ETSense: Adaptive Portable Essential Tremor Monitor

ETSense：自适应便携式特发性震颤监测仪

• 批准号: 8200062
• 负责人: Dustin A. Heldman
• 金额: $ 69.23万
• 依托单位: GREAT LAKES NEUROTECHNOLOGIES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8200062
• 关键词: Academic Medical Centers; Accounting; Activities of Daily Living; Affect; Age; Algorithms; Caring; Cells; Clinical; Clinical Data; Clinical Research; Complex; Computers; Continuous Tremors; Data; Data Collection; Data Reporting; Data Storage and Retrieval; Deep Brain Stimulation; Detection; Development; Device or Instrument Development; Devices; Discrimination; Disease; Ensure; Essential Tremor; Evaluation; Fingers; Functional disorder; Generations; Genes; Growth; Health Care Costs; Health Services Accessibility; Home environment; Hour; Housing; Human; Intention Tremor; Intervention; Judgment; Kinetics; Life; Limb structure; Masks; Measures; Medical Device; Medicine; Memory; Monitor; Motion; Movement; Movement Disorders; Multiple Sclerosis; Office Visits; Online Systems; Outcome; Parkinson Disease; Patients; Performance; Pharmaceutical Preparations; Pharmacologic Substance; Phase; Population; Prevalence; Radio; Reporting; Research; Resolution; Rest; Rural Population; Secure; Severities; Signal Transduction; Silicones; Symptoms; System; Technology; Testing; Therapeutic Intervention; Time; Transplantation; Treatment Protocols; Tremor; Underserved Population; United States; Validation; Wireless Technology; Wrist; actigraphy; base; college; data acquisition; data exchange; design; diaries; ergonomics; improved; innovation; kinematics; novel; novel therapeutic intervention; programs; prototype; research and development; response; sensor; web interface

DESCRIPTION (provided by applicant): The objective is to design, implement, and clinically assess ETSense", an adaptive, compact, portable essential tremor (ET) monitor for optimizing therapeutic interventions. ET is characterized primarily by postural and kinetic (action) tremors of the limbs, which are rated by various subjective tremor rating scales. These scales all provide a discrete, subjective symptom rating at a discrete point in time, require a clinician to visually assess the patient, and cannot capture complex fluctuations that occur throughout the day in response to interventions. Objectively capturing ET symptoms continuously during daily activities and using adaptive algorithms to both classify tremor types and severity will help clinicians better titrate therapy to minimize symptom fluctuations and expand care to rural and underserved populations. The Phase I ETSense effort successfully used kinematic data recorded from a sensor unit placed on the finger of subjects with ET to discriminate tremor from voluntary motion associated with daily activities and objectively quantified tremor severity with scores highly correlated with clinicians' qualitative ratings, providing a standardized platform for continuous ET assessment. Tremor quantification algorithms were extrapolated to non-standardized tasks, suggesting that it is feasible to rate tremor continuously throughout the day during activities of daily living. The three primary innovations of the proposed system include: 1) a compact, portable, user-worn device for continuous monitoring during ADLs, 2) intelligent, adaptive algorithms to continuously classify tremor type and rate severity, and 3) web-based access to symptom response reports. The clinically deployable system will be contained in a lightweight, finger-worn housing for continuous wear while patients perform everyday tasks at home or in public. A push button diary will allow the patient to indicate when medication is taken. All data will be stored in memory for subsequent analysis and report generation detailing symptom fluctuations in response to therapeutic interventions. Adaptive algorithms developed in Phase I will be further optimized to account for voluntary motion that can create tremor false positives or mask over kinematic tremor signals. The system will shift between scoring algorithms (i.e. rest, kinetic) based on any voluntary motion detected. After data collection is complete, clinicians will use a web-interface to view patient reports. These reports will detail tremor type, severity, and fluctuations, as well as when medication was taken to aid clinicians in optimizing existing therapeutic interventions or in the research and development of novel treatment protocols. We hypothesize that the commercial ETSense system will 1) continuously quantify tremor severity throughout the day during activities of daily living, 2) improve patient outcomes with better and/or faster medication optimization, 3) decrease healthcare costs by reducing office visits, and 4) enable the testing and validation of novel therapeutic interventions, facilitated by high-resolution continuous home monitoring. PUBLIC HEALTH RELEVANCE: Essential tremor, characterized primarily by tremor during movement, affects approximately 4% of the population over age 40 in the United States, though exact prevalence may be much higher since up to 90% of ET patients do not seek treatment. The proposed ETSense adaptive, portable essential tremor monitor will classify tremor type and rate tremor severity continuously throughout the day while a patient performs typical activities, which should help clinicians to better prescribe treatment and aid in the development of novel therapeutic interventions.

描述（由申请人提供）：目的是设计，实施和临床评估Etsense”，“一种适应性，紧凑的，便携式的基本震颤（ET）监视器，用于优化治疗干预措施。ET的特征是姿势和动力学和动力学（动作）肢体的特征，主要由各种主题震颤量表提供了一种范围。临床医生在视觉上评估患者，并且在日常活动中不断捕获整天的复杂波动。单位放在具有ET的受试者的手指上，以区分震颤与与日常活动相关的自愿运动，并客观地量化震颤的严重程度，而得分与临床医生的定性评级高度相关，为连续ET评估提供了标准化的平台。将震颤定量算法推断到非标准的任务，这表明在日常生活活动中，整天不断地对震颤进行评分是可行的。提出的系统的三个主要创新包括：1）一种紧凑的，便携式，用户磨损的设备，用于在ADL期间连续监测，2）智能，适应性算法，可连续对震颤类型和评分严重性进行分类，以及3）基于Web的访问症状响应报告。临床上可部署的系统将包含在轻巧的，戴着手指戴的外壳中，用于连续磨损，而患者在家中或在公共场合执行日常任务。按下按钮日记将使患者何时服用药物。所有数据都将存储在记忆中，以进行后续分析和报告生成，以详细介绍治疗干预措施的症状波动。在第一阶段开发的自适应算法将进一步优化，以说明自愿运动，该运动可能会产生震颤误报或在运动震颤信号上的掩盖。该系统将根据检测到的任何自愿运动在评分算法（即休息，动力学）之间移动。数据收集完成后，临床医生将使用Web-Interface查看患者报告。这些报告将详细介绍震颤类型，严重性和波动，以及何时服用药物来帮助临床医生优化现有的治疗干预措施或在研究和开发新型治疗方案时。我们假设商业环境系统将1）在日常生活活动中不断量化震颤的严重程度，2）通过更好和/或更快的药物优化，改善患者预后，3）3）3）通过降低办公室就诊的医疗费用，以及4）启用新型治疗疗程的测试和验证，可以通过新颖的治疗干预措施进行高度监控，可通过高位进行置换，可连续进行辅助措施​​。 公共卫生相关性：基本震颤主要是运动过程中震颤的特征，在美国40岁以上的人口中约有4％，尽管精确的患病率可能高得多，因为多达90％的ET患者不寻求治疗。拟议的Etsense自适应，便携式基本震颤监测器将全天不断地对震颤类型进行分类，并在患者进行典型活动时不断地对震颤的严重性进行评分，这应该有助于临床医生更好地开出治疗并帮助开发新的治疗干预措施。