Use of wearable sensors to improve the early diagnosis of DLB

项目摘要/摘要 路易体痴呆(DLB)在病程早期很难诊断，原因是 与阿尔茨海默病(AD)的初始症状重叠。因此，许多患有DLB的人 在收到准确的诊断时经历了很长的延误。共识中缺乏敏感性 诊断DLB，特别是在专科护理中心之外，意味着DLB与 干预措施延迟，照顾者负担加重。因此，我们建议分两个阶段进行研究 调查将可穿戴传感器、生态瞬时评估 (EMAS)和传统方法作为早期诊断DLB的多域方法。至 收集和分析这些综合的客观测量，我们将建立一个研究 基础设施，包括由工程师、临床医生、研究人员和 生物技术公司。 在R21中，我们将估计和比较认知、运动、睡眠和 可能患有DLB(n=20)和AD痴呆(n=30)的受试者的行为监测资料。如果 R21演示了在该人群中使用可穿戴传感器和EMA的可行性以及他们的 为了提高对DLB和AD的辨别能力，我们将进入下一个研究阶段。这个 R33旨在刻画和比较这些相同的传统认知和新认知的轨迹， 轻度认知障碍受试者的运动、睡眠和行为监测 一个或多个核心DLB特征(MCI-DLB；n=75)，以及患有遗忘性MCI和无核心DLB者 特征(MCI-AD；n=25)。我们假设一个综合指标结合了来自 纵向R33中的基线和轨迹测量将改善对 患有MCI-DLB的个人，他们将转换为DLB、AD或仍为MCI。 我们预计，这项研究的结果将对研究人员、临床医生、 病人，以及病人的照顾者。改进的区分早期DLB和早期AD的能力 将协助研究人员为AD和相关疾病的临床试验选择合适的受试者 (ADRD；例如，DLB)。此外，由于R33的纵向性质，研究人员和 临床医生将拥有关于疾病进展的可访问数据，这可能对 评价治疗效果。最重要的是，通过提高对早期DLB的诊断， 临床医生将被更好地装备以避免开出潜在有害的治疗(例如， 用于DLB的抗精神病药物)，并更准确地为患者更早地定制当前或未来的干预措施 在他们的疾病病程中，这种干预措施最有可能有效。

Project Summary/Abstract Dementia with Lewy bodies (DLB) is difficult to diagnose early in its disease course due to the overlap in initial symptoms with Alzheimer's disease (AD). Many individuals with DLB therefore experience long delays in receiving an accurate diagnosis. This lack of sensitivity in the consensus diagnosis for DLB, particularly outside of specialty-care centers, means that DLB is associated with delayed interventions and increased caregiver burden. We thus propose a two-phase study that investigates the utility of combining data from wearable sensors, ecological momentary assessments (EMAs), and traditional measures as a multidomain approach for the early diagnosis of DLB. To collect and analyze these integrated objective measurements, we will establish a research infrastructure that includes an interdisciplinary team of engineers, clinicians, researchers, and biotechnology companies. In the R21, we will estimate and compare the distributions of cognitive, motor, sleep, and behavioral monitoring profiles in subjects with probable DLB (n=20) and AD dementia (n=30). If the R21 demonstrates the feasibility of using wearable sensors and EMAs in this population and their ability to improve discrimination between DLB and AD, we will proceed to the next study phase. The R33 aims to characterize and compare the trajectories of these same traditional and novel cognitive, motor, sleep, and behavioral monitoring profiles in subjects with mild cognitive impairment (MCI) and one or more core DLB features (MCI-DLB; n=75) and in subjects with amnestic MCI and no core DLB features (MCI-AD; n=25). We hypothesize that a composite measure combining information from the baseline and trajectory measures in the longitudinal R33 will improve discrimination between individuals with MCI-DLB who will convert to DLB, AD, or remain MCI. We anticipate that the results of this study will have tangible benefits to researchers, clinicians, patients, and the caretakers of patients. The improved ability to differentiate early DLB from early AD will assist researchers in selecting appropriate subjects for clinical trials of AD and related disorders (ADRD; e.g., DLB). Moreover, because of the longitudinal nature of the R33, researchers and clinicians will have accessible data on disease progression, which can be tremendously helpful in evaluating the efficacy of treatment. Most importantly, by improving the diagnosis of early DLB, clinicians will be better equipped to avoid prescribing potentially harmful treatments (e.g., antipsychotics for DLB) and to more accurately tailor current or future interventions to patients earlier in their disease course at the time that such interventions are most likely to be effective.