Abstract
Objective
To explore the use of digital biomarkers to distinguish healthy controls (HC) from subjects with a radiologically isolated syndrome (RIS).
Methods
We developed a smartphone application called MS Screen Test (MSST) to explore several dimensions of the neurological exam such as finger tapping speed, agility, hand synchronization, low contrast vision and cognition during a short evaluation. This app was tested on a cohort of healthy volunteers including a subset of subjects who underwent two evaluations on the same day to assess reproducibility. In a second step, the app was tested on a cohort of RIS subjects. Performances of RIS subjects were compared with age and genre-matched HC.
Results
HC underwent two consecutive evaluations on MSST. The analysis showed good reproducibility for all measures. Then 21 RIS subjects were compared to 32 matched HC. Compared to HC, we found that RIS subjects had a lower finger tapping speed on the dominant hand (5.6 versus 6.5 taps per second; p = 0.005), a longer inter hand interval during the hand synchronization task (14.4 versus 11.3 ms; p = 0.03) and significantly poorer scores on the low contrast vision and cognition tests.
Conclusion
MSST only requires a smartphone to obtain digital biomarkers relative to several dimensions of the neurological examination. Our results highlighted subtle differences between HC and RIS subjects. We plan to evaluate this tool in MS patients, which will allow us to get a much larger sample of subjects, to determine whether digital biomarkers can predict disease course.
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The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.
Code availability
The MSST app has been developed by Dr. Mikael Cohen with a custom code which is not open source.
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Acknowledgements
The authors acknowledge the Observatoire Français de la Sclérose en Plaques (OFSEP) group. The authors acknowledge RIS subjects as well as healthy controls that participated to this study.
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This research did not receive any support.
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Authors and Affiliations
Contributions
Mikael Cohen: MS Screen Test app development; Subjects recruitment; Data analysis; Manuscript drafting. Lydiane Mondot: MRI reviewing for RIS diagnosis confirmation; Analysis of MRI images (SIENAX); Manuscript drafting and reviewing. Salim Fakir: Study design and data management; Subjects recruitment; Manuscript reviewing. Cassandre Landes: Study design and data management; Subjects recruitment; Manuscript reviewing. Christine Lebrun: Subjects recruitment; Data analysis; Manuscript drafting.
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The authors have nothing to disclose related to this study.
Ethical approval
The study conforms with World Medical Association Declaration of Helsinki and it was approved by the Comité de Protection des Personnes (Hôpital Pasteur2, Nice, France) for the French MS Observatory (Observatoire Français de la Sclérose En Plaques-OFSEP).
Consent collection
All RIS subjects gave a written informed consent to participate to the French MS Observatory (Observatoire Français de la Sclérose En Plaques-OFSEP) project, which includes clinical and imaging data collection to determine demographical and prognostic factors of central nervous system inflammatory diseases.
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Cohen, M., Mondot, L., Fakir, S. et al. Digital biomarkers can highlight subtle clinical differences in radiologically isolated syndrome compared to healthy controls. J Neurol 268, 1316–1322 (2021). https://doi.org/10.1007/s00415-020-10276-w
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DOI: https://doi.org/10.1007/s00415-020-10276-w