Smartphone app monitors chemo-induced peripheral neuropathy

Remote assessment of severe chemotherapy-induced peripheral neuropathy (CIPN) is feasible through NeuroDetect, a novel smartphone app, according to a recent study. Functional assessments through the app could help catch CIPN manifestations in the hands and feet early.

“We found evidence that patients with CIPN have shorter step length, unique swaying acceleration patterns during a walking task, and shorter hand moving distance in the dominant hands during a manual dexterity task,” the researchers said.

“Our results indicate that functional assessments of feet and hands via a smartphone app may be helpful in detecting CIPN during chemotherapy treatment, but future studies are needed,” they added.

The cross-sectional pilot study included 26 patients who had completed neurotoxic chemotherapy, of whom 17 had CIPN and nine did not. The NeuroDetect app was used to collect CIPN data through functional assessments and patient-reported surveys. Participants were also interviewed after study completion.

NeuroDetect used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Chemotherapy-induced Peripheral Neuropathy 20-item scale (CIPN20) to survey participants for self-reported CIPN. Overall scores were significantly higher in CIPN patients than in controls (28.1 vs 10.0; p<0.001), as were scores in all subscales. [JMIR Mhealth Uhealth 2021;9:e27502]

Functional analysis also detected significant differences in patients vs controls. Twelve patients provided consent for the collection of pedometer data, which showed that median step lengths were significantly shorter in those with CIPN (0.54 vs 0.78 m; p=0.007).

Acceleration analysis was possible in 16 participants after excluding faulty data points, and principal component analysis revealed unique acceleration patterns in CIPN patients during the Gait and Balance test. Gait was characterized by higher Shannon entropy (p=0.01) and median frequency (p=0.009) and lower maximum frequency (p=0.007), skewness (p=0.004), and kurtosis (p=0.007).

Manual dexterity was assessed via the 9-Hole Peg Test, where patients were tasked to place and then remove a virtual peg into and from a virtual hole as quickly as possible.

Touch screen data showed that CIPN patients had significantly lower mean (p=0.008), median (p=0.01), and maximum (p=0.001) distance and lower maximum speed (p=0.02) of the peg removal movement in the dominant hand.

“CIPN is a common and debilitating toxicity of chemotherapy that has both subjective and objective components,” the researchers said. “Smartphone apps are being used to collect subjective data … and may also be a convenient platform for integrating objective CIPN assessments.”

“CIPN monitoring via a smartphone would circumvent several challenges to objective CIPN assessment. Patients could complete assessments whenever and wherever is most comfortable and convenient for them,” they said. “Collection via a smartphone does not require any trained personnel or specialized equipment other than a free app, eliminating most costs associated with CIPN monitoring.”

Future studies should conduct longitudinal assessments in patients undergoing chemotherapy and add app functionality to identify correlates of CIPN.