Real Time Monitoring and Digital Biomarkers in Parkinson's Disease
- Lifespark
- 9 hours ago
- 4 min read
Part of the STEP 2026 World Parkinson's Day Event expert sessions
Delivered by Dr. Vibhor Pardasani, Neurologist
When symptoms don’t follow the textbook: a practical talk for Parkinson’s patients and caregivers
If you live with Parkinson’s—whether as a patient or caregiver—you already know the hardest part isn’t learning the “list” of symptoms. It’s that symptoms don’t behave consistently. A day can start with steady hands and end with stiffness you didn’t plan for. Medication can feel perfect one week and unpredictable the next.
In this expert session, Dr. Vibhor Pardasani kept returning to one core idea: the more clearly you can “see” your symptoms over time, the more precisely your care team can help you. And today, that “seeing” is increasingly possible through structured symptom tracking—sometimes with simple notes, and sometimes with technology that captures patterns the human memory misses.
The session captures the spirit of it:“personalized medicine” isn’t a buzzword here—it’s the goal of getting you closer to the right timing and right dose for your day-to-day reality.
Why symptom tracking matters (even when you’re already seeing a specialist)
A common frustration for families is this: by the time the appointment arrives, you can’t accurately recall how often tremor happened, when stiffness peaked, or what triggered a “bad patch.” Parkinson’s symptoms fluctuate, and those fluctuations carry useful clinical information.
Dr. Pardasani pointed to the value of capturing frequency and timing—because it directly affects medication planning.
“They help in choosing the right time [and] finding the right dose of the medication.”
This is especially relevant when symptoms are not steady, but change across the day—something he explicitly linked to fluctuations and dyskinesia:
When symptoms are unpredictable, a vague description becomes a barrier. But a pattern—captured in a diary, a chart, or wearable data—can become a map.
What to track: a simple symptom list that actually helps
The transcript repeatedly circles around a few symptom clusters—especially those that change with time and medication. For patients and caregivers, the most useful tracking is often short, consistent, and time-stamped. Here’s a practical template aligned with what was discussed:
1) Movement symptoms (motor)
Track what happened, when, and how long:
Tremor (resting tremor, action tremor, one side vs both)
Stiffness / rigidity
Slowness (bradykinesia)—trouble starting movement, smaller steps
Dyskinesia (involuntary writhing movements), and when it appears
2) “Wearing off” and “on/off” periods
If you’re on levodopa or other dopaminergic meds, tracking the relationship to dose timing is high-yield:
When does the dose start helping?
When does it stop helping?
Are there sudden “offs”?
Does dyskinesia follow a dose peak?
Even a rough pattern—“45 minutes after dose I improve” or“late afternoon is consistently worse”—can help the clinician adjust timing.
3) Non-motor symptoms that influence the whole day
The transcript is messy in places, but it clearly flags common real-world issues families mention:
Constipation (it can affect medication absorption and overall comfort)
Vertigo / dizziness (if present)
Sleep quality, fatigue, mood changes (if relevant to the individual)
4) Triggers and context
Dr. Pardasani’s discussion suggests tracking what surrounds symptoms—not just the symptom itself:
Activity level (busy day vs restful day)
Stressful events
Caffeine sensitivity (mentioned as a factor some people track)
The “how”: from notebook to wearables (and why graphs can change the conversation)
One of the most actionable parts of the session was the emphasis on commercially available tracking tools—especially watches and phones—used as symptom mirrors.
He also described symptom data being visualized as graphs—which is often the turning point for families. Instead of arguing whether a week was “bad,” you can point to trends.
What wearables can be useful for (in plain terms)
Even basic wearables can estimate:
Overall activity and movement patterns
Tremor-like motion patterns (depending on device and software)
Periods of decreased mobility (possible “off” times)
Sleep duration/fragmentation (in some watches)
And phones can help with structured check-ins—quick taps rather than long diaries—so symptom logging doesn’t become another burden.
A key caregiver advantage: fewer memory battles
Caregiving often includes a hidden emotional labor: trying to reconstruct the week accurately in a short appointment. Tracking tools reduce that load by creating a shared record—less “I think,” more “Here’s what happened.”
Actionable steps you can start this week
Here’s a practical plan that matches the spirit of the talk—simple, consistent, and aimed at medication and quality-of-life decisions.
Step 1: Pick ONE tracking method and keep it frictionless
Choose either:
A small notebook (time + symptom + severity 0–10), or
A notes app with a daily template, or
A wearable + brief daily check-in
Don’t aim for perfect. Aim for repeatable.
Step 2: Track around medication—just 3 time points per dose
For each main dose, capture:
Before dose (baseline)
60 minutes after (peak benefit for many, but varies)
When symptoms return (wearing off)
If that’s too much, do it once per day at the same times for a week.
Step 3: Use a simple severity scale
Example:
Tremor: 0–10
Stiffness: 0–10
Walking confidence: 0–10
Dyskinesia (if present): 0–10
Step 4: Track one non-motor symptom that affects the day
Pick the most relevant (often constipation, sleep, anxiety, dizziness). Add one line per day.
Step 5: Bring “patterns,” not pages, to the appointment
At the end of 7–14 days, summarize:
Most common symptom and when it peaks
Any consistent “off” windows
Any dyskinesia windows
Any link to meals, stress, or constipation
This supports what Dr. Pardasani emphasized: using tracked patterns to help the clinician adjust timing and dose more intelligently.
A grounded caution: not every device is equally proven
A valuable note in the session was the reminder to be careful with claims that jump ahead of evidence.
What this means for families:Use technology as a tool for observation and conversation, not as a replacement for medical decision-making. If an app or device promises dramatic cures, treat it skeptically. If it helps you log symptoms clearly and consistently, it may be genuinely useful—especially when your doctor can interpret it in context.
Conclusion: tracking is not “extra work,” it’s a bridge
For many families, Parkinson’s care becomes a loop of trial-and-adjust: a medication change, a few weeks of uncertainty, a follow-up, another adjustment. Symptom tracking doesn’t eliminate that process—but it can make it less guessy, less emotionally draining, and more tailored.
If you take one message from the session, let it be this: your daily experience is data. When you capture it in a structured way—whether on paper or through a wearable—you give your care team a clearer path toward stability.
