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The advent of unexpensive mutlipurpose devices like the Wii, the Kinect, the iPhone, and other motion capturing devices have opened up the opportunity for patients to track with objective measures the evolution and treatment of their Parkinson's Disease. Beyond this QuantifiedSelf approach, this have also created the possibility to run simple clinical trials at a very low cost, that could be funded thanks to the new crowdfunding approach.
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2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
QuantifiedSelf Paris May 22, 2012
Quantifying Your Parkinson’s
with a Wii
Parkinson’s Disease
A brief introduction
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
What is Parkinson’s Disease?
Neurological degeneration of substantia nigra’s cells
Cells producing dopamine
Disease characterized by tremors, bradykinesia (slowness),
rigidity
Looking for biomarkers – PPMI Michael J Fox Foundation’s initiative
DatScan measures?
Cerebral Spinal Fluid analysis?
Blood levels?
Diagnostic is currently only clinical (observation)
DaTScan can spot dopaminergic deficits and help differentiate with other
disorders but is not an official base for a diagnostic
Only evaluation by a neurologist is recognized for diagnosis
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
Causes of Parkinson’s
We don’t know!
But we know that
Dopamine producing cells in the Substantia Nigra (SN) degenerate
Basal ganglia cells do not receive enough dopamine and can’t perform their complex job for motor, and mood, processing loops
Motor alterations of movements is more and more pronounced, “potentially” until a bed-ridden stage
“Usually” leading to a constant degradation in Quality of Life
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
Compensate the loss of dopamine by supplying more levodopa,
a precursor that is transformed in dopamine
by the Substantia Nigra cells
Though, we can’t monitor directly the number of SN cells
We could see, thanks to a heavy procedure (DaTScan),
the uptake of dopamine in basal ganglia improving
But mainly, we can see the improvement in motor condition
Which is the basis for an official diagnosis
What’s the treatment?
Exercise is also shown to be important (as potent as dopamine agonists,
another drug class)
“Use it or loose it” situation
Probably improves uptake of dopamine
Put neuroplasticity in motion
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
The situation is Motor symptoms are the only easily
observable impact of the disease
Depression is difficult to evaluate, and can be made worse by motor problems
Every Parkinson’s patient is different
Mechanisms are extremely complex and idiopathies probably very different
Symptoms vary greatly among patients
Levodopa has a short plasma half-life cycle (1 hour)
Should be taken several times a day
Proper doses throughout the day and adherence to schedule are critical
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
Why the Wii (or the Kinect, or the
iPhone,..) can help?
Helps you exercising
Monitors your movements
Provides measures or indexes that you can track (e.g. Wii-Fit age)
Several studies are built on using the Wii to create physical exercises, and monitor their impact
Wii has been an early (objective) indicator for a UK lady prior to her diagnosis
Wii could serve to quantify objective measures among a large set of patients, and control group
Sara Riggare
A woman with Parkinson’s Disease. Not patient but im-patient
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND 2012 Sara Riggare – http://twitter.com/SaraRiggare CC BY-NC-ND
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND
2012 Sara Riggare – http://twitter.com/SaraRiggare
CC BY-NC-ND 2012 Sara Riggare – http://twitter.com/SaraRiggare CC BY-NC-ND
When crowdfunding meets
quantified-self
Clinical trials that patients consider important, at fractions of the
cost
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
Using un-expensive material to monitor patient and control groups
Opening the scope of hypotheses to be quickly tested
Exercise, dietary regimens
Existence of sub-types for the disease
Big Data coming to medical research
23AndMe gathered genetic material from 6500+ people with Parkinson’s, leading to new correlations between certain genes and the disease
We could create a database of daily-living measures for symptoms and impact of drugs (are there compounds slowing down progression?)
Crowdfunding clinical trials
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
CC BY-NC-ND
If you’re interested in a crowdfunding
challenge for quantified-self trials
Let’s emulate #SciFund Challenge success. If you’re interested in
seeing a similar Challenge for #quantifiedself #medicaltrials:
Show this presentation around
Contact me at [email protected]