Smartphone Passive Digital Phenotyping in Frontotemporal Lobar Degeneration.
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Paolillo Emily W, Dhanam Sreya, Taylor Jack Carson, Sanderson-Cimino Mark, Fregly Ray, Saloner Rowan, Casaletto Kaitlin B, Kramer Joel H, Miller Bruce L, Seeley William W, Gorno-Tempini Maria Luisa, Ljubenkov Peter A, Rojas Julio C, Lee Suzee, Sturm Virginia, Appleby Brian, Bayram Ece, Clark David, Considine Ciaran M, Darby Richard R, Day Gregory S, De Vito Alyssa, Eldaief Mark, Fields Julie A, Ghoshal Nupur, Huey Edward D, Irwin David J, Kantarci Kejal, Kwan Justin Y, Mackenzie Ian R, Masdeu Joseph C, Onyike Chiadi U, Pantelyat Alexander, Pascual Belen, Popli Tanav, Rascovsky Katya, Rezaii Neguine, Scholz Sonja W, Snyder Allison, Tartaglia M Carmela, Traynor Bryan J, Wong Bonnie, Kornak John, Kremers Walter K, Forsberg Leah K, Heuer Hilary W, Boeve Bradley F, Rosen Howard J, Boxer Adam L, Staffaroni Adam M
Аннотация
METHODS: Participants were 567 adults (53% clinically normal, 21% prodromal FTLD, 26% symptomatic FTLD) who completed an in-person study visit and downloaded the ALLFTD Mobile App on their personal smartphones. The app delivered unsupervised cognitive tests and passively collected continuous data on battery percentage (proxy for smartphone use) and step count. Longitudinal follow-up included smartphone monitoring and annual in-person study visits. Primary analyses examined associations between passive smartphone features and markers of disease severity at baseline and longitudinally, and tested whether passive features added incremental value beyond app-based cognitive testing.
RESULTS: Passive smartphone features were feasible to collect and showed excellent reliability with <2 weeks of monitoring (ICCs>0.9). Features capturing smartphone use and movement demonstrated sensitivity to gold-standard clinical measures of disease severity both at baseline and longitudinally. A classification model combining passive features, the app-based cognitive composite score, and demographics detected longitudinal functional decline (AUC=0.89); passive features alone (AUC=0.84) performed comparably to a cognitive screener (AUC=0.85).
DISCUSSION: Passive smartphone monitoring is a valid, zero-burden measure of disease severity and progression in FTLD that adds modest incremental value beyond app-based cognitive testing. Findings support its use as a scalable digital endpoint in longitudinal FTLD research.