An APP to assist with the differential diagnosis of patients with Parkinson’s disease and essential tremor

Essential Tremor is a type of movement disorder that is frequently erroneously diagnosed as Parkinson’s disease. Essential Tremor is not degenerative and presents as a rhythmic tremor in movement that is generally accentuated for positions in posture. In contrast, Parkinson’s disease is of a neurodegenerative nature and mainly affects movement at rest. The treatment with dopamine that is administered to Parkinson’s patients is extremely aggressive and harmful if it is given to patients who do not suffer from this disease, for example, patients with Essential Tremor. In addition to this major drug contraindication, the test to determine whether a patient has Parkinson’s disease, Single Photon Emission Computed Tomography (SPECT), is extremely costly and often has long waiting lists. SPECT is an examination that requires the administration of a radiopharmaceutical (a source of gamma radiation) to the patient to identify the distribution in brain regions and determine the amount of neurodegeneration.

The mobile application that was developed is based on a biomechanical test in two positions (relaxation and posture) to register and analyse hand tremor with inertial sensors, whether using a mobile phone or specific wireless devices. The linear acceleration and/or angular velocity of the movements is processed to provide biometric characteristics of the patients in the time and frequency domain. Then, algorithms are used based on neural networks. The resulting values are compared with those obtained in diagnosed cases to determine whether the patient has Parkinson’s disease or Essential Tremor. Currently, the database is being expanded with the help of several hospitals and associations to improve the reliability of the tool for differential diagnosis. The diagnosis provided by the application will give doctors additional information on complex patients or patients in early phases in which the right treatment is vital to improve quality of life.

This new technology is accessible for developing countries that lack more sophisticated diagnostic devices.

The project is being developed in collaboration with the doctors Josep Valls and Eduard Tolosa, from the neurology unit of Hospital CLINIC, the Universidad Autónoma de Occidente de Colombia, Universidad de Chile and the Ostbayerische Technische Hochschule of Germany. The project will be end in 2022.