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Algorithms and Measures

Cardinal Symptoms

Continuous tracking and objective data collection of cardinal symptoms in chronic diseases can help increase the specificity and accuracy of measuring changes in these symptoms over time.

Cardinal Symptoms

Cardinal Symptoms

In chronic and/or progressive disorders, symptoms can be highly variable from day-to-day and between individuals. Continuous, real-world data from low-burden wearable devices enables more objective and sensitive measures to adequately capture symptom fluctuations and progression over time. ActiGraph's wearable digital health technology platform gives researchers a powerful tool to capture clinically meaningful metrics with a single, fit-for-purpose wearable device. 

ActiGraph has partnered with PKG Health to deliver a suite of clinically validated1 algorithms for the measure of abnormal movements in movement disorders, enabling the use of wearable devices for Parkinson’s disease, Huntington’s disease, and Essential Tremor research.  

The Digital Endpoint Collaboration to accelerate Outcome DEvelopment (DECODE) Nocturnal Scratch working group is validating nocturnal scratch as a fit-for-purpose digital measure in dermatology conditions such as Atopic Dermatitis and Psoriasis.

Commonly Used mobility Measures

  •  Bradykinesia Score
  •  Dyskinesia Score
  •  Percent Time Tremor
  •  Nocturnal Scratch
CARDINAL SYMPTOMS SENSORS ACTIVITY MONITORS SOFTWARE
Measures Accelerometer Gyroscope Wear Location Supported CentrePoint ActiLife
Bradykinesia Score (BKS) Wrist All
Active BKS Wrist All
Percent Time Bradykinesia (PTB) Wrist All
Dyskinesia Score (DKS) Wrist All
Percent time Tremor (PTT) Wrist All
Fluctuations and Dyskinesia Score (FDS) Wrist All
Nocturnal Scratch Wrist LEAP TBD

   PKG Health Licensed Algorithms

CARDINAL SYMPTOMS
Measures
Bradykinesia Score (BKS)
Active BKS
Percent Time Bradykinesia (PTB)
Dyskinesia Score (DKS)
Percent time Tremor (PTT)
Fluctuations and Dyskinesia Score (FDS)
Nocturnal Scratch

   PKG Health Licensed Algorithms

SENSORS
Accelerometer Gyroscope

   PKG Health Licensed Algorithms

ACTIVITY MONITORS
Wear Location Supported
Wrist All
Wrist All
Wrist All
Wrist All
Wrist All
Wrist All
Wrist LEAP

   PKG Health Licensed Algorithms

SOFTWARE
CentrePoint ActiLife
TBD

   PKG Health Licensed Algorithms

1. Validation References

Automated Assessment Of Bradykinesia And Dyskinesia In Parkinson's Disease. J Parkinsons Dis. Griffiths RI, Kotschet K, Arfon S, Xu ZM, Johnson W, Drago J, Evans A,Kempster P, Raghav S, Horne MK. 2012;2(1):47-55. 

Conditioned Response As A Measure Of Impulsive-Compulsive Behaviours In Parkinson's Disease. Evans AH, Kettlewell J, McGregor S, Kotschet K, Griffiths RI, Horne M. A. PLoS One. 2014 Feb 24;9(2):e89319.doi:10.1371/journal.pone.0089319. eCollection 2014. 

An Objective Fluctuation Score For Parkinson's Disease. Horne M, McGregor S, Bergquist F. 2015. PLOS One. Apr 2015. DOI:10.1371. 

The Clinical Validation Of Objective Measurement Of Movement In Parkinson’s Disease. Horne M, Kotschet K, McGregor S. 2016. CNS 2016: Jun 2016. 2:(1). 

An Ambulatory Tremor Score For Parkinson's Disease. Braybrook M, O’Connor S, Churchward P, Perera T, Farzanehfar P, Horne M. J Parkinsons Dis. 2016 Oct 19;6(4):723-731. 

Correlation Of Quantitative Motor State Assessment Using A Kinetograph And Patient Diaries In Advanced PD: Data From An Observational Study. Ossig C, Gandor F, Fauser M, Bosredon C, Churilov L, Reichmann H, Horne MK, Ebersbach G, Storch A. PLoS One. 2016 Aug 24;11(8):e0161559. doi: 10.1371/journal.pone.0161559. eCollection 2016. 

The Potential Use Of Parkinson's KinetiGraph: A Prospective Comparative Study. Klingelhoefer L, Rizos A, Sauerbier A, McGregor S, Martinez-Martin P, Reichmann H, Horne M, Chaudhuri KR. Night-time sleep in Parkinson’s disease. Eur J Neurol. 2016 Aug;23(8):1275-88. doi: 10.1111/ene.13015. Epub 2016 May 10. 

The Role Of The Personal KinetiGraph ™ Fluctuator Score In Quantifying The Progression Of Motor Fluctuations In Parkinson’s Disease. E. Tan, M. Horne, E. Hogg, P. Chang, J. Mirocha and M. Tagliati. Functional Neurology 2019; 34(1):21-28. 

The Use Of Data From The Parkinson’s KinetiGraph To Identify Potential Candidates For Device Assisted Therapies. Khodakarami H, Farzanehfar P, Horne M. Sensors 2019, 19, 2241; doi: 10.3390/s19102241.  

Prediction Of The Levodopa Challenge Test In Parkinson’s Disease Using Data From A Wrist Worn Sensor. Khodakarami H, Ricciardi L, Contarino MF, Pahwa R, Lyons K, Geraelts V, Morgante F, Leake A, Paviour D, De Angelis A, Horne M. Sensors 2019, 19(23), 5153; https://doi.org/10.3390/s19235153 

A Method For Measuring Time Spent In Bradykinesia And Dyskinesia In People With Parkinson's Disease Using An Ambulatory Monitor. Khodakarami H, Shokouhi N, Horne M. J Neuroeng Rehabil. 

Accuracy Of Step Count Estimations In Parkinson’s Disease Can Be Predicted Using Ambulatory Monitoring. Shokouhi N, Khodakarami H, Fernando C, Osborn S and Horne M (2022) Front. Aging Neurosci. 14:904895. doi: 10.3389/fnagi.2022.904895

PKG Health

The PKG® system contains the most comprehensive library of measures for movement disorders. PKG algorithms for bradykinesia, dyskinesia, tremors, fluctuations, sleep, gait, and other clinically meaningful symptoms have undergone rigorous analytical and clinical validation and have been used for years in numerous clinical trials across all stages in both disease modifying and symptomatic product types. See extensive clinical evidence at www.pkghealth.com/evidence. 

DECODE: Nocturnal Scratch

Launched in November 2023, the Digital Endpoint Collaboration to accelerate Outcome DEvelopment, (DECODE), in Nocturnal Scratch is a cross-industry collaboration between ActiGraph and pharmaceutical companies that aims to research and develop a novel, fit-for-purpose digital measure to support patient-focused drug programs for dermatological conditions such as atopic dermatitis (AD) and psoriasis. Learn more at www.theactigraph.com/decode/nocturnal-scratch. 

ActiGraph

Pioneering the Digital Transformation of Clinical Research™