Abstract Details

Title GEORGE® – The First Smartphone Application for Huntington Disease: A Pilot Study

Topic Movement Disorders

Presentation(s) P6 - Poster Session 6 (12:00 PM-1:00 PM)

Poster/Presentation
Number 3-006

Background Current measures of Huntington disease are insensitive, subjective, and restricted to in-person visits. As technology becomes increasingly inexpensive, ubiquitous, and advanced, smartphones present a unique opportunity to objectively measure disease. Previous studies in Parkinson disease have demonstrated that smartphones effectively measure motor symptoms and correlate well with clinician assessments. We developed the first smartphone application for HD, GEORGE®, at the University of Rochester. GEORGE® uses the smartphone’s sensors to assess chorea and balance, the screen to assess tapping speed, and the microphone to assess voice.

Objective

To objectively measure motor features of Huntington disease (HD) using a smartphone application and assess feasibility of use in this population.

Design/Methods We conducted an observational study of 23 participants: 8 with manifest HD, 5 with prodromal HD, and 10 controls. Participants attended two in-person visits which included standard, clinical assessments of HD and a set of tasks in the smartphone application. Outside of the clinic, participants completed the smartphone tasks three times daily for one month.

Results All but one participant completed study activities. On average, participants used the application 2.3 times daily, with no significant difference in frequency based on disease status. We observed a significant difference in speed of finger tapping, gait regularity, and chorea score between individuals with and without manifest HD. Individuals with manifest HD had a higher mean chorea score (38.44, p<0.001) than either the prodromal HD (9.26) or control (21.76) cohorts based on our novel chorea algorithm. Individuals with manifest HD also tapped the slowest (2.48 taps/second).

Conclusions Use of a smartphone application by individuals with HD is feasible. GEORGE® successfully differentiates individuals with and without manifest HD and objectively measures disease features, including chorea, incoordination, and gait dysfunction. Refinement of the application’s interface and activities will improve usability and sensitivity of data and, ideally, make it useful for clinical trials.

Authors/Disclosures
Jamie L. Adams, MD (University of Rochester Medical Center) PRESENTER	Dr. Adams has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Adams has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Michael J. Fox Foundation. Dr. Adams has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BioSensics. The institution of Dr. Adams has received research support from NIH/NINDS. The institution of Dr. Adams has received research support from Biogen. The institution of Dr. Adams has received research support from The Michael J. Fox Foundation. The institution of Dr. Adams has received research support from Critical Path Institute. Dr. Adams has received personal compensation in the range of $500-$4,999 for serving as a KINECT-HD Steering Committee Member with Huntington Study Group. Dr. Adams has received personal compensation in the range of $500-$4,999 for serving as a ORCHESTRA-PD Steering Committee Member with Parkinson Study Group.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Christopher Tarolli, MD (University of Rochester)	Dr. Tarolli has received personal compensation for serving as an employee of University of Rochester. The institution of Dr. Tarolli has received research support from Biosensics. The institution of Dr. Tarolli has received research support from National Institutes of Health. The institution of Dr. Tarolli has received research support from Biogen. Dr. Tarolli has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Davis Phinney Foundation. Dr. Tarolli has received personal compensation in the range of $500-$4,999 for serving as a Speaker, Committee Member with American Academy of Neurology. Dr. Tarolli has a non-compensated relationship as a Committee Member with American Academy of Neurology that is relevant to AAN interests or activities.
	No disclosure on file
Michael Curtis	No disclosure on file
	No disclosure on file
	No disclosure on file
E. Ray Dorsey, MD, MBA (University of Rochester)	Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acorda. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BrainNeuroBio. Dr. Dorsey has received personal compensation in the range of $0-$499 for serving as a Consultant for Clintrex. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Curasen Therapeutics. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Denali Therapeutics. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Dorsey has received personal compensation in the range of $0-$499 for serving as a Consultant for Grand Rounds. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medopad. Dr. Dorsey has received personal compensation in the range of $0-$499 for serving as a Consultant for Michael J. Fox Foundation. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Origent Data Sciences, Inc.. Dr. Dorsey has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Otsuka. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Dorsey has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Spark. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sunovion Pharma. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theravance. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Voyager Therapeutics. Dr. Dorsey has received personal compensation in the range of $0-$499 for serving as a Consultant for Alzheimer's Drug Discovery Foundation. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bial-Biotech Investments, Inc.. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BluePrint Orphan, Inc.. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Caraway T. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for DeciBio. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Mediflix. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NACCME/CONSULTANT 360. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Dr. Dorsey has received personal compensation in the range of $0-$499 for serving as a Consultant for Olson Research Group. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pear Therapeutics. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Prilenia. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for WebMD. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Spark. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Caraway. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Huntington Study Group. Dr. Dorsey has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Voyager. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurocrine. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genetech/Roche. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for ANA. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MCM Education. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Physician's Education Resource, LLC. Dr. Dorsey has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Texas Neurological Society. Dr. Dorsey has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Karger. Dr. Dorsey has stock in Grand Rounds. The institution of Dr. Dorsey has received research support from Biogen - WATCH-PD. The institution of Dr. Dorsey has received research support from NIH - AHPD. Dr. Dorsey has received research support from NIH - Biosensics. The institution of Dr. Dorsey has received research support from Pfizer - SQUAD. The institution of Dr. Dorsey has received research support from Greater Rochester Health Foundation - PDCNY. The institution of Dr. Dorsey has received research support from Safra Foundation - PDCNY. The institution of Dr. Dorsey has received research support from Burroughs Wellcome - Smartphones. The institution of Dr. Dorsey has received research support from NIH - CTSA. The institution of Dr. Dorsey has received research support from Gary & Mary West Foundation - d.health. The institution of Dr. Dorsey has received research support from PCORI -PD Virtual Care. The institution of Dr. Dorsey has received research support from WAVE Life Sciences. The institution of Dr. Dorsey has received research support from Acadia Pharmaceuticals - PDTV. The institution of Dr. Dorsey has received research support from Roche Pharmaceuticals - PDTV. The institution of Dr. Dorsey has received research support from Michael J. Fox Foundation - Fox Insight. The institution of Dr. Dorsey has received research support from Michael J. Fox Foundation - Emerald. The institution of Dr. Dorsey has received research support from PCORI. The institution of Dr. Dorsey has received research support from Safra Foundation.