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Abstract Details

Detecting Bradykinesia in Early Morning Off: A Large Database Study using the Personal KinetiGraph® (PKG®)
Movement Disorders
P11 - Poster Session 11 (8:00 AM-9:00 AM)
3-001

To identify bradykinesia (BK) as part of Early Morning OFF (EMO) episodes in people with Parkinson’s Disease (PD) in the U.S. using an objective measurement (COM) device, the Personal KinetiGraph® (PKG®).
Bradykinesia (BK) is a primary manifestation of PD and often used as a marker for levodopa responsiveness with persistent BK reflecting suboptimal treatment.   EMO episodes are characterized by the re-emergence or worsening of symptoms which occur upon awakening, before the first dosage of levodopa and until its beneficial effects begin. EMO episodes can be associated with significant disability and result in a negative impact on health-related quality of life. COM systems offer an opportunity to better detect OFF episodes including EMO.
A deidentified global database of PKG assessments performed in routine clinical care from 18,318 individuals with Parkinson’s disease, with 3469 from the U.S., were used in the analyses.  An objective measurement score using the PKG was calculated to characterize those individuals above a specified target BK range, if they alternated in/out of the target range, the severity of BK, and to determine the occurrence of EMO episodes.

Within the U.S. cohort, 69% had EMO episodes Only 48% of this group had an improvement of greater than 4 BKS points measured by PKG (~15 UPDRS III points) within 90 minutes after receiving their first levodopa dose.  The level of severity of early morning bradykinesia was much worse in the undertreated population. The proportion of patients in the undertreated range also showed a smaller response to levodopa after the first dose. 

EMO episodes are a common manifestation in levodopa-treated patients with PD and may be under-recognized in clinical practice.  Patients with higher BKS measurements at baseline have a smaller response to their first levodopa dose measured by PKG, which may be due to undertreatment. 

Authors/Disclosures
Stuart H. Isaacson, MD, FÂ鶹´«Ã½Ó³»­ (Parkinson's Dis & Mov Dis Ctr of Boca Raton)
PRESENTER 		The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acadia. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sunovion. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for acorda. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Supernus. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocrine. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Kyowa. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for adamas. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neuroderm. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for amneal. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurocrine. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for adamas. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Supernus. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acadia. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amneal. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie.
Rajesh Pahwa, MD, FÂ鶹´«Ã½Ó³»­ (University of Kansas Medical Center) Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for ACADIA. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amneal. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Supernus. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Insightec. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jaaz. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Fasikl. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genetech. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Mitsubishi Tanabe. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Photopharmics. The institution of Dr. Pahwa has received research support from Abbott. The institution of Dr. Pahwa has received research support from Abbvie. The institution of Dr. Pahwa has received research support from Biogen. The institution of Dr. Pahwa has received research support from Parkinson Foundation. The institution of Dr. Pahwa has received research support from Roche. The institution of Dr. Pahwa has received research support from Sage. The institution of Dr. Pahwa has received research support from Sun Pharma. The institution of Dr. Pahwa has received research support from Theravance. The institution of Dr. Pahwa has received research support from Neuroderm. The institution of Dr. Pahwa has received research support from Ask Bio. The institution of Dr. Pahwa has received research support from Blue Rock. The institution of Dr. Pahwa has received research support from Cerevance. The institution of Dr. Pahwa has received research support from Fasikl. The institution of Dr. Pahwa has received research support from Scion. The institution of Dr. Pahwa has received research support from UCB. The institution of Dr. Pahwa has received research support from Ono. The institution of Dr. Pahwa has received research support from Intra-cellular Therapies. The institution of Dr. Pahwa has received research support from Ask Bio. The institution of Dr. Pahwa has received research support from Michael J Fox Foundation . The institution of Dr. Pahwa has received research support from Neuron 23. The institution of Dr. Pahwa has received research support from Roche.
Eric J. Pappert, MD (Neurology Associates) No disclosure on file
Diego Torres-Russotto, MD, FÂ鶹´«Ã½Ó³»­ (Miami Neuroscience Institute - Baptist Health South Florida) Dr. Torres-Russotto has received personal compensation for serving as an employee of Movement Disorders Consulting, Inc. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie. The institution of Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. The institution of Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Revance. The institution of Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Anneal. Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for IPSEN. Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurocrine. Dr. Torres-Russotto has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Your Nest Asset Solutions, LLC. Dr. Torres-Russotto has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Bright Future Asset Solutions, LLC.