Study Phases

Phase 1: In-Person Testing

Digital technology enables us to quantify symptoms associated with PSP and PD objectively. A range of features can be measured on a granular level, obtaining rich datasets for robust analyses. Technology expands the clinical experience beyond the data obtained. By collecting data via specified, active tasks, clinical visits can be streamlined to the benefit of researcher and patient. The participants cohorts included involved are PSP, PD, healthy control (HC), and deep brain stimulation (DBS) participants.

Timeline of Phase 1 study. Months along the x axis. 9 visits at three month intervals, with an additional visit 2 for off-medication

V = Visit

Movement Categories

White man with brown hair resting chin on headrest and staring at a red dot on a computer screen being recorded by a camera underneath the screen.
White hand extending out with the thumb at a right angle to the fingers. Black sensor on index finger.

Saccadic eye movements

Fine motor movements

Person standing with black sensors attached at the chest, waist, wrists, and feet.

Gait movements

Levodopa Challenge

On occasion, participants were asked to omit their antiparkinsonian medication on the morning of testing. Participants were tested twice; first when they arrived (off-meds), and then they were asked to take their medication before being tested for a second time one hour later (on-meds). This allows us to identify features that were affected by levodopa (important biomarkers for symptomatic therapies) and features not affected by levodopa (important biomarkers for disease modifying therapies).

Blue and white pills falling to the ground.

Deep Brain Stimulation

Deep brain stimulation (DBS) is the dominant surgical treatment for PD. The procedure involves implanting a pulse generator into specific brain regions to stimulate deep brain structures via small current pulses.

DBS participants are tested prior to DBS surgery both on- and off-levodopa medication, and a year post-surgery on- and off-stimulation. This allows us to elucidate the effect of both medication and DBS stimulation on PD motor symptoms.

Translucent brain pulsing and emitting blue electricity.

Phase 2: Telemedicine

Phase 2 of the OxQUIP study was designed to be entirely remote. Participants attended virtual clinics every four months on Microsoft Teams to perform classic ‘gold standard’ clinical tests. The digital technology component of the study involved the use of a smart devices to perform monthly digital sessions on an app with set tasks designed to extract disease-related features.

V = Visit, S = Session

Timeline of Phase 2. Months along the x-axis up to 16 months. 5 visits at four month intervals for virtual clinics. 17 sessions at monthly intervals for digital sessions.
iPhone 13 Pro Max open on the home screen with colourful screensaver.

iPhone 13 Pro Max

Apple Watch Series 7 with navy strap.

Apple Watch Series 7

Commercial devices have been selected for this study for numerous reasons:

  • A simpler set-up that standard scientific movement sensor equipment.

  • Less cumbersome to wear.

  • Devices in commercial circulation are more accessible for the general public.

  • Opens the possibility to passive monitoring.

In addition to the phone and watch, participants were provided a waist pouch to place the phone into during the balance & walking activities.