Wearable Sensors in Huntington Disease: A Pilot Study

Article type: Research Article

Authors: Andrzejewski, Kelly L.^a | Dowling, Ariel V.^b | Stamler, David^c | Felong, Timothy J.^d | Harris, Denzil A.^e | Wong, Cynthia^c | Cai, Hang^b | Reilmann, Ralf^f | Little, Max A.^{g; h} | Gwin, Joseph T.^b | Biglan, Kevin M.^{a; d} | Dorsey, E. Ray^{a; d; *}

Affiliations: [a] Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA | [b] BioSensics LLC, Cambridge, MA, USA | [c] Teva Pharmaceuticals, La Jolla, CA, USA | [d] CHET, University of Rochester Medical Center, Rochester, NY, USA | [e] University of Rochester School of Medicine and Dentistry, Rochester, NY, USA | [f] Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany | [g] Aston University, Birmingham, UK | [h] Massachusetts Institute of Technology, Cambridge, MA, USA

Correspondence: [*] Correspondence to: Ray Dorsey, University of Rochester Medical Center, 265 Crittenden Blvd, CU 420694, Rochester,NY 14642, USA. Tel.: +1 585 275 0663; E-mail: ray.dorsey@chet.rochester.edu.

Abstract: Background: The Unified Huntington’s Disease Rating Scale (UHDRS) is the principal means of assessing motor impairment in Huntington disease but is subjective and generally limited to in-clinic assessments. Objective: To evaluate the feasibility and ability of wearable sensors to measure motor impairment in individuals with Huntington disease in the clinic and at home. Methods: Participants with Huntington disease and controls were asked to wear five accelerometer-based sensors attached to the chest and each limb for standardized, in-clinic assessments and for one day at home. A second chest sensor was worn for six additional days at home. Gait measures were compared between controls, participants with Huntington disease, and participants with Huntington disease grouped by UHDRS total motor score using Cohen’s d values. Results: Fifteen individuals with Huntington disease and five controls completed the study. Sensor data were successfully captured from 18 of the 20 participants at home. In the clinic, the standard deviation of step time (time between consecutive steps) was increased in Huntington disease (p < 0.0001; Cohen’s d = 2.61) compared to controls. At home with additional observations, significant differences were observed in seven additional gait measures. The gait of individuals with higher total motor scores (50 or more) differed significantly from those with lower total motor scores (below 50) on multiple measures at home. Conclusions: In this pilot study, the use of wearable sensors in clinic and at home was feasible and demonstrated gait differences between controls, participants with Huntington disease, and participants with Huntington disease grouped by motor impairment.

Keywords: Huntington disease, remote sensing technology, clinical study, movement, gait, chorea, ambulatory monitoring

DOI: 10.3233/JHD-160197

Journal: Journal of Huntington's Disease, vol. 5, no. 2, pp. 199-206, 2016