Objective: Explore the association of smartphone-based active tests in the Roche Huntington’s disease (HD) Digital Monitoring Platform (dMP) with brain imaging.

Background: Remote digital monitoring of HD may aid assessing symptoms and tracking of HD progression by supplementing clinic-based testing. We previously described the potential for the Roche HD dMP to provide reliable, valid and continuous remote monitoring of symptoms using smartphone-based active tests in the cognitive, motor and functional domains of HD.

Method: Participants with manifest HD from the Natural History Study (N=93; NCT03664804) completed a subset of eight daily active tests (data aggregated two weeks from clinical visit) assessing cognitive and motor functions on a smartphone, and underwent brain imaging (at first clinical visit). Participants’ T1-weighted magnetic resonance imaging (MRI) scans were segmented into 26 cortical and subcortical regions using an automated method accounting for inter-subject variability. Statistical analyses were performed applying Spearman’s correlation between active test results and individual volumes of parcellated brain regions.

Results: Significant correlations (p<0.05, adjusted for multiple comparisons) were found between all active tests and subcortical structures including caudate nucleus, putamen and globus pallidus. The strongest correlations were detected for Symbol Digit Modalities Test (SDMT) and putamen (ρ=0.63), caudate nucleus (ρ=0.61) and for Stroop and globus pallidus (ρ=0.57). For cortical regions, significant correlations were observed between SDMT and middle frontal gyrus (ρ=0.53), angular gyrus (ρ=0.51) and superior frontal gyrus (ρ=0.49). For Speeded Tapping, significant correlations were found for the precentral sulcus (ρ=0.28). Chorea test results correlated with the middle frontal gyrus (ρ=0.33) and middle temporal gyrus (ρ=0.32).

Conclusion: Significant associations of dMP-based measures with established clinical MRI features were observed. These were strongest for subcortical regions, which are known to be the most affected by HD. These findings further confirm the validity of dMP-based measures for assessing HD-related neurocognitive decline. Furthermore, significant correlations of various cortical regions with dMP measures were found, indicating their potential involvement in the neuropathology of HD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/validation-of-smartphone-based-active-tests-with-structural-neuroimaging-in-huntingtons-disease/