Parkinson’s disease results in motor dysfunction with varying response to exogenous levodopa. Response to treatment is monitored with ratings scale such as the Unified Parkinson Disease Rating Scale (UPDRS). However, this paradigm of care results in slow response times and limited reliability. The development of technologies to assist with clinical assessments is essential to improving care. Mass market VR devices with their ability to measure movement and generate testing environments may be able to increase objectivity, validity, and monitoring frequency.

Individuals with levodopa responsive PD without other complicating conditions were selected (n=20). Participants were first evaluated in their off-state using the UPDRS motor scale and participated in a virtual reality assessment which mirrored the clinical exam. Hand positioning was recorded. Afterwards, levodopa was administered and individuals were reassessed clinically and with the VR device.

Severity of tremor decreased after levodopa administration in all assessed states with statistical significance achieved reliably in two of three states (p<0.05). Bradykinesia measures improved in all three states, though statistical significance was only achieved reliably in one state.

For tremor, strong correlations between various device and physician measures of tremor severity were present (r = 0.5-0.8). For bradykinesia, moderate correlations existed between the state which had achieved statistical significance in the on-off state comparison (r ~ 0.5).

Patient perception surveys noted most individuals were willing to incorporate similar devices into their care.

VR devices are can detect patient responsiveness to levodopa and device generated metrics correlate with validated physician metrics. Device use is accepted and essentially side-effect free. This study argues for the further evaluation of PD by VR devices with future focus on complex tasks.