Real-World Driving Data Indexes Dopaminergic Treatment Effects in Parkinson's Disease.

Autor: Chang JH; Department of Neurological Sciences University of Nebraska Medical Center Omaha Nebraska USA., Bhatti D; Department of Internal Medicine University of Central Florida Orlando Florida USA., Rizzo M; Department of Neurological Sciences University of Nebraska Medical Center Omaha Nebraska USA., Uc EY; Department of Neurology University of Iowa Iowa City Iowa USA.; Neurology Service Iowa City VA Medical Center Iowa City Iowa USA., Bertoni J; Department of Neurological Sciences University of Nebraska Medical Center Omaha Nebraska USA., Merickel J; Department of Neurological Sciences University of Nebraska Medical Center Omaha Nebraska USA.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2023 Jun 12; Vol. 10 (9), pp. 1324-1332. Date of Electronic Publication: 2023 Jun 12 (Print Publication: 2023).
DOI: 10.1002/mdc3.13803
Abstrakt: Background: Driving is a complex, everyday task that impacts patient agency, safety, mobility, social connections, and quality of life. Digital tools can provide comprehensive real-world (RW) data on driver behavior in patients with Parkinson's disease (PD), providing critical data on disease status and treatment efficacy in the patient's own environment.
Objective: This pilot study examined the use of driving data as a RW digital biomarker of PD symptom severity and dopaminergic therapy effectiveness.
Methods: Naturalistic driving data (3974 drives) were collected for 1 month from 30 idiopathic PD drivers treated with dopaminergic medications. Prescriptions data were used to calculate levodopa equivalent daily dose (LEDD). The association between LEDD and driver mobility (number of drives) was assessed across PD severity, measured by the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).
Results: PD drivers with worse motor symptoms based on self-report (Part II: P  = 0.02) and clinical examination (Part III: P  < 0.001) showed greater decrements in driver mobility. LEDD levels >400 mg/day were associated with higher driver mobility than those with worse PD symptoms (Part I: P  = 0.02, Part II: P  < 0.001, Part III: P  < 0.001).
Conclusions: Results suggest that comprehensive RW driving data on PD patients may index disease status and treatment effectiveness to improve patient symptoms, safety, mobility, and independence. Higher dopaminergic treatment may enhance safe driver mobility in PD patients with worse symptom severity.
(© 2023 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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