ArticleScientific reports2026
Association between wearable-derived dyskinesia time burden and longitudinal change in disability in people with Parkinson's disease: a real-world treat-to-target cohort study.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Wearable monitoring offers a way to quantify motor-state burden in Parkinson's disease during routine care, but the clinical meaning of longitudinal change in dyskinesia burden remains uncertain. This secondary analysis used a publicly available real-world treat-to-target dataset from people with Parkinson's disease managed with serial Personal KinetiGraph (PKG) monitoring. Participants with paired baseline and final total Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores were included in the paired clinical analyses. The primary adjusted regression used a complete-case sample restricted to participants with paired percent time in dyskinesia (PTD) values and complete covariate data. Change-score linear regression was used to examine whether longitudinal change in PTD was associated with change in total MDS-UPDRS score, adjusting for baseline total MDS-UPDRS, sex, disease duration, and baseline PTD. Among 30 participants with paired MDS-UPDRS data, total scores improved from 65.3 (SD 19.2) at baseline to 53.9 (SD 23.9) at final assessment (mean change - 11.4, 95% CI - 16.7 to - 6.0; p < 0.001). In the primary adjusted regression (n = 25), each 1-percentage-point increase in PTD corresponded to an estimated 0.25-point less favourable change in total MDS-UPDRS score (β = 0.25, SE 0.13, 95% CI - 0.02 to 0.52; p = 0.064). The estimate was in the expected direction, but the confidence interval crossed zero and the result was not conventionally statistically significant. Sensitivity analyses, including ANCOVA-type modelling and bootstrap resampling, were supportive only and did not materially change the overall interpretation. In this exploratory secondary analysis, increasing wearable-derived dyskinesia burden tended to accompany less favourable change in disability during routine treat-to-target care for Parkinson's disease. These findings should be interpreted cautiously because of the small complete-case sample and the observational design. Larger prospective studies are needed to clarify whether wearable-derived dyskinesia burden has clinically useful prognostic or treatment-guiding value and to determine whether clinically meaningful thresholds can be defined.
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