Digital Remote Patient Monitoring in Neurodegenerative Diseases

The development of sensitive, miniature electronic digital health sensors has stimulated growth of a multi-billion dollar consumer products for the health tech industry. Devices like wrist and finger worn wearables, smartphones, specialized peripherals and home based IoMT devices are capable of utilizing these technologies coupled with associated algorithms to accurately measure vital signs, cognitive functions and fine motor movements. This now opens the opportunity for measuring subtle changes in chronic degenerative diseases using a suite of digital tools with the potential to detect a change within a reasonable time during the early course of the disease. These slowly progressing conditions manifest clinical symptoms and functional impairment over a period of several years. Thus deploying technologies to facilitate early diagnosis, characterization and monitoring disease progression longitudinally might enable informed decisions on treatment, care, and early interventions. They can also provide key data to underscore the efficacy of therapeutics designed to prevent, delay or modify the course of the disease, addressing an unmet need in this area and generating data of relevance to the regulatory authorities and Payors. The need for use of such technologies is becoming acute, as the rising prevalence of diseases such as Alzheimer’s, Parkinson’s and multiple sclerosis represent an enormous societal, economic and healthcare burden globally.

In this Research Topic, we will highlight recent developments in remote patient monitoring derived from experts in the academy, pharmaceutical industry, government laboratories and research foundations. Examples range from routine measurements of blood pressure, heart rate variability and sleep cycles to more complex interrogation of acoustic, oculomotor, and ballistographic signals which can provide insight to disease states to enable early intervention. Additionally, specialized digital programs can give insight to cognitive state and function. If captured longitudinally, they can provide informative data on disease progression and classification. A benefit of digital monitoring in the early stages of disease lies in the potential to explore disease preventing approaches during limited time periods of a clinical study and offer long term monitoring via registries, and electronic health records. Based on the considerable promise of these digital technologies, we are delighted to showcase cutting edge advances and emerging directions in the field through this exciting collection which we cordially welcome authors to consider submitting to.

Potential topics could include (but are not restricted to) the following subject areas:

• Use of digital technologies to facilitate early diagnosis, characterization and monitoring of neurodegenerative disease
• Data driven approaches to interrogate the efficacy of symptomatic and disease modifying therapies
• Development of standards and metrics to guide registration, validation and regulatory approaches
• Future remote monitoring environments – from clinical studies to IoMT at home
• Ethical considerations around the capture, storage, transmission and ownership of patient captured data
• Clinical and real world evaluation of sensors and sensing technologies in neurodegenerative disease
• Progress in human factor engineering in the design of patient friendly remote monitoring devices
• Passive versus active monitoring – the impact of patient friction / burden on longitudinal data capture
• Strategies to align and translate patient voice into clinical meaningfulness measures


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Conflict of interest statements:
Topic Editors Dr Graham Jones and Amit Khanna work in drug development for Parkinson's Disease with Novartis Pharmaceuticals. Dr Jones also sits on the NIH grant advisory group for new technologies for neuroscience. Dr Diane Stephenson is a full-time employee at the Critical Path Institute, a non-profit focused on improving drug development.