Understanding Neurodegenerative Diseases with Wearable Sensors

Millions of people across the globe struggle with neurodegenerative diseases every day. Neurodegenerative diseases are characterized by a breakdown of the central and peripheral nervous systems and cause progressive deterioration of a normally functioning human body. However, a significant challenge in studying neurodegenerative diseases is that direct measurements of neurological systems are invasive and expensive.

Wearable sensors can be used to understand disease progression and manifestation by measuring physical symptoms and physiological outcomes.

The Wide Spectrum of Neurodegenerative Disease Symptoms

The brain plays a central role in coordinating multiple systems in the body to perform complex tasks and sustain life. A breakdown in any component of the central or peripheral nervous system causes impaired body functioning, leading to specific disease and symptom manifestation.

For example, Parkinson’s disease causes damage to the part of the brain that controls physical movements; as a result, patients often present with tremors, stiffness, and a slowing of movements. In contrast, spinal muscular atrophy destroys nerve cells that control life-sustaining respiratory function. Depending on the disease and the individual, the rate of neurodegeneration and the progression of functional impairments can vary widely.

Benefits of Using Wearable Sensors for Neurodegenerative Disease

Wearable sensors have the potential to substantially advance how we diagnose, treat, and manage neurodegenerative diseases. However, disease progression is currently assessed using a combination of complex and invasive tests, clinical examinations, and patient reports performed episodically at routine or emergency clinic visits. As a result, clinicians are often left to piece together incomplete slivers of information and make sense of a patient’s comprehensive health status. Making treatment decisions with this limited view is like imagining what a jigsaw puzzle will look like with only half of the pieces.

Wearable sensors offer a way for clinicians to “see the whole picture.” Since they are deployed remotely, passively, and continuously, wearable sensors capture unique aspects of disease progression and manifestation in a patient’s own environment. Real-world measures of patient functioning derived from wearable sensors have the potential to augment, or even replace, invasive and complex tests and provide a holistic view of a patient’s lived experience.

Selecting the Most Appropriate Wearable or Remote Monitoring Technology for Neurodegenerative Disease

Using wearable sensors in neurodegenerative disease to capture a patient’s functioning in their own environment has great promise, but, as we always say, “one size does not fit all.”

Neurodegenerative disease encapsulates a wide variety of conditions with different manifestations, and consequently, the right wearable sensor for every patient population will not be the same. The right sensor that accurately captures a patient’s lived experience will:

• • Fit the unique needs of the patient.
• • Measure outcomes that are most important and meaningful for the patient.
• • Be deployed in the right setting, at the right time, and for the right duration.

Here are some examples of common and burdensome neurodegenerative disease symptoms that can be assessed with wearable sensors.

Motor Symptoms: Inertial sensors, like accelerometers, gyroscopes, and magnetometers, are frequently used to capture real-world measures of physical function in a variety of diseases. By measuring participation in real-world physical behaviors (e.g., stepping) and assessing relevant parameters of how those behaviors are performed (e.g., stride length while walking or how quickly a patient changes direction or turns around), we can capture motor impairments in neurodegenerative disease.

Respiratory Symptoms: Respiratory impairments can be assessed using wearable sensors, like dual-band respiratory inductance plethysmography (RP) sensors or polyplethysmography (PPG), which capture breathing patterns over 24-hour cycles in real-world environments. These sensors can detect apnea events during sleep or other respiratory outcomes like resting respiratory rates or respiratory timing indicative of disease burden and treatment effects.

Cardiovascular Symptoms: Neurologic-related cardiovascular events such as arrhythmias and decompensation can be assessed using wearable electrocardiogram (ECG) or polyplethysmography (PPG) sensors. ECG sensors can range from a single to 12-lead and come in the form of shirts, patches, or straps. Though the traditional sites for PPG have been the finger or ear, many wrist-worn watches incorporate PPG sensors and are associated with a low patient burden.

Contextualizing Objective Sensor Data for Holistic Assessments of Neurodegenerative Disease

Neurodegenerative diseases have a widespread impact on multiple systems of the body. In isolation, data from wearable sensors provide one view of patient functioning in their environment, but integrating episodic patient self-reports or other clinical test results with objective wearable sensors creates contextually rich data. These data help understand the multidimensional impact of neurodegeneration on multiple systems in the body and can generate a thorough picture of the patient’s experience.

VivoSense software provides tools to synchronize time-series data from multiple sources and integrates subjective ePRO/eCOA data for complex analysis and visualizations. If you are interested in exploring neurodegenerative disease in new ways with wearable sensors or connected technologies, contact us today to set up a consultation.