BM
authors.lastname: Eskofier
authors.affiliation: Department of Neuroscience "Rita Levi Montalcini", Città della salute e della scienza di Torino, Torino, Italy.
authors.forename: Aristide
authors.initials: A
authors.lastname: Merola
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland VA Medical System, Portland, Oregon.|APDM, Inc., Portland, Oregon, USA.
authors.forename: Fay
authors.initials: F
authors.lastname: Horak
authors.affiliation: Morton and Gloria Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
authors.affiliation: George-Huntington-Institute, Muenster, Germany.|Department of Radiology, University of Muenster, Muenster, Germany.|Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Reilmann
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, Ohio, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Giuffrida
authors.affiliation: Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Alice
authors.initials: A
authors.lastname: Nieuwboer
authors.affiliation: Global Kinetics Corporation & Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Horne
authors.affiliation: Department of Mathematics, Aston University, Birmingham, UK.|Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
authors.forename: Max A
authors.initials: MA
authors.lastname: Little
authors.affiliation: Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Litvan
authors.affiliation: Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: Tanya
authors.initials: T
authors.lastname: Simuni
authors.affiliation: Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: E Ray
authors.initials: ER
authors.lastname: Dorsey
authors.affiliation: Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Burack
authors.affiliation: Michael J Fox Foundation for Parkinson's Research, New York City, New York, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Neurology, National Institute of Clinical Neurosciences, Budapest, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Kamondi
authors.affiliation: Center of Interdisciplinary Research Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Godinho
authors.affiliation: Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Daneault
authors.affiliation: Apptomics LLC, Wellesley, Massachusetts, USA.
authors.forename: Georgia
authors.initials: G
authors.lastname: Mitsi
authors.affiliation: Medtronic Neuromodulation, Minneapolis, Minnesota, USA.
authors.forename: Lothar
authors.initials: L
authors.lastname: Krinke
authors.affiliation: Sackler School of Medicine, Tel Aviv University and Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Jeffery M
authors.initials: JM
authors.lastname: Hausdorff
authors.affiliation: Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands.
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Spyros
authors.initials: S
authors.lastname: Papapetropoulos
mesh_terms: D020811:Biomedical Technology / Q000592:standards*; D006801:Humans; D010300:Parkinson Disease / Q000175:diagnosis* / Q000628:therapy*
keywords: Parkinson's disease; digital biomarkers; digital health; eHealth; precision medicine; remote monitoring; technology; wearable technology