PERFORM: A system for the monitoring and management of persons with chronic motor neurodegenerative disorders A study on Parkinson's Disease and Amyotrophic Lateral Sclerosis Dina Baga, Dimitrios I. Fotiadis Dept. of Computer Science Unit of Medical Technology and Intelligent Information Systems University of Ioannina Ioannina, Greece baga@cs.uoi.gr, fotiadis@cs.uoLgr Metin Akay Harrington Dept. of Bioengineering Arizona State University Arizona, USA metin.akay@asu.edu Spiros Konitsiotis Medical School Dept. of Neurology University of Ioannina Ioannina, Greece skonitso@cc.uoLgr Abstract-In this work we describe a system for the monitoring and management of patients with neurodegenerative diseases, focusing on Parkinson's Disease and Amyotrophic Lateral Sclerosis. The system exploits a single wearable sensors' setting to detect and quantify all patient symptoms. An easy to use touchscreen interface allows patients and caregivers to provide additional useful information and assist patients to perform standard predefined tests which otherwise are performed in the clinician's office. The system exploits patient information to suggest appropriate treatment changes based on accumulated medical knowledge. In this paper the architecture of the system, as well as, its innovative features are presented. Continuous wearable patient monitoring system; treatment adjustment; Parkinsons' Disease;ALS; I. INTRODUCTION The proposed system addresses both monitoring and management of patients with chronic neurodegenerative diseases exhibiting motor disabilities. Such patients present various motor symptoms which are evolving with time. The monitoring of these symptoms and their evolution provides valuable information on the patient's health status and wellbeing. However, each symptom is expressed differently in each patient and the evolution of the disease is highly personalized. Accurate patient health assessment is a prerequisite for correct treatment evaluation and adjustment of therapy, according to patient characteristics. PERFORM continually monitors all patient's symptoms, and thus allows an accurate assessment of the patient's condition and disease's evolution. This is fmally used, for the first time, to propose appropriate treatment changes which assist the treating ICT programme, PERFORM project: 215952 Digital Object Identifier: 10.4108I1CST.P£RVAS/V£H£ALTH2009.5936 http://dx.doi.org/10.4108/ICST .P£RVAS/V£H£ALTH2009 .5936 clinician and the patient to maintain or improve when possible, the patient's quality of life for a prolonged period of time. It focuses on two such diseases: Parkinson's Disease (PD) and Amyotrophic Lateral Sclerosis (ALS). PD main symptoms are tremor, dyskinsesia, bradykenisia and gait abnormalities, such as slower walking pace, shuffling, freezing, falls. Pharmacological treatment improves patient's status; however it also causes undesirable symptoms (e.g. on- off fluctuations) which require treatment adjustments. ALS symptoms are impaired walking, breathing and generally every body function is affected due to muscle weakening. Treatment focuses on recognizing life-threatening situations and rapid disease evolution. II . STATE OF THE ART Over the past decades various methodologies and systems have been proposed for the monitoring and assessment of PD symptoms. Two trends can be distiguished. The first, focuses on the study of specific motor tests, such as handwritting, inserting pegs and various games ([1], [2], [3], [4], [5], [6]). In these studies, the researchers monitor and analyse the patient movements during a specific well defined motion test. The analysis of the collected signals or images, allows them to quantify the condition of the patient, usually tremor and bradykinesia. The second trend focuses on the study of specific symptoms during daily patient activities. The researchers suggest the use of different types of wearable systems that can be used at home and record patient signals for several hours during the day.