{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:05:45Z","timestamp":1792695945498,"version":"4.5.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008272","name":"Novartis Pharmaceuticals Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Mol. Med."],"abstract":"<jats:p>Diagnosis, assessment and monitoring of Huntington\u2019s disease (HD) requires measurement of a complex array of motor, cognitive and psychiatric symptoms over sustained periods. However, the prodromal stages often span over a decade with symptoms presenting in a non-linear manner with short term fluctuations. This presents challenges for investigational drug development as treatment effects may become masked. To help address this issue, a number of digital health technology tools are being investigated for use in HD studies with increasing degrees of utility and sophistication. Herein we outline how remote passive monitoring technologies could be integrated into managed care of HD patients, and have the potential to inform algorithms and digital tools which could be used to improve our understanding of disease trajectories and improve early detection rates. Steps to implementation and the potential to derive learnings from adjacent technologies is presented, affording a key opportunity for next- generation approaches to patient monitoring. Measures derived from such technologies will also provide data to capture disease progression and treatment effects with high fidelity and granularity, and complement existing clinical research outcomes (clinROs) and patient reported outcomes (PRO\u2019s). Given the ethical, economic, and societal burden presented by neurodegenerative diseases, such developments could have long term impact in managed healthcare.<\/jats:p>","DOI":"10.3389\/fmmed.2026.1966010","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:25:57Z","timestamp":1791185157000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The potential of AI inspired approaches for patient monitoring in drug development for Huntington\u2019s disease: capturing the digital exhaust for activities of daily living"],"prefix":"10.3389","volume":"6","author":[{"given":"Amit","family":"Khanna","sequence":"first","affiliation":[{"name":"Neuroscience Development, Novartis AG","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Jones","sequence":"additional","affiliation":[{"name":"Clinical Innovation, Novartis Pharmaceuticals","place":["Cambridge, MA, United States"]},{"name":"Clinical and Translational Science Institute, Tufts University Medical Center","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"172","DOI":"10.3390\/s24010172","article-title":"A new framework for smart doors using mmWave radar and camera-based face detection and recognition techniques","volume":"24","author":"Akbari","year":"2023","journal-title":"Sensors (Basel)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1437877","DOI":"10.3389\/fbioe.2025.1437877","article-title":"Wearable sensors-based assistive technologies for patient health monitoring","volume":"13","author":"Almujally","year":"2025","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1038\/nrg1686","article-title":"The molecular genetics of Huntington disease \u2014 a history","volume":"6","author":"Bates","year":"2005","journal-title":"Nat. Rev. Genet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/S1474-4422(17)30124-2","article-title":"Neurofilament light protein in blood as a potential biomarker of neurodegeneration in Huntington's disease: a retrospective cohort analysis","volume":"16","author":"Byrne","year":"2017","journal-title":"Lancet Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"107346","DOI":"10.1016\/j.parkreldis.2025.107346","article-title":"Daily variation in symptoms and functioning in Huntington disease: Feasibility and variability","volume":"133","author":"Carlozzi","year":"2025","journal-title":"Park. Relat. Disord."},{"key":"B6","doi-asserted-by":"publisher","first-page":"7371","DOI":"10.1038\/s41598-018-25095-3","article-title":"Salivary levels of total huntingtin are elevated in Huntington's disease patients","volume":"8","author":"Corey-Bloom","year":"2018","journal-title":"Sci. Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"6363","DOI":"10.3390\/ijms21176363","article-title":"Levels of Interleukin-6 in saliva, but not plasma, correlate with clinical metrics in Huntington's disease patients and healthy control subjects","volume":"21","author":"Corey-Bloom","year":"2020","journal-title":"Int. J. Mol. Sci."},{"key":"B8","doi-asserted-by":"publisher","first-page":"69","DOI":"10.3233\/JHD-190375","article-title":"A longitudinal wearable sensor study in Huntington's disease","volume":"9","author":"Dinesh","year":"2020","journal-title":"J. Huntingt. Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1177\/19322968231171399","article-title":"Remote digital technologies for the early detection and monitoring of cognitive decline in patients with type 2 diabetes: Insights from studies of neurodegenerative diseases","volume":"18","author":"DuBord","year":"2024","journal-title":"J. Diabetes Sci. Technol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1001\/jamaneurol.2024.3533","article-title":"Digital biomarkers for neurodegenerative disease","volume":"82","author":"Erickson","year":"2025","journal-title":"JAMA Neurol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"161","DOI":"10.3390\/brainsci12020161","article-title":"Understanding the burdens associated with Huntington's disease in manifest patients and care partners-comparing to parkinson's disease and the general population","volume":"12","author":"Exuzides","year":"2022","journal-title":"Brain Sci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"122319","DOI":"10.1016\/j.techfore.2023.122319","article-title":"Digital health platforms for the elderly? Key adoption and usage barriers and ways to address them","volume":"189","author":"Frishammar","year":"2023","journal-title":"Technol. Forecast. Soc. Change"},{"key":"B13","doi-asserted-by":"publisher","first-page":"awaf127","DOI":"10.1093\/brain\/awaf127","article-title":"A digital motor score for sensitive detection of progression in Huntington's disease","volume":"11","author":"Giboin","year":"2025","journal-title":"Brain"},{"key":"B14","first-page":"3322","article-title":"Detection of high levels of mutant huntingtin protein in tear fluid of patients with Huntington\u2019s disease","author":"Gijs","year":"2024"},{"key":"B15","doi-asserted-by":"publisher","first-page":"6471","DOI":"10.1007\/s00415-024-12634-4","article-title":"Optical coherence tomography measurements in Huntington's disease: a systematic review and meta-analysis","volume":"271","author":"Gouravani","year":"2024","journal-title":"J. Neurol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1186\/s12913-020-05945-5","article-title":"Digital tools as promoters for person-centered care practices in chronic care? Healthcare professionals' experiences from rheumatology care","volume":"20","author":"Granstr\u00f6m","year":"2020","journal-title":"BMC Health Serv. Res."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2854","DOI":"10.1109\/TBME.2024.3396650","article-title":"Remote gait analysis using ultra-wideband radar technology based on joint range-doppler-time representation","volume":"71","author":"Hadjipanayi","year":"2024","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"B18","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1159\/000498922","article-title":"Passive monitoring at home: a pilot study in parkinson disease","volume":"3","author":"Kabelac","year":"2019","journal-title":"Digit. Biomark."},{"key":"B19","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.ajhg.2015.12.018","article-title":"The HTT CAG-expansion mutation determines age at death but not disease duration in Huntington disease","volume":"98","author":"Keum","year":"2016","journal-title":"Am. J. Hum. Genet."},{"key":"B20","doi-asserted-by":"publisher","first-page":"803315","DOI":"10.3389\/fdgth.2021.803315","article-title":"Envisioning post-pandemic digital neurological, psychiatric and mental health care","volume":"3","author":"Khanna","year":"2021","journal-title":"Front. Digit. Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1038\/s41531-024-00837-5","article-title":"Accelerating Parkinson's disease drug development with federated learning approaches","volume":"10","author":"Khanna","year":"2024","journal-title":"NPJ. Park. Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1177\/1877718X251336118","article-title":"The potential of distributed diagnostics for the early detection of parkinson's disease","volume":"15","author":"Khanna","year":"2025","journal-title":"J. Park. Dis."},{"key":"B23","doi-asserted-by":"publisher","first-page":"S421","DOI":"10.3233\/THC-151109","article-title":"An intelligent health monitoring system using radio-frequency identification technology","volume":"24","author":"Lai","year":"2015","journal-title":"Technol. Health Care"},{"key":"B24","doi-asserted-by":"publisher","first-page":"9000","DOI":"10.3390\/s150409000","article-title":"An ultrasonic sensor system based on a two-dimensional state method for highway vehicle violation detection applications","volume":"15","author":"Liu","year":"2015","journal-title":"Sensors (Basel)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"3061","DOI":"10.3390\/diagnostics13193061","article-title":"Keystroke biometrics as a tool for the early diagnosis and clinical assessment of parkinson's disease","volume":"13","author":"Liu","year":"2023","journal-title":"Diagn. (Basel)"},{"key":"B26","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3233\/AIS-210162","article-title":"Ambient assisted living framework for elderly care using internet of medical things, smart sensors, and GRU deep learning techniques","volume":"14","author":"Liyakathunisa","year":"2021","journal-title":"J. Ambient Intell. Smart Environ."},{"key":"B27","doi-asserted-by":"publisher","first-page":"958","DOI":"10.3390\/jpm14090958","article-title":"Early detection of mental health crises through Artifical-Intelligence-Powered social media analysis: a prospective observational study","volume":"14","author":"Mansoor","year":"2024","journal-title":"J. Pers. Med."},{"key":"B28","first-page":"35","article-title":"Role of artificial intelligence and internet of things in neurodegenerative diseases","volume-title":"AI and Neuro-Degenerative Diseases. Studies in Computational Intelligence","author":"Mathur","year":"2024"},{"key":"B29","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1111\/cts.12488","article-title":"The role of public-private partnerships in catalyzing the critical path","volume":"10","author":"Maxfield","year":"2017","journal-title":"Clin. Transl. Sci."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.21437\/interspeech.2018-2029","article-title":"Classification of Huntington disease using acoustic and lexical features","volume":"2018","author":"Perez","year":"2018","journal-title":"Interspeech"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e2519047","DOI":"10.1001\/jamanetworkopen.2025.19047","article-title":"Passive smartphone sensors for detecting psychopathology","volume":"8","author":"Ringwald","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"B32","doi-asserted-by":"publisher","first-page":"106219","DOI":"10.1016\/j.cct.2020.106219","article-title":"Using digital technologies in clinical trials: Current and future applications","volume":"100","author":"Rosa","year":"2021","journal-title":"Contemp. Clin. Trials"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1007\/s00702-022-02550-0","article-title":"The efficacy of acoustic-based articulatory phenotyping for characterizing and classifying four divergent neurodegenerative diseases using sequential motion rates","volume":"129","author":"Rowe","year":"2022","journal-title":"J. Neural Transm. (Vienna)"},{"key":"B34","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1587\/comex.2019XBL0136","article-title":"Screening of mild cognitive impairment in elderly via doppler radar gait measurement","volume":"9","author":"Saho","year":"2020","journal-title":"IEICE Commun. Express"},{"key":"B35","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1109\/TITB.2009.2037619","article-title":"Toward a highly accurate ambulatory system for clinical gait analysis via UWB radios","volume":"14","author":"Shaban","year":"2010","journal-title":"IEEE Trans. Inf. Technol. Biomed."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1109\/TBME.2015.2393371","article-title":"A device for human ultrasonic echolocation","volume":"62","author":"Sohl-Dickstein","year":"2015","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1007\/s13311-023-01440-x","article-title":"Drug development for neurological disorders: Proceedings from a multidisease area workshop","volume":"20","author":"Stephenson","year":"2023","journal-title":"Neurotherapeutics"},{"key":"B38","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1089\/tmj.2006.12.146","article-title":"Monitoring daily living activities of elderly people in a nursing home using an infrared motion-detection system","volume":"12","author":"Suzuki","year":"2006","journal-title":"Telemed. J. E Health"},{"key":"B39","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1016\/S1474-4422(22)00120-X","article-title":"A biological classification of Huntington's disease: the integrated staging system","volume":"21","author":"Tabrizi","year":"2022","journal-title":"Lancet Neurol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"73717","DOI":"10.1007\/s11042-024-19830-4","article-title":"State-of-the-art radar technology for remote human fall detection: a systematic review of techniques, trends, and challenges","volume":"83","author":"Tewari","year":"2024","journal-title":"Multimed. Tools Appl."},{"key":"B41","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.parkreldis.2021.01.006","article-title":"The use of wearable\/portable digital sensors in Huntington's disease: A systematic review","volume":"83","author":"Tortelli","year":"2021","journal-title":"Park. Relat. Disord."},{"key":"B42","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1080\/17582024.2024.2388507","article-title":"Comparing balance using the BESTest in Alzheimer, Huntington and Parkinson disease","volume":"14","author":"Tueth","year":"2024","journal-title":"Neurodegener. Dis. Manag."},{"key":"B43","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/00222895.2011.580390","article-title":"Behavioral measures of saccade latency and inhibition in manifest and premanifest Huntington's disease","volume":"43","author":"Turner","year":"2011","journal-title":"J. Mot. Behav."},{"key":"B44","doi-asserted-by":"publisher","first-page":"293","DOI":"10.3233\/JHD-200452","article-title":"GEORGE\u00ae: a pilot study of a smartphone application for Huntington's disease","volume":"10","author":"Waddell","year":"2021","journal-title":"J. Huntingt. Dis."},{"key":"B45","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3390\/metabo15010010","article-title":"Lipidomics of Huntington's disease: A comprehensive review of Current status and future directions","volume":"15","author":"Yilmaz","year":"2025","journal-title":"Metabolites"},{"key":"B46","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.mcn.2019.02.004","article-title":"Fluid and imaging biomarkers for Huntington's disease","volume":"97","author":"Zeun","year":"2019","journal-title":"Mol. Cell. Neurosci."},{"key":"B47","doi-asserted-by":"publisher","first-page":"344","DOI":"10.3390\/s20020344","article-title":"Cost-effective wearable indoor localization and motion analysis via the integration of UWB and IMU","volume":"20","author":"Zhang","year":"2020","journal-title":"Sensors (Basel)"}],"container-title":["Frontiers in Molecular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmmed.2026.1966010\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:25:58Z","timestamp":1791185158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmmed.2026.1966010\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":47,"alternative-id":["10.3389\/fmmed.2026.1966010"],"URL":"https:\/\/doi.org\/10.3389\/fmmed.2026.1966010","relation":{},"ISSN":["2674-0095"],"issn-type":[{"value":"2674-0095","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"article-number":"1966010"}}