Objective: The current study aims to explore the similarities and differences between neuronal correlates of established clinical or novel Roche Huntington’s disease (HD) Digital Monitoring Platform (dMP) measures.

Background: Remote monitoring of HD utilizing smartphone sensors and assessments, such as those implemented in the Roche HD dMP, has shown potential for providing reliable and valid assessments of HD signs and symptoms. It has been demonstrated that patients’ performance in dMP tests correlated with volume measurements of several brain regions measured with magnetic resonance imaging (MRI). Similarly, correlations have long been known between established clinical tests and MRI results.

Method: Participants with manifest HD from the Natural History Study (N=93; NCT03664804) underwent clinical cognitive and motor assessments, as well as brain imaging at the first clinical visit of the study. All participants completed daily dMP active tests on a smartphone assessing cognitive and motor functions. Results from clinical and dMP tests were correlated with MRI volume measurements to assess similarity of correlation patterns.

Results: On a subcortical level, we found highly similar correlation patterns across all clinical and digital tests driven by strong correlations of nearly all tests with the caudate nucleus, the globus pallidus and the putamen. When comparing correlations on a cortical level, we observed that the dMP tests fell into two distinct clusters, with one containing the 2-minute walk and U-turn Gait tests as well as Draw-A-Shape. This first cluster shows a similar correlation pattern with the Unified HD Rating Scale (UHDRS) Gait item. The other cluster contained the digital Symbol Digit Modalities Test (SDMT) and Stroop cognitive tests, as well as the Speeded Tapping, Balance and Chorea tests, and showed similar correlation patterns with the composite UHDRS, clinical SDMT, and Stroop tests.

Conclusion: Our analysis shows that the dMP motor and cognitive assessments have largely similar correlations with cortical structural brain volumes as their respective clinical counterparts, thus strengthening the validity of the Roche HD dMP. These results will help to ultimately close the loop of neuropathology, clinical scales and digital biomarkers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-of-correlations-of-structural-magnetic-resonance-imaging-measures-with-smartphone-based-active-tests-and-clinical-tests-in-huntingtons-disease/