Using smartphones and smartwatches to monitor disease course via the FLOODLIGHT app leads to high adherence and satisfaction among patients with multiple sclerosis (MS), results from a pilot study show. The research, “Adherence and Satisfaction of Smartphone- and Smartwatch-Based Remote Active Testing and Passive Monitoring in People With Multiple Sclerosis: Nonrandomized Interventional Feasibility Study,” was published in the Journal of Medical Internet Research. Assessing MS progression commonly requires periodic in-clinic visits, and doctors may miss subtle changes occurring between such visits. Smartphones may be a solution for real-time data collection and better patient monitoring outside the clinic. The Roche-sponsored FLOODLIGHT study assessed the feasibility of using smartphones and smartwatches to assess MS symptoms, including hand function, gait and posture, mood, and cognitive impairment. FLOODLIGHT primarily evaluated adherence and feedback to the smartphone- and smartwatch-based assessments, as well as the participants’ satisfaction, as determined by their impact on daily activities. The study included 76 MS patients (ages 20 to 57; 53 were women) and 25 healthy controls, who were recruited at the Multiple Sclerosis Centre of Catalonia in Barcelona, and the University of California, San Francisco. Most patients (91%) had relapsing-remitting MS. The mean time since symptom onset was 11.3 years, and the mean Expanded Disability Status Scale score was 2.4. The test battery included active tests performed daily, weekly, every two weeks, or on demand for 24 weeks, and passive monitoring, which analyzed sensor-based gait and mobility. Participants were instructed to complete the active tests at roughly the same time every day, and to carry the smartphone and smartwatch with them all the time. Adherence was assessed via the proportion of weeks with at least three days of completed testing, and four daily hours of passive monitoring. Satisfaction was determined through a questionnaire. Clinical evaluations were conducted at the study's start, after 12 weeks, and at the study's end. Brain magnetic resonance imaging scans were taken at the enrollment visit and at week 24 (study's end). Most participants finished the study – 92% of MS patients and 64% of the controls. Reasons for discontinuation included the burden of continuous monitoring and lack of availability for the three required in-clinic visits. Over an 18-month period, from November 2016 to April 2018, most participants performed five to seven active tests per week, including the Two-Minute Walk Test (2MWT). Adherence to both active tests and passive monitoring for the 24 weeks was good, and remained stable over time after week six. In the final week, participants had a minimum of four hours of passive monitoring data over an average of four days. Adherence was higher for passive monitoring than the tests. Data showed that 70% of participants completed all active tests, 75% did all active tests except the 2MWT, and 79% had data collected via smartphone- or smartwatch-based passive monitoring. The longer a person's disease duration, the lower was their adherence. In contrast, disease severity was not seen to impact adherence. Overall scores reflecting satisfaction was 73.7 out of 100 at week 24, having remained stable since week 12. Sixty-one patients reported that the test battery had an at least an acceptable impact on daily activities. Thirty-two had no issue with the active tests, while one-third would rather avoid the 2MWT. A majority, 60%, of the MS patients said they would like to continue using the FLOODLIGHT app to better understand their disease and improve its management. “Persons with multiple sclerosis were engaged and satisfied with the FLOODLIGHT test battery,” the scientists wrote. As such, “FLOODLIGHT sensor-based measures may enable continuous assessment of multiple sclerosis disease in clinical trials and real-world settings.” FLOODLIGHT tests are being assessed in long-term studies with larger patient groups in the CONSONANCE Phase 3b trial of Ocrevus (ocrelizumab, by Roche-owned Genentech) in people with progressive MS still enrolling, contact information is here), and in a global study open to all MS patients with a mobile device, called FLOODLIGHT Open.
symptoms
Social cognitive deficits in patients with multiple sclerosis (MS) are associated with higher levels of fatigue, depressive symptoms, and anxiety, new research conducted at the Kessler Foundation has found. Even though the study included only a small group of participants, it represents a step toward better understanding of the underlying…
Higher levels of vitamin D in the blood may help to protect the myelin sheath, slowing damage to nerve cells in people with progressive forms of multiple sclerosis (MS), a brain imaging study reports. The study, “Vitamin D and MRI measures in progressive multiple sclerosis,” was published in the…
Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “How do you feel about journaling? It’s a good way to keep track…
The relationship between fatigue and patterns of physical activity in people with multiple sclerosis (MS) is not straightforward. New findings show that, among MS patients with similar fatigue levels, there are three different types — or “clusters” — of physical behavior. Clinicians should be aware of these behavioral…
I Dreamed That I Was Walking
When asleep, many people dream they can fly. Some dream about being naked in public, failing an exam, or (gasp!) about sex. Last night, I dreamed that I was walking. I have that walking dream a couple of times a year. I’m walking along and all of a sudden,…
Detecting changes to the brain’s central vein using common magnetic resonance imaging (MRI) scans is a useful and accurate strategy to enhance diagnosis of multiple sclerosis (MS), a new study shows. Analysis of more than 4,000 brain lesions, obtained from contrast-enhanced MRI scans collected from eight neuroimaging European…
Persistent fatigue in people with multiple sclerosis (MS) is associated with damage in specific areas of the brain, regardless of depression symptoms, a study shows. The study, “Microstructural fronto-striatal and temporo-insular alterations are associated with fatigue in patients with multiple sclerosis independent of white…
I was struck down by sclerosis in 2006 — literally. I was playing tennis and ran to return a drop shot. I never made it, but I did drop myself and rupture my right shoulder. It was so severe that it took two operations to rectify. The first few years…
Treatment with rituximab — sold as Rituxan in the U.S. by Roche and Biogen, and as MabThera by Roche in Europe — reversed disease course in a “dramatic fashion,” leading to complete remission in a 12-year-old boy with aggressive relapse-remitting multiple sclerosis (RRMS), a case report states. The report, “…
Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Have you ever had an MS hug? What does it feel like?”…
Females of certain species — like humans and mice — have a known ability to produce more of the gene Kdm6a than males because it’s located on the X chromosome, of which females have two. Kdm6a is also quite active in immune system T-cells, a study found, and silencing it in a mice model…
Interleukin-17A (IL-17A), a molecule that mediates immune and inflammatory responses, likely promotes inflammation and tissue damage in relapsing-remitting multiple sclerosis (RRMS) and should be considered a potential target for treating the disease, a study reports. The findings of the study, “IL-17A is associated with the breakdown of the…
When it comes to initial treatment selection for relapsing-remitting multiple sclerosis (RRMS), there is one question that has yet to be answered: Is it better to start with potentially safer moderately effective disease-modifying treatments (DMTs) or to hit the disease immediately with a high-efficacy DMT that may be…
Dark Rimmed Brain Lesions May Be Signal of Aggressive Disease, NIH Study Says Researchers in this study found that specific brain lesions, notable for their dark rims, may indicate that a patient’s multiple sclerosis is likely to progress quickly. They suggest that early detection of these lesions can help…
Imaging techniques that measure damage to the brain, in addition to those that detect lesions, may be useful in predicting likely disease progression in people with clinically isolated syndrome (CIS), a study found. The study, “Early imaging predictors of longer term multiple sclerosis risk and severity…
The joys of MS are never-ending. One area that gets disrupted by this disease of the central nervous system is our pelvic regions. That affects bladder, bowel, and sexual function. I’ve written about all of this in previous columns. My bladder failed less than two years after I…
The presence of chronic active lesions in the brain may provide a clue as to how quickly multiple sclerosis (MS) symptoms will progress. Researchers at the U.S. National Institutes of Health (NIH) call these lesions “smoldering inflammation.” Their study, just published in JAMA Neurology, indicates that the more lesions…
Brain lesions appearing as dark rimmed, “smoldering” spots on imaging scans, representing active inflammation, may be a hallmark of more aggressive and disabling forms of multiple sclerosis (MS), researchers at the National Institutes of Health (NIH) report. Using a powerful MRI brain scanner and a 3D printer, the…
Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Have you had a lumbar puncture to help diagnose your MS?” from Jan. 29.
Testing for the types of fat (lipid) molecules present in the cerebrospinal fluid (CSF) of people with multiple sclerosis (MS) may be a very useful way to diagnose and monitor the disease, a study suggests. “MS patients present a different lipid profile at the time of diagnosis” than…
Opioid addiction increases the risk for a number of physical and psychological problems in people with multiple sclerosis (MS), a new study has found. The study, “Impact of opium dependency on clinical and neuropsychological indices of multiple sclerosis patients,” was published in the journal Neurological Sciences. Opioids,…
Smartphones could be used as an inexpensive and effective way to measure tremors in mice, which may allow for more research on tremor medications, a new study reports. The study, “Accurate and affordable assessment of physiological and pathological tremor in rodents with the accelerometer of a smartphone,”…
Though known mainly for killing tumor and virally infected cells, a T-cell subtype may restrain immune responses and be protective in autoimmune diseases such as multiple sclerosis (MS), according to new research. The study, “Opposing T cell responses in experimental autoimmune encephalomyelitis,” was published recently in…
People listening to music during an extended walk tend to sync their steps to its beat — and for those with multiple sclerosis (MS), such synchronization helps to overcome mental fatigue and improve motivation, a study found. “Continuous 12 min walking to music, metronomes and in silence:…
Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Do you suffer from the MS symptom of ‘drop foot?’” from Sept. 20,…
I am quite outspoken. I have no problem voicing my opinion or needs — or so I thought. An exchange this morning left me speechless. While my head was swimming with semi-intelligible responses, I was rendered mute. Let me just say that I have been on pain medication for…
An amino acid change to phenylalanine, and a specific class I HLA gene variant are associated with greater risk for multiple sclerosis (MS), according to a study in Japanese patients. Researchers also identified an HLA variant, or mutation, associated with neuromyelitis optica spectrum disorder (NMOSD), an autoimmune condition…
The U.S. Food and Drug Administration (FDA) has approved Bracco Diagnostics’ oral suspension of barium sulfate, called Varibar Thin Liquid, for use as imaging agent to detect swallowing disorders known as dysphagia, a problem common among multiple sclerosis (MS) patients. In the U.S., 1 in 25 adults are estimated to…
July was unusually hot in much of the Northern Hemisphere. So, pull out your electric fan and use it to help your multiple sclerosis (MS) beat that heat and humidity, right? Maybe not. A study recently published in the Annals of Internal Medicine reports that using a fan to…