In honor of April being Parkinson’s Awareness Month, IBM and pharmaceutical giant Pfizer announced they have entered into a research collaboration to develop an Internet of things (IoT) remote monitoring solution that could transform the care of individuals that suffer from the debilitating Parkinson’s disease.
Parkinson’s disease is a chronic and progressive movement disorder that involves the malfunction and death of neurons in the brain. More than 60,000 Americans are diagnosed with Parkinson’s disease each year, and the debilitating symptoms of the disease get progressively worse over time, requiring adjustments to medication dosing and timing or treatment changes.
Through a system of sensors, mobile devices, real-time analytics and machine learning, IBM hopes to provide researchers and clinicians with real-time, around-the-clock disease status information to help inform treatment decisions and speed the development of new and better therapies, said Ajay Royyuro, PhD., director of Healthcare and Life Sciences at IBM Research, in an interview with eWEEK.
The first phase of the project is to measure and quantify the symptoms that Parkinson’s individuals have. Today Parkinson’s patient symptoms are only measured when they visit their doctor. However, that only gives an episodic measurement, Royyuro said.
“In reality the symptoms that a Parkinson’s patient has really are continuous,” he said. “It’s relentless, the disease doesn’t go away. You take medication and the medication may modify the symptoms during the period that the medication is in you. And patients have ‘on’ periods where they are relieved by the drug during which they may also have some side effects, and then they have off periods where the drug is not in their body anymore and all the symptoms are severe. They may not have side effects but they have symptoms. So it’s kind of a seesaw that is continuous for them. There’s no off time for them; they’re never disease-free. So it’s this relentless characteristic of the disease that is very taxing to patients. And quantifying what exactly the symptoms are, minute by minute, is really the goal – to be able to document the symptoms and say what they are like and how they were able to deal with them.”
However, to get a minute-by-minute readout of symptoms, you have to monitor the symptoms as they occur in the environment that the patient is living their normal routine life in. It cannot be measured in a clinic.
“So you have to bring the measurement to the patient and not the patient to the measurement,” Royyuro said. “To do that you have to deploy sensors on the person and you have to deploy sensors, like the Internet of things, in the environment that they’re already in – such as in their kitchen, in their living room, in their bathroom. So the idea is to sprinkle their entire home environment with a wide array of sensors. Couple them in such a way that through analysis we are actually able to read, as detailed as possible, symptom information and quantitate the symptoms that they have. And symptoms vary in detail. So there is a tremor, for example, and that interferes with a lot of fine motor activity, like using a knife in the kitchen. Many Parkinson’s patients will not use sharp knives.”
This might require placing a wearable sensor on the elbow or wrist. The IBM/Pfizer joint effort also will seek to measure motor function using motion sensors to monitor changes in the patient’s walking pace or the time it takes to button a shirt, IBM said. Indeed, common wearables may be able to accurately track sleep and level of activity, while speech analysis may be able to spot changes in cognition, Royyuro said.
“We are experimenting with all available off-the-shelf devices including wearables and including things that require more than just an individual strapping it onto their bodies – like devices that could give you readouts like EKG and EEG,” Royyuro said. “It doesn’t mean that we’ll deploy them in the field, but we want to understand which of those give us signals that point us in the direction that we should be going.”
IBM, Pfizer Collaborate on Parkinson’s Disease IoT Research
Royyuro said IBM has taken a portion of a house on the IBM Research Yorktown Heights, NY, campus and has converted it into a living lab. And Pfizer is working on a lab that will mirror what IBM’s does.
IBM’s primary goal with the project is to build the technology in a manner that it would scale, he said.
“The intention is to deploy this in the field and actively monitor a large number of Parkinson’s subjects in a future clinical trial that Pfizer might run,” Royyuro said. “So this has to be field deployable and scalable. IBM’s effort is very focused on the technology and ease of scalability and deployment. Then, from the environment, we’re looking at how do we vary the flow of data from the sensor to some intermediate hub that does all the data cleansing and protects the patient’s privacy and does some rudimentary analysis and provides some analyzed data out into the cloud.”
That’s the infrastructure activity IBM is examining. The company also is looking at analytics to help give out the proper data, because individual sensors are very “chirpy” and may give off extraneous information, Royyuro said.
Meanwhile, Pfizer is looking to recruit subjects into trials. If IBM is successful with this technology, it will directly feed into Pfizer clinical trials that will test the technology and the readouts it generates in a clinical setting. In essence, Pfizer’s efforts complement what IBM does on the technology side, Royyuro said.
“It’s IBM’s vision that as we finalize the system, it naturally feeds into the solution portfolio that we have in IBM in the Watson Health business unit,” he said. “It’s not a business today. But if you look at what the outcome that the research can be it is really a solution that provides this kind of clinical monitoring and enables this practice in clinical trials in the future. And the business part of IBM that can serve it to companies like Pfizer and others is our Watson Health business unit. So we are creating some research and prototype technology that if we were to develop and test and validate, it becomes something that our Watson Health business unit can take advantage of and create business out of.”
Moreover, this could also in the future lead to more cognitive assistance, where Parkinson’s patients could get information about the condition of their symptoms and get guidance on options to consider to alleviate symptoms or avoid activities such as driving, Royyuro said.
“The research effort between IBM and Pfizer aims to fundamentally change the way that healthcare professionals care for patients with Parkinson’s disease by providing real-time, around-the-clock disease and symptom information from specific patients to clinicians and researchers,” said Charles King, principal analyst at Pund-IT. “In turn, they can make necessary adjustments in medication and treatment to ensure that patients receive optimal care. The companies will explore approaches that leverage integrated IBM wireless technologies, mobile sensors and machine learning, resulting in what are essentially highly personalized IoT solutions. If the project is successful it will likely have applications in treating other neurological disorders, including Alzheimer’s disease, stroke, multiple sclerosis and epilepsy which the World Health Organization estimates accounts for or contributes to about 12 percent of all deaths. No research project can offer guaranteed results but if IBM and Pfizer succeed they will have the potential to improve the lives of millions of individuals and families.”