Remote Monitoring of Motor, Speech, and Cognitive Function in Progressive Supranuclear Palsy
Ram Kinker Mishra1, Mansi Sharma2, Anna J. Hall3, Jose Casado1, Adonay Nunes1, Ashkan Vaziri1, Alexander Pantelyat3, Anne-Marie Willis2
1BioSensics, 2Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 3Department of Neurology, Johns Hopkins University School of Medicine
Objective:
Develop and implement a multi-modal remote monitoring digital solution to assess motor, speech, and cognitive function in Progressive Supranuclear Palsy (PSP) patients.
Background:
PSP is a debilitating neurodegenerative disease that rapidly and profoundly impairs motor, speech and cognitive function. A multi-modal monitoring approach addressing multiple clinical domains can provide valuable insights into disease progression and may help develop targeted therapies.
Design/Methods:
Individuals diagnosed with PSP were enrolled and followed for 12 months. Clinical assessments including PSP Rating Scale (PSPRS) and MoCA were administered every three months for a total of 5 assessments. Digital psychomotor, speech and cognitive assessments were collected using the BioDigit Home tablet (BioSensics, Newton, MA, USA). Wearable sensors (PAMSys and LEGSys) were used for objective motor assessment of the Timed Up and Go test (TUG), 2-minute walk test (2MWT), and for continuous monitoring of physical activity and posture.
Results:
To date, 20 individuals diagnosed with PSP have been enrolled in the study and followed for 6-12 months. Correlations between PSPRS scores and sensor-derived measured of physical activity, such as cadence and stride duration, show moderate effect sizes. We also observed significant correlations between several parameters of digital speech and cognitive assessment scores compared to the relevant clinical scores (e.g., bulbar subdomain scores of PSPRS and MoCA).
Conclusions:
Multi-modal remote monitoring shows promise in assessing PSP's clinical progression, offering insights into specific aspects of the disease, including motor, gait, and speech. We plan to create a digital PSP Rating Scale to quantitatively measure progression in each of these domains. These results will allow for remote capture of clinically relevant outcomes, improving access for patients with geographic constraints and physical disabilities who are currently unable to participate in clinical trials. Ultimately, our findings may help improve clinical care and therapy development in PSP.