Smartwatches Can Detect Parkinson's Years Before It Is Diagnosed

Smartwatches have a number of sensors that allow you to record physical activity, heart rate and sleep quality. Nastasic (Getty Images)

Before Parkinson’s disease becomes noticeable, patients begin to write with smaller and smaller letters. Before they even realize it, they are holding down the cell phone buttons for longer when sending a message. And several years before the diagnosis, the first movement disorders appear. By the time doctors diagnose Parkinson’s disease, 60% or more of the neurons that produce dopamine have stopped doing so, making tremors, muscle stiffness, and depression evident. Now, a study of thousands of people wearing smartwatches has predicted who will have Parkinson’s long before it becomes obvious.

A study has been running since 2006 in which the British health authorities are monitoring the health of half a million people over the age of 40 (UK Biobank). A decade later, 103,712 of them received smartwatches that allowed them to track their activities for a week. This data has allowed a group of scientists to investigate something that science is desperate to find: an objective marker of Parkinson’s that can be used for early detection. When they put the watches on, 273 of the participants had a clinical diagnosis of Parkinson’s. And since then, another 196 have been diagnosed. The data from these two groups was key to detecting abnormal signals that indicate something is wrong in the substantia nigra, the part of the brain that degenerates as the disease progresses.

“Parkinson’s is a neurodegenerative movement disorder characterized by slow disease progression,” recalls Cynthia Sandor, a researcher at the University of Cardiff in the UK and co-author of the study. “Sufferers experience motor symptoms such as slow movements, stiffness, lack of coordination, and tremors,” she adds. All of these prodromes—signs that precede the disease—appear long before they are diagnosed. “They can produce subtle motor or non-motor symptoms that often go unnoticed by the person themselves.” But the accelerometers, magnetometers, and gyros found in motion tracking devices and smartwatches are able to pick them up. In theory, cell phones also have this technology, but since these are not always carried by a person, the records would be invalid.

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In the study, the researchers relied on the data provided by a smartwatch’s accelerometer. This sensor registers acceleration, the start of every movement, and is represented in a three-dimensional system that changes every second. To distinguish characteristic patterns in the thousands and thousands of resulting diagrams, the scientists used an artificial intelligence system. The results of the study, just published in the journal Nature Medicine, show a decrease in mobility between 7 a.m. and 12 p.m. in people diagnosed with Parkinson’s when wearing the smartwatches. Artificial intelligence was able to distinguish this pattern from the more than 40,000 people in the control group.

With this training, the researchers went a step further and also identified nearly 200 people who were diagnosed an average of 4.33 years after their movements were recorded. In some cases, the discovery was made up to seven years earlier. “We show that a single week of collected data can predict events up to seven years in advance. With these results, we could develop a valuable tool to help in the early detection of Parkinson’s disease,” says Sandor, who is also Director of the Institute for Dementia Research in the UK. Data from smartwatches is easily accessible and in the UK a third of the population already uses the device. A platform would need to be set up to centralize the data, and the researchers were aware that this poses a technological challenge and also has legal and privacy implications. But there is no cure for Parkinson’s and all treatments to stop its progression have failed.

Francisco Grandas, Parkinson’s expert at the Gregorio Marañón Hospital in Madrid, points out that all the treatments available are symptomatic: they improve the patient’s condition “but do not prevent his progression”. He also says there are several experimental-stage trials of drugs designed to slow the progression of the disease, but so far have been unsuccessful. “In addition to problems like the blood-brain barrier [the membrane that protects brain tissue]”We suspect that it is because the moment has already passed because the disease is already at an advanced stage,” explains Grandas. That’s why he’s optimistic about the new research. “Other markers are being studied, such as B. Brain imaging, lifestyle, blood biochemistry… Non-motor symptoms appear years before, but now we are beginning to learn that there are subtle motor signs as well, and systems that analyze those movements might detect them.” ,” he says. This would open the possibility of using experimental treatments in the prodromal phase of the disease.

Sirwan Darweesh from the Department of Neurology at the Faculty of Medicine at Eramus University in Rotterdam (Netherlands) has been studying the onset and development of Parkinson’s for years. In 1990, researchers from the university began a very ambitious study to monitor the health of all residents over the age of 55 in Ommord, a neighborhood in the Dutch city. As part of this work, Darwesh focused on one hundred people who were ultimately diagnosed with Parkinson’s. Based on his research, Darwesh can say that “the pathology of the disease begins more than two decades before a clinical diagnosis can be made.” The first symptoms usually appear 10 years before the diagnosis.” Darwesh agrees with Grandas that Parkinson’s is diagnosed too late: “Disease-modifying therapies are ineffective in the clinical phase of Parkinson’s. The likely reason for this is that the pathology of the disease is already too advanced at this point, since more than 60% of the main brain dopaminergic cells have already been exhausted at the time of diagnosis.”

One of the weaknesses of the new research is that the smartwatches only tracked activity for a week, but if applied in a real-world environment, collecting data over a longer period could refine the alerts. Prior to Sandor’s current work, a group of scientists in the US used artificial intelligence to recognize patterns in data from smartwatches. They also used the UK Biobank sample, but started with data from patients who had already been diagnosed with Parkinson’s. One of the authors of this research is neurologist Karl Friedl. Scanning movement patterns for a whole week is enough for him “to identify someone who has Parkinson’s disease”. From a broader perspective, “we can help people discover many important traits of their health and well-being through the way they exercise,” adds Friedl. “If we add in all the other prodromal features that are associated with Parkinson’s disease [anosmia, REM sleep disturbance, depression]”The prediction algorithms in our new AI world will be very powerful,” he concludes.

In fact, the smartwatch study also collected data on sleep patterns, in this case using a sample of 65,000 people. Again, artificial intelligence was able to detect a deterioration in sleep duration and quality, both in those with Parkinson’s who were diagnosed at the time their activity was recorded and in those who were diagnosed years later. “The smartwatches tell us that people wake up more often at night and sleep longer at night several years before they are diagnosed with Parkinson’s disease,” says Sandor. Combined with day and night data, the accelerometers could give doctors time to try to contain the disease.