title: Correlation of Quantitative Motor State Assessment Using a Kinetograph and Patient Diaries in Advanced PD: Data from an Observational Study.
abstract: BACKGROUND
  Effective management and development of new treatment strategies for response fluctuations in advanced Parkinson's disease (PD) largely depends on clinical rating instruments such as the PD home diary. The Parkinson's kinetigraph (PKG) measures movement accelerations and analyzes the spectral power of the low frequencies of the accelerometer data. New algorithms convert each hour of continuous PKG data into one of the three motor categories used in the PD home diary, namely motor Off state and On state with and without dyskinesia.
  
  
  OBJECTIVE
  To compare quantitative motor state assessment in fluctuating PD patients using the PKG with motor state ratings from PD home diaries.
  
  
  METHODS
  Observational cohort study on 24 in-patients with documented motor fluctuations who completed diaries by rating motor Off, On without dyskinesia, On with dyskinesia, and asleep for every hour for 5 consecutive days. Simultaneously collected PKG data (recorded between 6 am and 10 pm) were analyzed and calibrated to the patient's individual thresholds for Off and dyskinetic state by novel algorithms classifying the continuous accelerometer data into these motor states for every hour between 6 am and 10 pm.
  
  
  RESULTS
  From a total of 2,040 hours, 1,752 hours (87.4%) were available for analyses from calibrated PKG data (7.5% sleeping time and 5.1% unclassified motor state time were excluded from analyses). Distributions of total motor state hours per day measured by PKG showed moderate-to-strong correlation to those assessed by diaries for the different motor states (Pearson's correlations coefficients: 0.404-0.658), but inter-rating method agreements on the single-hour-level were only low-to-moderate (Cohen's κ: 0.215-0.324).
  
  
  CONCLUSIONS
  The PKG has been shown to capture motor fluctuations in patients with advanced PD. The limited correlation of hour-to-hour diary and PKG recordings should be addressed in further studies.
authors.affiliation: Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, D-01307, Dresden, Germany.
authors.forename: Christiana
authors.initials: C
authors.lastname: Ossig
authors.affiliation: Movement Disorders Clinic, D-14547, Beelitz-Heilstätten, Germany.
authors.forename: Florin
authors.initials: F
authors.lastname: Gandor
authors.affiliation: Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, D-01307, Dresden, Germany.
authors.forename: Mareike
authors.initials: M
authors.lastname: Fauser
authors.affiliation: Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, D-01307, Dresden, Germany.|German Center for Neurodegenerative Diseases (DZNE), D-18147, Rostock, Germany.
authors.forename: Cecile
authors.initials: C
authors.lastname: Bosredon
authors.affiliation: Florey Institute for Neuroscience and Mental Health, University of Melbourne, Heidelberg, 3084, Australia, and RMIT University, Melbourne, 3000, Australia.
authors.forename: Leonid
authors.initials: L
authors.lastname: Churilov
authors.affiliation: Department of Neurology, Technische Universität Dresden, D-01307, Dresden, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Reichmann
authors.affiliation: Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, 3010, Australia, and St Vincent's Hospital, Fitzroy, Victoria, 3065, Australia.
authors.forename: Malcolm K
authors.initials: MK
authors.lastname: Horne
authors.affiliation: Movement Disorders Clinic, D-14547, Beelitz-Heilstätten, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ebersbach
authors.affiliation: Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, D-01307, Dresden, Germany.|German Center for Neurodegenerative Diseases (DZNE), D-18147, Rostock, Germany.|Department of Neurology, University of Rostock, D-18147, Rostock, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Storch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D020820:Dyskinesias / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology*; D012720:Severity of Illness Index