Table 4.
Actigraphy in Parkinson’s Disease.
| [Ref] | Study Aim | PSG | Actigraphy Location | Monitoring Duration | Outcome Measures | Main Findings | Clinical-Behavioural Correlations |
|---|---|---|---|---|---|---|---|
| [13,16,17,20,21,22,23,24,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88] | Assessment of sleep features | [17,20,72,73,75,76,79] | Non-dominant wrist, least or most affected arm, lower limbs | 1 to 14 days | Nocturnal activity; movement and fragmentation indices; mean duration of immobility periods; ratio of nighttime and daytime activity (relative amplitude); sleep latency, time, efficiency; WASO; daytime napping | Linear correlation between actigraphy and PSG measurements partially dependant on disease stage; higher sleep efficiency and total sleep time when recording lower limbs compared to upper limbs. Higher nighttime activity level, daytime napping, and movement and fragmentation indices; worse WASO and sleep efficiency, latency, and time in PD than HS. Worse sleep measures in patients with advanced PD, mild cognitive impairment, hallucinations, and probable RBD | Actigraphic sleep measures correlated with disease stage and severity, PDSS sleep quality, non-motor symptoms, morning mobility, LEDD, cognitive function, and melatonin blood concentration. No significant associations between the periodic limb movement index and restless legs syndrome |
| [14,15,83,89,90,91,92,93,94] | Evaluation of therapeutic intervention | [14,89,94] | Non-dominant wrist or least affected arm | 14 to 28 days | Total time in bed; movement and fragmentation indices; nocturnal immobility onset and offset times; and sleep latency, time, and efficiency | Good agreement rate (0.85) between actigraphy and PSG for sleep time. LCIG infusion, DBS, melatonin, parietal rTMS and bright light therapy improved actigraphic measures (e.g., sleep quality, latency, duration, fragmentation, and efficiency) during sleep in PD. Dopaminergic therapy was associated with earlier waking and immobility offset times. Pergolide worsened sleep efficiency and fragmentation | Nighttime psychotic symptoms and daytime somnolence correlated with awakening times |
| [95,96] | Validation of clinical scales | NA | Non-dominant wrist | 7 days | Total time in bed; total sleep time; time spent in the awake state; nocturnal activity and motility time | NMSQ, sleep logs, and PDSS appropriately detect sleep disturbances | NMSQ sleep-fatigue questions, sleep logs, and PDSS correlated with actigraphic measures |
| [18,19] | Identification of sleep disorders | [18] | Least affected arm | 7 to 14 days | Number of wake bouts, duration of awakenings | A higher number of wake bouts in PD with RBD than in PD without RBD; actigraphy has high specificity but low sensitivity in the diagnosis of RBD compared to PSG | Total rest time and number of wake bouts positively correlated with RBDSQ |
DBS: deep brain stimulation; LCIG: L-Dopa/carbidopa intestinal gel; LEDD: L-Dopa equivalent daily dose; NA: not available; NMSQ: Non-Motor Symptoms Questionnaire; PD: Parkinson’s disease patients; PDSS: Parkinson’s Disease Sleep Scale; PSG: polysomnography; RBD: rapid eye movement sleep behaviour disorder; RBDSQ: REM Sleep Behaviour Disorder Screening Questionnaire; rTMS: repetitive transcranial magnetic stimulation; UPDRS: Unified Parkinson’s Disease Rating Scale; WASO: wake after sleep onset.