PDCheck3D: Tracking the Progression of Parkinson's

Parkinson's Disease (PD) affects 7-10 million people globally. Usual observable symptoms of PD include stiffness, slowness, tremor, gait change and speech distortion. Currently, there is no objective way for day-to-day tracking of symptoms and progression of PD. Dosage planning is done based on the narrated experience of the patient making it slightly unscientific. One cannot control what one cannot measure. Hence, there is a need to measure and profile the observable symptoms like tremor, gait change, stiffness / slowness and speech distortion and make it available to doctor and caregivers on demand. This will help in more accurate dosage planning, physio-therapy planning and retuning of brain pacemaker of patients who have undergone Deep-Brain-Stimulation surgery. 

To solve the above-mentioned problem, a setup consisting of wearable devices, sensor, controller and cloud database to track and profile the symptoms has been developed. JStiffness-3D measures stiffness and slowness of the body. JGait-3D measures gait changes over time. JTremor-3D tracks and profiles tremors of the patients. JSpeech is specially designed and developed to measure the speech distortion among patients who have undergone Deep-Brain-Stimulation surgery. An objective measure called PDProgression Index (PDPI) provides a quantitative measure of the progression of PD based on the captured symptoms. The overall setup is based on three themes, viz. Ease and affordability, On demand real-time accessibility, and quantifiable measurements. Measurements are done with respect to the body, hence can distinguish voluntary movements from involuntary. Normalized PDPI has been validated using Parkinson’s Disease’s UPDMS-based dataset of 5600+ patients and found that it matches well with the overall PD levels in this dataset for mid and advanced cases. This can assist the doctors during dosage planning, physio-therapy planning and caregivers during retuning of brain pacemaker of DBS-surgery patients. Possible uses also include digital biomarker for PD trials and eventual integration with DBS pacemaker for its autotuning. Large data generated by devices can be used for classification and prediction.

Overview of the product:

PDCheck3D Overview

The targeted audience for this solution is all patients of Parkinson's Disease (10 million new patients every year globally), Epilepsy (5 million new patients every year globally) and Primary Orthostatic Tremor (rare disease).

• The solution can help in remove monitoring on demand, profiling and tracking progression of these diseases including the rare condition (Primary Orthostatic Tremor).  This can reduce the extra travel of patients and caregivers. This can really be very helpful especially if the patient is staying in a different town or far from the doctor. Even physiotherapist can monitor improvements. Timely monitoring can help in more accurate dosage management. 

• The arrangement can be used as a digital biomarker and can be used during remote monitoring of patients during clinical trials. This can make patient recruitment easier as patient doesn't need to be admitted to the site, but can be at home and still the symptoms can be tracked. This cloud connected system can make data collection easier.
  

In order to engage the patients, I lead an initiative called 'Beat-the-tremor foundation'. I have built a community of 120+ patients. I send out monthly newsletters to these patients covering recent advancements and lifestyle tips based on curated information from top sources. So far 63 newsletters have been sent out in 3 languages - English, Hindi and Marathi.

My uncle, a patient of Parkinson's Disease is my advisor. Hence, I receive most accurate insights about the symptoms from him. 

I receive several suggestions from the patient community of Beat-the-tremor foundation. Please check www.beatthetremor.org for more details.

The device and setup has received two international awards at STEM competition (International Science and Engineering Fair, US) and national level awards, including the Prime Minister's award for Innovation in India (PMRBP'2022 - Top civilian honour for citizen under 18). I have been working on this device for last 3 years. Hence I feel I am equipped to solve this problem.  

The solution can capture the data from the wearable sensors and can make the data available remotely on demand. 

This Prize can help in following ways:

1) Help in getting access to markets like US and Europe

2) Help in getting access to best mentors and partner companies

3) Funding to take the product forward

I as a team lead also lead an initiative called 'Beat-the-tremor' foundation. I have built a community of 120+ patients. I am deeply connected with the community. This community building is helpful in three ways:

1) It bridges the information gap in patients' mind by helping them get information about recent advancements, lifestyle top from information curated from top open sources.

2) In order to curate the information, I end up reading at least 20 research papers on the top every month there by building my knowledge base.

3) I get valuable insights from patients about their experiences about the disease and symptoms.

Please check www.beatthetremor.org for more details.

There have been some solutions that are trying to solve part of the problems. E.g. A university researcher has built a Radio wave based device to monitor movements of patients from gait change standpoint. There is a glove device that can help in hiding the tremors.

None of these devices capture all observable symptoms. Following are the important aspects of PDCheck3D:

•Progression of PD (JPDProgressionIndex) can be arrived at through tracking of intensity of symptoms namely – slowness, tremor, gait change and ,for DBS patients, speech distortion

•JSlowness compares the muscle response vis-à-vis response from a healthy person

•JGait objectively track the changes in the gait (manner of walking). It can provide a fairly accurate view of impact of PD on the patients ability to move the body.

•JTremor3D is an accurate way to measure tremors of patient or his / her body part.

•JSpeech has an easy to use way of checking the level of speech distortion due to PD. This is especially relevant for DBS Surgery patients

All the movements are tracked with reference to the body

Some advanced facts about PDCheck3D:

•Devices capture movements with reference to the body.  E.g. Can detect and differentiate tremulous movements of limbs from non-tremulous movements

•Can assist in dosage planning. Can also be used as a digital bio-marker during PD trials

•Can be extended to integrate other med devices like blood pressure monitor, and etc., to make this a complete solution for Parkinson’s Disease

•Is compact and affordable

•Can generate a lot of data. With patient’s consent, can be used to train AI model to classify new cases based on pattern and predict the progression of disease (JPDProgressionIndex)

•May potentially be extended to other disorders involving tremors (like Epilepsy). It may help in understanding the disease better

•May be integrated with the brain pacemaker (DBS patients) some day its auto-tuning

2024: Build the user interface, make it compact, affordable and aesthetically good.

2025: Safety certification Trials, Testing in few labs

2026: Launch in India through a partner company

2027: Launch in US through a partner company

2028: Launch in EU through a partner company

Following have been my goals:

Understand and define the problem statement (Done)

Keep connected with the community of patients (Done)

Build the working model (Done)

File for US patent (Done)

Complete the user interface and submit it for safety certification (Pending)

Trial and tests in few hospitals and clinics (Pending)

Identify a medical devices company as partner and launch the product through them in India (Pending)

Launch it into US and EU through local partner companies (Pending)

Patients with chronic diseases slowly stop working / earning their bread. They become dependent on others for the livelihood and survival. At times they feel a sense of embarrassment (e.g. tremors can make patient feel embarrassed). They get isolated from the society.

My goal through the devices is help the patients (and doctors) during the dosage planning so that patients can lead a normal life despite the symptoms. I would like patients to continue to feel a sense of equality in the society.

Hardware:

Position capturing devices

RF sensors

Raspberri Pi

Microphones, speakers, etc.

Software:

Ubuntu 20.4

Mysql database

2 people: full time

1 parttime

3 years

I am a woman. My advisor is my uncle (man, patient).

Including a patient who has advanced disease, is bringing him a sense of satisfaction. At the same time, I am gaining valuable insights.

As part of Beat the tremor foundation, I include students from various language background and states to support me in content creation and outreach.

The device has two primary business models:

1) Patient acquires the device and invites the doctor to view the reports / data / analysis of symptoms and progression.

2) Doctor acquires the device and leases it to the patient during initial visit

For sustainability, following is the approach:

1) Once the device is safety certified, I plan to look for a partner company in medical devices space. The device can be lined up for clinical trial. Once done and approved, there can be profit sharing / royalty sharing arrangement with the partner company.

So far it has been self funded.

Since the current costs and very low, I am able to sustain it on my own and some funds from my father. I will soon need funds to finish the remaining work like UI development.