Using wearables to monitor biomarkers related to neuropsychiatric symptoms post-traumatic event

January 25, 2023 | by

Tracking biomarkers related to post-traumatic outcomes via a wrist-worn wearable. A January study published in JAMA Psychiatry (full text) monitored 2,021 participants who experienced traumatic stress exposure, mainly from car accidents but also physical assault, sexual assault, serious falls, and a mass casualty incident. 

The Advancing Understanding of Recovery After Trauma (AURORA) study examined adverse posttraumatic neuropsychiatric outcomes after traumatic stress exposure, especially among socioeconomically disadvantaged patients. Qualifying patients used the (Alphabet) Verily Life Sciences’ Study Watch for a minimum of 21 hours a day over the eight-week tracking period, starting with screening and qualification in the emergency department (ED). 

  • Participants used smartphones to complete a rotating battery of questionnaires consisting of 10 common adverse post-traumatic neuropsychiatric sequelae (APNS) symptom domains: pain, depressive symptoms, sleep discontinuity, nightmares, somatic symptoms, difficulty with concentration, thinking, or fatigue, avoidance of trauma reminders, trauma reexperiencing, anxiety, and hyperarousal.
  • Using the wearable’s accelerometer feature, it monitored eight significant biomarkers for pain, sleep, and anxiety. A reduction in 24-hour activity variance was associated with greater pain severity. Six others were associated with rest-activity measures indicative of changes in pain over time and one with repeated sleep-wake disruption indicative of changes in pain, sleep, and anxiety.

Depending on the data plus self-reporting on the questionnaires, the patient could be recovering or worsening post-event. The study concluded that “wrist-wearable device biomarkers may have utility as screening tools for pain, sleep, and anxiety symptom outcomes after trauma exposure in high-risk populations.” This Editor notes that over time, wearable monitoring was coupled with plentiful subjective information.

The group was selected from an initial 19,019 patient pool drawn from 27 emergency departments. 3,040 patients met the study criteria including being within 72 hours of the trauma, aged 18 to 65 years, and were able to speak and read English. They also provided informed consent and completed baseline assessments for a final completion group of 2,021. Most of the participants were female, half of the study were African American, 34% were white and 11% were Hispanic. Nearly 80% of the study did not have a college degree, while 64% earned $35,000 per year or less. The study was headed by a team at the University of North Carolina at Chapel Hill.  Also Mobihealthnews

Slow gait speed at age 45 as an accelerated aging predictor–and result: Duke University study

October 17, 2019 | by

Tracking gait not just for tracking acuity and functioning in older adults in care homes. A five-decade cohort study made of over 900 45 year-old adults in a single community–Dunedin, New Zealand–correlates slowness of gait with accelerated aging, including brain health measured as early as age 3. These markers include:

  • Decreased cortical thickness
  • Reduced brain volume
  • Poorer physical functions such as balance, hand grip, stepping, and physical-motor coordination
  • 19 biomarkers taken at ages 26, 32, 38, and 45 years including body mass index, waist-to-hip ratio, glycated hemoglobin level, leptin level, blood pressure, cholesterol, C-reactive protein level, white blood cell count, and dental health

Why this matters: the cohort study goes back to age 3. Assessed at that time by a pediatric neurologist were standardized tests of intelligence, receptive language, and motor skills; and examiner ratings of each child’s emotional and behavioral regulation. MRIs were not available for physical examination at that time and for many years after for children, but were used on the adult respondents to determine structural age-related features of the brain. 

At age 3 and later, poor scores on brain health judged from standardized tests were indicative of future slower gait and accelerated aging at 45, though the exact causality is not clear. In addition to the biomarkers and brain changes, their facial age was also older.

The study was conducted primarily by Duke University and New Zealand university researchers. The original cohort was 1037 participants (535 [51.6%] male). 997 were still alive at age 45 years, and 938 took part in the assessment at age 45 years between April 2017 and April 2019. Of the 997 still alive, 904 (90.7%; 455 [50.3%] male; 93% white) completed the gait test. Disabled (e.g. broken leg, amputation) were eliminated.

In looking back at this significant study, could a physical assessment of children’s health beyond the ordinary, with remedial work on motor skills and emotional state, stave off accelerated aging? Duke Today, JAMA Network Open, New Atlas

Breathe, exhale: a future bracelet that may predict asthma attacks through breath

May 24, 2017 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/05/micronano201722-f1.jpg” thumb_width=”175″ /]A sensor developed by a research team from Rutgers University may in future lead to wearables that predict asthma attacks. The team developed a reduced graphene oxide sensor to detect telltale biomarkers–elevated nitrite levels in exhaled breath condensate (EBC)–that mark the increased airway inflammation present in a developing asthma attack. Currently, breath has to be condensed before being sampled by the nanoelectric sensor, but the team’s goal is “to develop a device that someone with asthma or another respiratory disease can wear around their neck or on their wrist and blow into it periodically to predict the onset of an asthma attack or other problems,” according to researcher Mehdi Javanmard. This concept is far more convenient than a bulky spirometer. Beyond warning the person of an asthma attack, the technology could also be used for other obstructive lung diseases and for tracking treatment/drug effectiveness. Hat tip to Toni Bunting of TASK Ltd. Futurity. Microsystems & Nanoengineering (journal, full text)

It is good to see credible academic R&D in this area of wearables, since there have been others claiming measurement of calories, blood glucose, and hydration, that have been, or been close to, scams. We suspected the Healbe GoBe couldn’t do what it claimed in calorie and BG measurement in 2014 [TTA 26 June 14 and 24 Feb 15] after raising $1 million (more…)