Longitudinal study of Progressive Supranuclear Palsy (PSP) using remote at-home multi-modal digital assessments and wearable devices
Mansi Sharma1, Anna J Hall2, Rylee Cole3, Jose Casado3, Ram Kinker Mishra3, Ashkan Vaziri3, Alexander Pantelyat2, Anne Marie Wills4
1Department of Neurology, Massachusetts General Hospital, 2Johns Hopkins University School of Medicine, 3BioSensics LLC, 4Department of Neurology, Massachusetts General Hospital and Harvard Medical School
Objective:

To measure Progressive Supranuclear Palsy (PSP) progression remotely in participants’ homes using wearable sensors, digital speech and cognitive assessments.

Background:

There are limited studies using technology to objectively measure disease progression in PSP and no studies using wearable technology in participants’ homes. We hypothesized that remote, objective, quantitative measures of disease progression will facilitate clinical trials and help spur development of new therapies for PSP.

Design/Methods:

Patients with clinically probable PSP by MDS 2017 criteria able to ambulate ≥10 feet unassisted were recruited at Massachusetts General Hospital and Johns Hopkins from November 2021 through September, 2022 and followed virtually monthly for 1 year.

Motor assessments performed monthly wearing LEGSysTM and BalanSenseTM (BioSensics LLC, Newton, MA USA) devices included: balance assessments, 5x sit-to-stand, 3-meter timed up and go, and 2-minute walk tests. Participants wore PAMSys TM (BioSensics LLC) pendant sensors for 1 year to measure physical activity, walking parameters, postural transitions, and falls during daily activities.

Digital cognitive and speech assessments performed using the BioDigit Home TM (BioSensics LLC) tablet every 3 months included: Color Trails, Conflicting Instructions, Go/No-Go, Forward and Backward Digit Span. The PSP Rating Scale (PSPRS), MoCA, PSP-QoL and CBFS were collected virtually every 3 months or in-person.

Results:

As of October 2022, 11 PSP participants were enrolled. By April 2023, 7 participants will have completed 12 months of follow-up. One participant was unable to complete virtual assessments due to lack of caregiver support and 3 participants could not perform walking tasks after 6 months.

Walking parameters, postural duration and transition times correlated strongly with disease progression as measured using the PSPRS and PSP-QoL. Instrumented gait measures correlated with activity levels.  

Conclusions:

Our study demonstrates the feasibility of remote longitudinal measurement of PSP progression in participants’ homes using wearable devices and digital assessments.  The study identifies possible digital biomarkers of PSP progression.

10.1212/WNL.0000000000203242