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Fichera M, Nanetti L, Monelli A, Castaldo A, Marchini G, Neri M, Vukaj X, Marzorati M, Porcelli S, Mariotti C. Accelerometer-based measures in Friedreich ataxia: a longitudinal study on real-life activity. Front Pharmacol 2024; 15:1342965. [PMID: 38567352 PMCID: PMC10985256 DOI: 10.3389/fphar.2024.1342965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Quantitative measurement of physical activity may complement neurological evaluation and provide valuable information on patients' daily life. We evaluated longitudinal changes of physical activity in patients with Friedreich ataxia (FRDA) using remote monitoring with wearable sensors. We performed an observational study in 26 adult patients with FRDA and 13 age-sex matched healthy controls (CTR). Participants were asked to wear two wearable sensors, at non-dominant wrist and at waist, for 7 days during waking hours. Evaluations were performed at baseline and at 1-year follow-up. We analysed the percentage of time spent in sedentary or physical activities, the Vector Magnitude on the 3 axes (VM3), and average number of steps/min. Study participants were also evaluated with ataxia clinical scales and functional tests for upper limbs dexterity and walking capability. Baseline data showed that patients had an overall reduced level of physical activity as compared to CTR. Accelerometer-based measures were highly correlated with clinical scales and disease duration in FRDA. Significantly changes from baseline to l-year follow-up were observed in patients for the following measures: (i) VM3; (ii) percentage of sedentary and light activity, and (iii) percentage of Moderate-Vigorous Physical Activity (MVPA). Reduction in physical activity corresponded to worsening in gait score of the Scale for Assessment and Rating of Ataxia. Real-life activity monitoring is feasible and well tolerated by patients. Accelerometer-based measures can quantify disease progression in FRDA over 1 year, providing objective information about patient's motor activities and supporting the usefulness of these data as complementary outcome measure in interventional trials.
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Affiliation(s)
- Mario Fichera
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorenzo Nanetti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessia Monelli
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Castaldo
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Gloria Marchini
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marianna Neri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Xhuljano Vukaj
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - Mauro Marzorati
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - Simone Porcelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Caterina Mariotti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Gupta N, Kasula V, Sanmugananthan P, Panico N, Dubin AH, Sykes DAW, D'Amico RS. SmartWear body sensors for neurological and neurosurgical patients: A review of current and future technologies. World Neurosurg X 2024; 21:100247. [PMID: 38033718 PMCID: PMC10682285 DOI: 10.1016/j.wnsx.2023.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/24/2023] [Indexed: 12/02/2023] Open
Abstract
Background/objective Recent technological advances have allowed for the development of smart wearable devices (SmartWear) which can be used to monitor various aspects of patient healthcare. These devices provide clinicians with continuous biometric data collection for patients in both inpatient and outpatient settings. Although these devices have been widely used in fields such as cardiology and orthopedics, their use in the field of neurosurgery and neurology remains in its infancy. Methods A comprehensive literature search for the current and future applications of SmartWear devices in the above conditions was conducted, focusing on outpatient monitoring. Findings Through the integration of sensors which measure parameters such as physical activity, hemodynamic variables, and electrical conductivity - these devices have been applied to patient populations such as those at risk for stroke, suffering from epilepsy, with neurodegenerative disease, with spinal cord injury and/or recovering from neurosurgical procedures. Further, these devices are being tested in various clinical trials and there is a demonstrated interest in the development of new technologies. Conclusion This review provides an in-depth evaluation of the use of SmartWear in selected neurological diseases and neurosurgical applications. It is clear that these devices have demonstrated efficacy in a variety of neurological and neurosurgical applications, however challenges such as data privacy and management must be addressed.
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Affiliation(s)
- Nithin Gupta
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - Varun Kasula
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | | | | | - Aimee H. Dubin
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - David AW. Sykes
- Department of Neurosurgery, Duke University Medical School, Durham, NC, USA
| | - Randy S. D'Amico
- Lenox Hill Hospital, Department of Neurosurgery, New York, NY, USA
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Chiang AA, Khosla S. Consumer Wearable Sleep Trackers: Are They Ready for Clinical Use? Sleep Med Clin 2023; 18:311-330. [PMID: 37532372 DOI: 10.1016/j.jsmc.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
As the importance of good sleep continues to gain public recognition, the market for sleep-monitoring devices continues to grow. Modern technology has shifted from simple sleep tracking to a more granular sleep health assessment. We examine the available functionalities of consumer wearable sleep trackers (CWSTs) and how they perform in healthy individuals and disease states. Additionally, the continuum of sleep technology from consumer-grade to medical-grade is detailed. As this trend invariably grows, we urge professional societies to develop guidelines encompassing the practical clinical use of CWSTs and how best to incorporate them into patient care plans.
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Affiliation(s)
- Ambrose A Chiang
- Division of Sleep Medicine, Louis Stokes Cleveland VA Medical Center, 10701 East Blvd, Suite 2B-129, Cleveland, OH 44106, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Seema Khosla
- North Dakota Center for Sleep, 1531 32nd Avenue S Ste 103, Fargo, ND 58103, USA
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Kim EH, Jenness JL, Miller AB, Halabi R, de Zambotti M, Bagot KS, Baker FC, Pratap A. Association of Demographic and Socioeconomic Indicators With the Use of Wearable Devices Among Children. JAMA Netw Open 2023; 6:e235681. [PMID: 36995714 PMCID: PMC10064258 DOI: 10.1001/jamanetworkopen.2023.5681] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/14/2023] [Indexed: 03/31/2023] Open
Abstract
Importance The use of consumer-grade wearable devices for collecting data for biomedical research may be associated with social determinants of health (SDoHs) linked to people's understanding of and willingness to join and remain engaged in remote health studies. Objective To examine whether demographic and socioeconomic indicators are associated with willingness to join a wearable device study and adherence to wearable data collection in children. Design, Setting, and Participants This cohort study used wearable device usage data collected from 10 414 participants (aged 11-13 years) at the year-2 follow-up (2018-2020) of the ongoing Adolescent Brain and Cognitive Development (ABCD) Study, performed at 21 sites across the United States. Data were analyzed from November 2021 to July 2022. Main Outcomes and Measures The 2 primary outcomes were (1) participant retention in the wearable device substudy and (2) total device wear time during the 21-day observation period. Associations between the primary end points and sociodemographic and economic indicators were examined. Results The mean (SD) age of the 10 414 participants was 12.00 (0.72) years, with 5444 (52.3%) male participants. Overall, 1424 participants (13.7%) were Black; 2048 (19.7%), Hispanic; and 5615 (53.9%) White. Substantial differences were observed between the cohort that participated and shared wearable device data (wearable device cohort [WDC]; 7424 participants [71.3%]) compared with those who did not participate or share data (no wearable device cohort [NWDC]; 2900 participants [28.7%]). Black children were significantly underrepresented (-59%) in the WDC (847 [11.4%]) compared with the NWDC (577 [19.3%]; P < .001). In contrast, White children were overrepresented (+132%) in the WDC (4301 [57.9%]) vs the NWDC (1314 [43.9%]; P < .001). Children from low-income households (<$24 999) were significantly underrepresented in WDC (638 [8.6%]) compared with NWDC (492 [16.5%]; P < .001). Overall, Black children were retained for a substantially shorter duration (16 days; 95% CI, 14-17 days) compared with White children (21 days; 95% CI, 21-21 days; P < .001) in the wearable device substudy. In addition, total device wear time during the observation was notably different between Black vs White children (β = -43.00 hours; 95% CI, -55.11 to -30.88 hours; P < .001). Conclusions and Relevance In this cohort study, large-scale wearable device data collected from children showed considerable differences between White and Black children in terms of enrollment and daily wear time. While wearable devices provide an opportunity for real-time, high-frequency contextual monitoring of individuals' health, future studies should account for and address considerable representational bias in wearable data collection associated with demographic and SDoH factors.
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Affiliation(s)
- Ethan H. Kim
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jessica L. Jenness
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Adam Bryant Miller
- RTI International, Research Triangle Park, North Carolina
- University of North Carolina at Chapel Hill
| | - Ramzi Halabi
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Kara S. Bagot
- Addiction Institute, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Abhishek Pratap
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Vector Institute for Artificial Intelligence, Toronto, Ontario, Canada
- King’s College London, London, United Kingdom
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle
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Minen MT, George A, Camacho E, Yao L, Sahu A, Campbell M, Soviero M, Hossain Q, Verma D, Torous J. Assessment of Smartphone Apps for Common Neurologic Conditions (Headache, Insomnia, and Pain): Cross-sectional Study. JMIR Mhealth Uhealth 2022; 10:e36761. [PMID: 35727625 PMCID: PMC9257611 DOI: 10.2196/36761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There are thousands of apps for individuals struggling with headache, insomnia, and pain, but it is difficult to establish which of these apps are best suited for patients' specific needs. If clinicians were to have access to a platform that would allow them to make an informed decision on the efficacy and feasibility of smartphone apps for patient care, they would feel confident in prescribing specific apps. OBJECTIVE We sought to evaluate the quality of apps for some of the top common, disabling neurologic conditions (headache, insomnia, and pain) based on principles derived from the American Psychiatric Association's (APA) app evaluation model. METHODS We used the Mobile Health Index and Navigation database and expanded upon the database's current supported conditions by adding 177 new app entries. Each app was rated for consistency with the APA's app evaluation model, which includes 105 objective questions based on the following 5 major classes of consideration: (1) accessibility, (2) privacy and security, (3) clinical foundation, (4) engagement style, and (5) interoperability. These characteristics were evaluated to gain a broader understanding of the significant features of each app category in comparison against a control group. RESULTS Approximately 90% (187/201) of all apps evaluated were free to download, but only 50% (63/201) of headache- and pain-related apps were truly free. Most (87/106, 81%) sleep apps were not truly free to use. The apps had similar limitations with limited privacy, accessibility, and crisis management resources. For example, only 17% (35/201) of the apps were available in Spanish. The apps offered mostly self-help tools with little tailoring; symptom tracking was the most common feature in headache- (32/48, 67%) and pain-related apps (21/47, 45%), whereas mindfulness was the most common feature in sleep-related apps (73/106, 69%). CONCLUSIONS Although there are many apps for headache, pain, and insomnia, all 3 types of apps have room for improvement around accessibility and privacy. Pain and headache apps share many common features, whereas insomnia apps offer mostly mindfulness-based resources. Given the many available apps to pick from, clinicians and patients should seek apps that offer the highest-quality features, such as complete privacy, remedial features, and the ability to download the app at no cost. These results suggest that there are many opportunities for the improvement of apps centered on headache, insomnia, and pain.
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Affiliation(s)
- Mia T Minen
- Department of Neurology, New York University Langone Health, New York, NY, United States
| | - Alexis George
- Department of Neurology, New York University Langone Health, New York, NY, United States
| | - Erica Camacho
- Department of Psychiatry, Beth Israel Deaconess Medical Center, New York, NY, United States
| | - Leslie Yao
- Barnard College, New York, NY, United States
| | - Ananya Sahu
- Barnard College, New York, NY, United States
| | | | - Mia Soviero
- Barnard College, New York, NY, United States
| | - Quazi Hossain
- The City College of New York, New York, NY, United States
| | - Deepti Verma
- The City College of New York, New York, NY, United States
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, New York, NY, United States
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