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Current gold-standard clinical scales use simplistic behavioral assessments, which require 18- to 24-month-long trials to determine if therapies are beneficial. Here we captured full-body movement kinematics from patients with wearable sensors, enabling us to define digital behavioral features based on the data from nine FA patients (six females and three males) and nine age- and sex-matched controls, who performed the 8-m walk (8-MW) test and 9-hole peg test (9 HPT). We used machine learning to combine these features to longitudinally predict the clinical scores of the FA patients, and compared these with two standard clinical assessments, Spinocerebellar Ataxia Functional Index (SCAFI) and Scale for the Assessment and Rating of Ataxia (SARA). The digital behavioral features enabled longitudinal predictions of personal SARA and SCAFI scores 9 months into the future and were 1.7 and 4 times more precise than longitudinal predictions using only SARA and SCAFI scores, respectively. Unlike the two clinical scales, the digital behavioral features accurately predicted\n                    <jats:italic>FXN<\/jats:italic>\n                    gene expression levels for each FA patient in a cross-sectional manner. Our work demonstrates how data-derived wearable biomarkers can track personal disease trajectories and indicates the potential of such biomarkers for substantially reducing the duration or size of clinical trials testing disease-modifying therapies and for enabling behavioral transcriptomics.\n                  <\/jats:p>","DOI":"10.1038\/s41591-022-02159-6","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T12:04:49Z","timestamp":1674129889000},"page":"86-94","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["A wearable motion capture suit and machine learning predict disease progression in Friedreich\u2019s ataxia"],"prefix":"10.1038","volume":"29","author":[{"given":"Balasundaram","family":"Kadirvelu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantinos","family":"Gavriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathiji","family":"Nageshwaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson Ping Kei","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4272-9292","authenticated-orcid":false,"given":"Suran","family":"Nethisinghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0421-0227","authenticated-orcid":false,"given":"Stavros","family":"Athanasopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1800-1987","authenticated-orcid":false,"given":"Valeria","family":"Ricotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7424-5401","authenticated-orcid":false,"given":"Thomas","family":"Voit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Giunti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Festenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0813-7207","authenticated-orcid":false,"given":"A. 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He received research funding paid to his institution from Fresenius-KABI, Shell, Airbus. He received donations given to his institution from Facebook, NVIDIA and Microsoft. RF has consulted for Pfizer and has received funding but not related to this study. VR was a Solid Biosciences employee at the time of the conduct of the study. Currently, VR is cofounder EVP, CMO and stockholder of DiNAQOR AG, the products of which are not related to this study. TV was a consultant for Antisense Therapeutics, BioPhytis, Catabasis, DZHK, Italfarmaco, Santhera, Sarepta, Servier, Syneos Health, Solid Biosciences. TV is a SAB member and stockholder of Constant Pharmaceuticals and a cofounder, CSO and stockholder of DiNAQOR AG. AF, RF, TV, and VR are coinventors of an International Patent Application PCT\/EP2020\/077703\u2014\u2019systems and methods for monitoring the state of a disease using a biomarker\u2019. The remaining authors have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}