Remote multimodal monitoring of motor neuron disease progression using wearable sensors and digital assessments
Andrew Geronimo1, Jose Casado3, Ram Kinker Mishra3, James Lim3, Ashkan Vaziri3, Zachary Simmons2
1Department of Neurosurgery, 2Departments of Neurology and Humanities, Penn State College of Medicine, 3Biosensics
Objective:

To develop and assess the feasibility of a robust multi-modal platform to remotely monitor motor neuron disease (MND) symptoms and disease progression using wearable sensors and digital assessments of speech, handwriting, and pattern-tracing skills.

Background:
Frequent remote assessments of different disease symptoms and progression are critical in improving care for patients with neurological disorders and clinical trial readiness. There is a need for a multi-modal technological solution to objectively measure and monitor disease progression in MND.
Design/Methods:

Participants with MND were enrolled for up to 12 months of remote monitoring.   They wore PAMSys TM pendant sensors for the duration of study to measure physical activity, walking parameters, postural transition, and falls during activities of daily living. Digital speech and handwriting and pattern tracing skill assessments were performed using the BioDigit HomeTM (BioSensics LLC) tablet on biweekly basis.

Results:

To date, nine participants have been enrolled (4 female), with a median age of 69 years (range 44-2 years). High compliance for the pendant-sensor-based physical activity monitoring was observed and provided a reliable tool to assess fall risk in patients with MND (with some subjects having up to 1.5 confirmed falls per week and one reported near fall per week). Furthermore, on average, subjects completed 91.9% (range 53.8%-100%) of assigned speech task. 88% of the participants were able to perform handwriting and pattern-tracing tasks.

Conclusions:

Our preliminary results demonstrate the feasibility of the multi-modal telemonitoring solution to remotely monitor mobility and disease symptoms in MND. The longitudinal monitoring may address the problem of subjective biases, measure functional changes over time, and compensate for the impact of biological variability in intermittent single visits. Patient recruitment and data collection is ongoing, and the most updated results will be presented during the meeting.

10.1212/WNL.0000000000203171