Objective: The complex nature of Parkinson's disease (PD) makes difficult to rate its severity, mainly based on visual inspection of motor impairments. Wearable sensors have been demonstrated to help overcoming such a difficulty, by providing objective measures of motor abnormalities. However, up to now those sensors have been used on advanced PD patients with evident motor impairment. As a novelty, here we report the impact of wearable sensors in the evaluation of motor abnormalities in newly diagnosed, untreated, namely de novo, patients. Methods: A network of wearable sensors was used to measure motor capabilities, in 30 de novo PD patients and 30 healthy subjects, while performing five motor tasks. Measurement data were used to determine motor features useful to highlight impairments and were compared with the corresponding clinical scores. Three classifiers were used to differentiate PD from healthy subjects. Results: Motor features gathered from wearable sensors showed a high degree of significance in discriminating the early untreated de novo PD patients from the healthy subjects, with 95% in accuracy. The rates of severity obtained from the measured features are partially in agreement with the clinical scores, with some highlighted, though justified, exceptions. Conclusion: Our findings support the feasibility of adopting wearable sensors in the detection of motor anomalies in early, untreated, PD patients. Significance: This work demonstrates that subtle motor impairments, occurring in de novo patients, can be evidenced by means of wearable sensors, providing clinicians with instrumental tools as suitable supports for early diagnosis, and subsequent management.

We propose a sign language recognition system based on wearable electronics and two different classification algorithms. The wearable electronics were made of a sensory glove and inertial measurement units to gather fingers, wrist, and arm/forearm movements. The classifiers were k-Nearest Neighbors with Dynamic Time Warping (that is a non-parametric method) and Convolutional Neural Networks (that is a parametric method). Ten sign-words were considered from the Italian Sign Language: cose, grazie, maestra, together with words with international meaning such as google, internet, jogging, pizza, television, twitter, and ciao. The signs were repeated one-hundred times each by seven people, five male and two females, aged 29–54 y ± 10.34 (SD). The adopted classifiers performed with an accuracy of 96.6% ± 3.4 (SD) for the k-Nearest Neighbors plus the Dynamic Time Warping and of 98.0% ± 2.0 (SD) for the Convolutional Neural Networks. Our system was made of wearable electronics among the most complete ones, and the classifiers top performed in comparison with other relevant works reported in the literature.

Early noninvasive reliable biomarkers are among the major unmet needs in Parkinson’s disease (PD) to monitor therapy response and disease progression. Objective measures of motor performances could allow phenotyping of subtle, undetectable, early stage motor impairments of PD patients. This work aims at identifying prognostic biomarkers in newly diagnosed PD patients and quantifying therapy-response. Forty de novo PD patients underwent clinical and technology-based kinematic assessments performing motor tasks (MDS-UPDRS part III) to assess tremor, bradykinesia, gait, and postural stability (T0). A visit after 6 months (T1) and a clinical and kinematic assessment after 12 months (T2) where scheduled. A clinical follow-up was provided between 30 and 36 months after the diagnosis (T3). We performed an ANOVA for repeated measures to compare patients’ kinematic features at baseline and at T2 to assess therapy response. Pearson correlation test was run between baseline kinematic features and UPDRS III score variation between T0 and T3, to select candidate kinematic prognostic biomarkers. A multiple linear regression model was created to predict the long-term motor outcome using T0 kinematic measures. All motor tasks significantly improved after the dopamine replacement therapy. A significant correlation was found between UPDRS scores variation and some baseline bradykinesia (toe tapping amplitude decrement, p = 0.009) and gait features (velocity of arms and legs, sit-to-stand time, p = 0.007; p = 0.009; p = 0.01, respectively). A linear regression model including four baseline kinematic features could significantly predict the motor outcome (p = 0.000214). Technology-based objective measures represent possible early and reproducible therapy-response and prognostic biomarkers.

Objective: In order to evaluate Parkinson disease patients response to therapeutic interventions, sources of information are mainly patient reports and clinicians assessment of motor functions. However, these sources can suffer from patients subjectivity and from inter/intra raters score variability. Our work aimed at determining the impact of wearable electronics and data analysis in objectifying the effectiveness of levodopa treatment. Methods: Seven motor tasks performed by thirty-six patients were measured by wearable electronics and related data were analyzed. This was at the time of therapy initiation (T0), and repeated after six (T1) and 12 months (T2). Wearable electronics consisted of inertial measurement units each equipped with 3-axis accelerometer and 3-axis gyroscope, while data analysis of ANOVA and Pearson correlation algorithms, in addition to a support vector machine (SVM) classification. Results: According to our findings, levodopa-based therapy alters the patients conditions in general, ameliorating something (e.g. bradykinesia), leaving unchanged others (e.g. tremor), but with poor correlation to the levodopa dose. Conclusion: A technology-based approach can objectively assess levodopa-based therapy effectiveness. Significance: Novel devices can improve the accuracy of the assessment of motor function, by integrating the clinical evaluation and patient reports.