Visual self-reporting for symptom communication in Parkinson's disease

Abstract

Background: The Parkinson's Image Self (PIS) Report app was developed to complement standard clinician-rated assessments, such as the Movement Disorder Society–Unified Parkinson's Disease Rating Scale (MDS-UPDRS), by enabling patients to digitally self-report Parkinson's disease (PD) symptoms, including pain, tremor, rigidity, and emotional states. Objective: To evaluate PIS Report validity and digital health utility by comparing patient-reported outcomes with clinician-rated MDS-UPDRS assessments. Methods: Seventy-eight PD participants completed baseline assessments; 70 provided week-8 follow-up data. PIS outcomes were compared with MDS-UPDRS items using ANOVA, correlation analysis, chi-square tests, and Cohen's kappa statistics. Results: PIS-derived pain scores differed significantly across MDS-UPDRS pain strata (Item 1.9; F = 4.48, p < 0.01). Head/neck and upper limb pain correlated with perceived OFF periods (r = 0.46–0.48, p < 0.001), while head/neck and lower limb pain correlated negatively with happiness (r = –0.35 to −0.41, p < 0.001). Tremor reports showed fair agreement with clinician ratings (χ2 = 18.54, p < 0.001; κ = 0.36), whereas rigidity showed negligible agreement (χ2 = 0.00, p = 1.000; κ = 0.01). Conclusion: The PIS Report provides a structured digital tool enhancing patient–clinician communication and remote monitoring by capturing pain, OFF states, and emotional symptoms. Integration with wearables and telemedicine may advance patient-centered PD care. Trial Registration: CRIS (KCT0006646); ClinicalTrials.gov (NCT05621772).