Smartphone-based tests may speed up Huntington’s drug trials by better tracking disease progression

Smartphone assessments could help researchers more precisely detect progression in Huntington’s disease, potentially improving the efficiency of clinical trials, new research suggests.

A five-minute test delivered via a custom app calculates a Huntington’s Disease Digital Motor Score (HDDMS) using five simple assessments of movement control – including balance, finger tapping and involuntary movements.

Huntington’s disease is a rare inherited neurodegenerative condition – a disorder where nerve cells in the brain gradually deteriorate – leading to progressive loss of motor function, cognitive ability and behavioural control.

There is no cure, and current treatments focus mainly on managing symptoms.

Professor Ed Wild from the UCL Huntington’s Disease Centre said: “Our findings suggest that incorporating the HDDMS in clinical trials will help to give clearer answers about whether a potential treatment is working, with fewer participants or shorter lead times than conventional measures.

“What’s more, the fact that the HDDMS is evaluated in a five-minute assessment in people’s homes makes it convenient and potentially more meaningful than in-clinic measures of motor impairment.”

The HDDMS generates a score after each test: lower scores reflect better motor function, while higher scores indicate greater impairment.

By repeating the tests at home, patients can be monitored remotely by clinicians and researchers over time.

The tool was developed using data from 1,048 people across four observational and interventional studies.

Researchers at University College London and Roche selected the most predictive tasks from a larger battery of smartphone-based assessments.

The team found the HDDMS was around twice as sensitive as the widely used composite Unified Huntington’s Disease Rating Scale in detecting changes in motor function.

This increased sensitivity could allow trials to detect smaller effects with fewer participants – a key consideration in rare diseases.

Wild said: “More sensitive tools to measure disease progression are particularly valuable in rare diseases like Huntington’s disease.

“The fewer people there are who can possibly participate in clinical trials, the more important it becomes to minimise trial burden and size,”

“Sensitive measurement tools like the HDDMS may therefore facilitate Huntington’s disease research across the scientific community.”

However, the researchers noted limitations.

All data was drawn from participants already enrolled in clinical trials, meaning the HDDMS has not been evaluated in people who are pre-symptomatic or in advanced stages of the disease.

Further research is also needed to confirm whether the score can reliably predict long-term functional decline.