MSLife

Abstract

Treatment for multiple sclerosis (MS) focuses on managing its symptoms (e.g., depression, fatigue, poor sleep quality), varying with specific symptoms experienced. Thus, for optimal treatment, there arises the need to track these symptoms. Towards this goal, there is great interest in finding their relevant phenotypes. Prior research suggests links between activities of daily living (ADLs) and MS symptoms; therefore, we hypothesize that the behavioral phenotype (revealed through ADLs) is closely related to MS symptoms. Traditional approaches to finding behavioral phenotypes which rely on human observation or controlled clinical settings are burdensome and cannot account for all genuine ADLs. Here, we present MSLife, an end-to-end, burden-free approach to digital behavioral phenotyping of MS symptoms in the wild using wearables and graph-based statistical analysis. MSLife is built upon (1) low-cost, unobtrusive wearables (i.e., smartwatches) that can track and quantify ADLs among MS patients in the wild; (2) graph-based statistical analysis that can model the relationships between quantified ADLs (i.e., digital behavioral phenotype) and MS symptoms. We design, implement, and deploy MSLife with 30 MS patients across a one-week home-based IRB-approved clinical pilot study. We use the GENEActiv smartwatch to monitor ADLs and clinical behavioral instruments to collect MS symptoms. Then we develop a graph-based statistical analysis framework to model phenotyping relationships between ADLs and MS symptoms, incorporating confounding demographic factors. We discover 102 significant phenotyping relationships (e.g., later rise times are related to increased levels of depression, history of caffeine consumption is associated with lower fatigue levels, higher relative levels of moderate physical activity are linked with decreased sleep quality). We validate their healthcare implications, using them to track MS symptoms in retrospective analysis. To our best knowledge, this is one of the first practices to digital behavioral phenotyping of MS symptoms in the wild.