Wearable Sensors in Huntington Disease: A Pilot Study

Andrzejewski, Kelly L.; Dowling, Ariel V.; Stamler, David; Felong, Timothy J.; Harris, Denzil A.; Wong, Cynthia; Cai, Haibing; Reilmann, Ralf; Little, Max A.; Gwin, Joseph T.; Biglan, Kevin; Dorsey, E. Ray

doi:10.3233/jhd-160197

Cited by 61 publications

(54 citation statements)

References 30 publications

(42 reference statements)

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“…American and French neurology (Thurman et al, 2008; Gilman, 2010; Collége des Enseignants de Neurologie [CEN], 2016) as well as rheumatology and gerontology societies recommended the use of standardized measures to assess gait: the 6-min walk test (assesses exercise tolerance in frail older adults), the timed 25-foot walk test (a shorter test mainly used for patients with multiple sclerosis), and the Timed-Up-and-Go (TUG) test (Andrzejewski et al, 2016). Nonetheless, protocols offer endless variabilities at each phase of their design as described below.…”

Section: Resultsmentioning

confidence: 99%

“…Ambulatory assessment is more representative of people’s gait. Indeed, the environment with ILG is physiological; hours of walking at different times of day can be recorded, which is key to valid interpretation of pattern and rhythm variability parameters that assess gait at a macro-level (Robles-García et al, 2015); and the putative “white-coat” syndrome (Andrzejewski et al, 2016) is avoided. Nevertheless, ambulatory data extraction and analysis entail great challenges because various algorithms have been developed for controlled testing, and their validity in this uncontrolled environment is questioned.…”

Section: Discussionmentioning

confidence: 99%

“…Reviewed studies were mostly set up in a laboratory or clinical space (69 of 78 studies). Two studies, analyzing both ambulatory and laboratory data ( Figures 2, 3 ), brought more arguments for higher sensitivity of ambulatory measures while enhancing the difficulty in controlling features that highly depend on bout length and algorithms for gait detection (Andrzejewski et al, 2016; Del Din et al, 2016a). …”

Section: Discussionmentioning

confidence: 99%

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Inertial Sensors to Assess Gait Quality in Patients with Neurological Disorders: A Systematic Review of Technical and Analytical Challenges

et al. 2017

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Gait disorders are major causes of falls in patients with neurological diseases. Understanding these disorders allows prevention and better insights into underlying diseases. InertiaLocoGraphy (ILG) –the quantification of gait by using inertial measurement units (IMUs) –shows great potential to address this public health challenge, but protocols vary widely and normative values of gait parameters are still unavailable. This systematic review critically compares ILG protocols, questions features extracted from inertial signals and proposes a semeiological analysis of clinimetric characteristics for use in neurological clinical routine. For this systematic review, PubMed, Cochrane and EMBASE were searched for articles assessing gait quality by using IMUs that were published from January 1, 2014 to August 31, 2016. ILG was used to assess gait in a wide range of neurological disorders – including Parkinson disease, mild cognitive impairment, Alzheimer disease, cerebral palsy, and cerebellar atrophy – as well as in the faller or frail older population and in people presenting rheumatological pathologies. However, results have not yet been driving changes in clinical practice. One reason could be that studies mainly aimed at comparing pathological gait to healthy gait, but there is stronger need for semiological descriptions of gait perturbation, severity or prognostic assessment. Furthermore, protocols used to assess gait using IMUs are too many. Likely, outcomes are highly heterogeneous and difficult to compare across large panels of studies. Therefore, homogenization is needed to foster the use of ILG to assess gait quality in neurological routine practice. The pros and cons of each protocol are emphasized so that a compromise can be reached. As well, analysis of seven complementary clinical criteria (springiness, sturdiness, smoothness, steadiness, stability, symmetry, synchronization) is advocated.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Inertial Sensors to Assess Gait Quality in Patients with Neurological Disorders: A Systematic Review of Technical and Analytical Challenges

et al. 2017

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“…The goal of digital biomarkers is to maximize the ecological validity and temporal and spatial resolution of capturing motor and nonmotor phenomena that are expected to change over time. As such, wearable technology may provide a more realistic portrayal of behaviors of interest in clinical and research settings [26]. …”

Section: Opportunity For Digital Biomarkersmentioning

confidence: 99%

The First Frontier: Digital Biomarkers for Neurodegenerative Disorders

et al. 2017

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Current measures of neurodegenerative diseases are highly subjective and based on episodic visits. Consequently, drug development decisions rely on sparse, subjective data, which have led to the conduct of large-scale phase 3 trials of drugs that are likely not effective. Such failures are costly, deter future investment, and hinder the development of treatments. Given the lack of reliable physiological biomarkers, digital biomarkers may help to address current shortcomings. Objective, high-frequency data can guide critical decision-making in therapeutic development and allow for a more efficient evaluation of therapies of increasingly common disorders.

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“…The onset of the disease typically occurs in individuals who are in their 30s and 40s with a long asymptomatic or minimally symptomatic prodromal period before diagnosis. Unlike Parkinson disease, there have been few studies of wearable sensors for Huntington disease with only two studies recently published [7, 8], and only one of which evaluated recordings from home [8]. Moreover, no studies have examined the prodromal period in Huntington disease, which is an area of unmet need [2].…”

Section: Introductionmentioning

confidence: 99%

Multiple Wearable Sensors in Parkinson and Huntington Disease Individuals: A Pilot Study in Clinic and at Home

Adams¹,

Dinesh²,

Xiong³

et al. 2017

Digit Biomark

1,919

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Background: Clinician rating scales and patient-reported outcomes are the principal means of assessing motor symptoms in Parkinson disease and Huntington disease. However, these assessments are subjective and generally limited to episodic in-person visits. Wearable sensors can objectively and continuously measure motor features and could be valuable in clinical research and care. Methods: We recruited participants with Parkinson disease, Huntington disease, and prodromal Huntington disease (individuals who carry the genetic marker but do not yet exhibit symptoms of the disease), and controls to wear 5 accelerometer-based sensors on their chest and limbs for standardized in-clinic assessments and for 2 days at home. The study’s aims were to assess the feasibility of use of wearable sensors, to determine the activity (lying, sitting, standing, walking) of participants, and to survey participants on their experience. Results: Fifty-six individuals (16 with Parkinson disease, 15 with Huntington disease, 5 with prodromal Huntington disease, and 20 controls) were enrolled in the study. Data were successfully obtained from 99.3% (278/280) of sensors dispatched. On average, individuals with Huntington disease spent over 50% of the total time lying down, substantially more than individuals with prodromal Huntington disease (33%, p = 0.003), Parkinson disease (38%, p = 0.01), and controls (34%; p < 0.001). Most (86%) participants were “willing” or “very willing” to wear the sensors again. Conclusions: Among individuals with movement disorders, the use of wearable sensors in clinic and at home was feasible and well-received. These sensors can identify statistically significant differences in activity profiles between individuals with movement disorders and those without. In addition, continuous, objective monitoring can reveal disease characteristics not observed in clinic.

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Wearable Sensors in Huntington Disease: A Pilot Study

Cited by 61 publications

References 30 publications

Inertial Sensors to Assess Gait Quality in Patients with Neurological Disorders: A Systematic Review of Technical and Analytical Challenges

Inertial Sensors to Assess Gait Quality in Patients with Neurological Disorders: A Systematic Review of Technical and Analytical Challenges

The First Frontier: Digital Biomarkers for Neurodegenerative Disorders

Multiple Wearable Sensors in Parkinson and Huntington Disease Individuals: A Pilot Study in Clinic and at Home

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