2023 American Academy of Neurology Abstract Website

Objective:

Our long-term goal is to employ smartphone-embedded sensors to measure various neurological functions in a patient-autonomous manner. The interim goal is to develop simple smartphone tests and evaluate the clinical utility of these tests by selecting optimal outcomes that correlate well with clinician-measured disability in different neurological domains.

Background:

There is a world-wide shortage of neurologists, which is predicted to only worsen as the world population ages. This shortage along with the recent Covid-related restrictions, has resulted in fewer neurological exams and this can result in a delayed diagnosis and cause suboptimal care for the patient. DTM Health worked with NIH to address this “gap in care” with a self-administered mobile app that can remotely monitor a patient’s condition.

Design/Methods:

We hypothesized that aggregating data from two simple smartphone tests of fine finger movements with differing contributions of specific neurological domains ( strength, cerebellar functions, vision, and reaction time) will allow establishment of secondary outcomes that reflect domain-specific deficit.

This hypothesis was tested by assessing correlations of smartphone-derived outcomes with relevant parts of neurological examination in multiple sclerosis patients. We developed a mobile app consisting of two simple tests: Finger Tapping and Balloon Popping.

The study consisted of 76 multiple sclerosis (MS) patients and 19 healthy volunteers (HV). The balloon popping and finger tapping tests were self-administered by the participants while the 9-hole peg test (9HPT) was administered by an investigator.

Results:

The primary outcomes of smartphone tests, the average number of taps and the average number of pops differentiated MS from HV with similar power to traditional, investigator-administered test of fine finger movements of 9HPT.

Conclusions:

In the time necessary for performing 9HPT, smartphone tests provide much richer and reliable measurements of several distinct neurological functions. This data suggests that combining more creatively-construed smartphone apps may one day recreate the entire neurological examination.