8370
Actigraphy for Detection of Clinical Disability Progression in Multiple Sclerosis: Preliminary Analysis of a Prospective Study

Thursday, June 2, 2022
Prince George's Exhibit Hall (Gaylord National Resort & Convention Center)
Nicole Bou Rjeily, MD , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Chen Hu, MS , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Blake E Dewey, PhD , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Christy Hulett, BA , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Gabriella Dagher, BS , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Alexandra Zambriczki Lee, BS , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Alyssandra Valenzuela, BS , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Erin Brennan, MSN, PMHNP-BC , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Anna DuVal, BA, MPH , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Peter A Calabresi, MD , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Vadim Zipunnikov, PhD , Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Kathryn C Fitzgerald, ScD , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Ellen M Mowry, MD, MCR , Dept. of Neurology, Johns Hopkins School of Medicine, Baltimore, MD



Background: The clinical tools currently used for detecting disease progression and worsening clinical disability in multiple sclerosis (MS) are limited. This impedes the development of medications that target progressive MS (PMS). Preliminary studies have found differences in patterns of activity levels in MS patients with increasing disability. Wrist-worn actigraphs are inexpensive and non-invasive tools that can measure patterns of activity levels in the real-world setting.

Objectives: To determine if actigraphy-derived activity levels can distinguish between patients with relapsing-remitting MS (RRMS) and PMS.

Methods: This study is a baseline analysis of an ongoing prospective observational study. Baseline visits were completed between January 2021 and March 2022. Participants with RRMS (n=109) and PMS (n= 52) were instructed to wear the actigraph on their non-dominant wrists, 24 hours a day for two weeks. Actigraphs were programmed to display only the time of day so that participants would not alter their behavior based on visualized activity levels. Differences in activity levels, reported as activity indices, between the two groups were analyzed.

Results: Actigraph wear length was similar between the two groups with a mean of 10.86 ± 2.40 days for RRMS and 10.83 ± 1.81 days for PMS (p=0.925). The mean daily total activity index was significantly higher in the RRMS group (4591.8 ± 1267.4) compared to the PMS group (3983.7 ± 1383.9) (p=0.006). PMS was associated with a significantly lower activity index between 8:26 AM – 5:45 PM, with β coefficients ranging from -1.82 (CI: [-3.00, -0.64]) to -0.91 (CI: [-1.81, -0.01]). Meanwhile, PMS was associated with a significantly higher activity index between 9:54 PM – 11:59 PM, with β coefficients ranging from 1.14 (CI: [0.02,2.26]) to 3.03 (CI: [0.98, 5.08]).

Conclusions: The PMS group had higher nighttime activity, while the RRMS group had higher daytime activity. Longitudinal analysis with larger datasets may be able to refine those findings and better delineate the differences between the two groups. Our preliminary results show promising prospects for actigraphy as a tool for distinguishing RRMS and PMS. We will monitor the participants longitudinally to distinguish the ability of actigraphy to identify patients at risk for progression of disability over time.

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