There was a recent video posted on TED.com talking about using a mobile phone to diagnose Parkinson’s disease. I watched this short video with interest, curious to see what exciting technology had been developed. With the growing body of evidence showing that exercise is front line defence against Parkinson’s disease there has been a lot of talk about people with Parkinson’s disease starting a lifelong commitment to exercise as early as possible following diagnosis- or even before diagnosis. I was hoping that this technology would have isolated a biomarker for identifying Parkinson’s disease earlier than what we have now.
At present, Parkinson’s disease is traditionally diagnosed on clinical presentation by a neurologist or GP. There are no MRI or CT scans that will show Parkinson’s disease, there is no blood test or X-ray you can have. Parkinson’s disease is made on presentation of hallmark symptoms such as tremor, rigidity and slow, small movement. It is when these symptoms have become clinically evident that, the majority of dopamine producing cells have already been destroyed.
If a method of diagnosis were possible, prior to clinical presentation of these symptoms, when fewer dopamine cells have been destroyed, it would stand to reason to think that Parkinson’s disease progression might be slowed. There is a significant amount of energy going into trying to determine these biomarkers to diagnose Parkinson’s disease years before traditional diagnosis.
While I think that the video was exciting, and highlighted an ingenious way of potentially diagnosing Parkinson’s disease, I was quite disappointed at the overall message of the video….to avoid going to see a neurologist. Parkinson’s disease is not only a clinical diagnosis; it is also a diagnosis of exclusion. This means that there are many other conditions and diseases that can present with symptoms like Parkinson’s disease, but are potentially more sinister. They need to be excluded as the cause of the symptoms in order for a definitive diagnosis to be made, and even that can take years depending on response to medication and symptom progression. I think that messages such as this open up potential for serious miss-diagnosis that can have tragic consequences. I would be keen to hear what the 99% accuracy of the testing actually means. Is this accuracy of identifiying vocal cord dysfunction or truly accuracy of identifying idiopathic Parkinson’s disease, and if so, how?
As there are some inaccuracies in the symptoms reported in the video, such as weakness being an incurable symptom of Parkinson’s disease, that make me worry about the data presented. Weakness is NOT a direct symptom of Parkinson’s disease, but more commonly linked to sedentary lifestyle changes associated with Parkinson’s disease. I wouldn’t say it could be cured, I am not sure how you decide if weakness is cured, but it can certainly be improved significantly.
I applauded anyone trying to find a better use for technology, especially in such a unique, low cost and innovative way, but in this case, I suggest that it is the interpretation of that technology that is the real success and that a specialist neurologist is the best person to diagnose the Parkinson’s disease.
To decide for yourself and watch the TED video, click here