Objective: To remotely monitor physical activity in people with PSP and to correlate it with disease progression on the modified PSP Rating Scale (mPSPRS-21).

Background: Digital health technologies have the potential to provide objective, quantitative digital biomarkers of disease remotely in patients’ homes (reviewed in¹). While remote in-home wearable sensors have been successfully used to measure Parkinson’s disease activity (reviewed in^2,3), such technology has not yet been tested in patients with PSP.

Method: Eleven participants with PSP were enrolled between November 2021 and November 2022. One participant was excluded due to uninterpretable data. The mean age was 67.6 ± 1.3 years with a disease duration of 14.0 ± 3.5 and 40% participants were female. Participants were consented and enrolled remotely and provided with the PAMSys ^TM (BioSensics LLC) pendant sensors to wear for up to 12 months to measure physical activity, walking, and posture during activities of daily living.  Participants also performed standard assessments virtually (the modified PSPRS-21) every 3 months during the study. Sensor-derived measures included >40 independent parameters of physical activity, including walking parameters that were monitored over time. Spearman correlation analysis was performed to quantify the association between the ordinal clinical scale scores and continuous sensor-derived measures. Significance was set at alpha=0.05 and Cohen’s coefficient (d) was used to measure effect size.

Results: There was a high degree of variability in step duration and steps per day between participants. Cadence, number of walking bouts, postural transitions, and daily step counts declined over time in all PSP participants. Preliminary results showed that daily step counts and several other walking parameters were inversely correlated with disease severity and rate of progression as measured with the modified PSPRS-21.

Conclusion: Remote continuous assessment of physical activity using wearable sensors for people with PSP is a novel, simple, non-invasive, and robust method of measuring PSP disease progression.  Our pilot study suggests that activity levels are inversely correlated with disease progression; however, causality cannot be established given the observational nature of this study.

References: 1. Stephenson D, Alexander R, Aggarwal V, et al. Precompetitive Consensus Building to Facilitate the Use of Digital Health Technologies to Support Parkinson Disease Drug Development through Regulatory Science. Digit Biomark. Winter 2020;4(Suppl 1):28-49.
2. Correno MB, Hansen C, Carlin T, Vuillerme N. Objective Measurement of Walking Activity Using Wearable Technologies in People with Parkinson Disease: A Systematic Review. Sensors (Basel). Jun 16 2022;22(12).
3. Sica M, Tedesco S, Crowe C, et al. Continuous home monitoring of Parkinson’s disease using inertial sensors: A systematic review. PLoS One. 2021;16(2):e0246528.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/remote-monitoring-of-physical-activity-in-progressive-supranuclear-palsy-psp-using-wearable-sensors/