Wearable sensors may detect early disability progression in multiple sclerosis

 With ANY BRAINS AT ALL your stroke medical 'professionals' would immediately use this to objectively diagnose gait abnormalities. And then objectively monitor the recovery. But nothing will occur, we have blithering idiots in stroke!

Wearable sensors may detect early disability progression in multiple sclerosis

A longitudinal study of people with multiple sclerosis (MS) found that declines in daytime physical activity detected through wearable accelerometers were associated with increased risk of disability progression and brain atrophy.

The findings, published in Neurology, suggest continuous activity monitoring may serve as a sensitive, noninvasive biomarker for early disease worsening before clinical symptoms become apparent.

“Timely identification of patients at risk for disease progression is essential to reduce long-term disability, but the current tests for measuring MS disability are not designed to detect small changes,” said Kathryn C. Fitzgerald, Johns Hopkins University, Baltimore, Maryland. “Using a relatively inexpensive and accessible device around the wrist may help us identify early changes in the disease.”

The study enrolled 238 adults aged ≥40 years who underwent annual brain MRI scans and wore wrist-based accelerometers 24 hours per day for 2 straight weeks every 3 months, for up to 3 years. The devices captured several activity metrics, including total activity levels, sedentary time, circadian rhythm parameters, and activity during specific two-hour daytime windows.

Participants had been living with MS for an average of 13 years. At the start of the study, they had an average disability level of 3 on the Expanded Disability Status Scale (EDSS).

Over an average follow-up of 2.9 years, 120 participants experienced confirmed disability progression based on the composite EDSS-plus. Overall physical activity declined by an average of about 2% per year.

Importantly, within-person decreases in daytime activity -- particularly between 8:00 AM and 2:00 PM -- were associated with a significantly higher risk of disability progression. A one-standard deviation decrease in morning or midday activity increased the risk of confirmed progression by roughly 20% to 24%.

MRI analyses also showed that reductions in morning activity were linked to greater brain atrophy, including loss of whole-brain, deep Gray matter, and thalamic volume. While individuals with lower average moderate-to-vigorous activity had smaller brain volumes overall, these between-person differences were not associated with disability progression.

“More research is needed to confirm these findings, but it’s exciting to think that using easily accessible devices could help us predict who is at risk of worsening disease and potentially prevent those changes,” said Ellen M. Mowry, Johns Hopkins University. “Detecting small changes could also help us speed up research on new treatments.”

A limitation of the study is that people who did not have MS were not included, which would help researchers understand how activity levels may change as a part of normal aging. Also, the participants were relatively older and more disabled, so the results may not apply to younger people with MS and those with less disability.

Reference: https://www.neurology.org/doi/10.1212/WNL.0000000000214678

SOURCE: American Academy of Neurology