Could a digital pen change how we diagnose brain function?

For all of the advances in medical technology, many of the world’s most widely-used diagnostic tools essentially involve just two things: pen and paper. Tests such as the Montreal Cognitive Assessment (MoCA) and the Clock Drawing Test (CDT) are used to detect cognitive change arising from a wide range of causes, from strokes and concussions to dementias such as Alzheimer’s disease. What’s disconcerting, though, is that, with dementia and other disorders growing in prevalence, most current diagnostic methods detect cognitive impairment only after it starts affecting people’s lives. In Alzheimer’s, for example, changes in the brain may occur 10 or more years before the cognitive change becomes noticeable, and no easily administered test can detect these changes at the very earliest stage. At least, not yet.

This month researchers at MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL) were part of a team that published a paper demonstrating a predictive model that, coupled with existing hardware, opens up the possibility of detecting disorders such as dementia earlier than ever before.

For several decades, doctors have screened for conditions including Parkinson’s and Alzheimer’s with the CDT, which asks subjects to draw an analog clock-face showing a specified time, and to copy a pre-drawn clock. But the test has limitations, because its benchmarks rely on doctors’ subjective judgments, such as determining whether a clock circle has “only minor distortion.” CSAIL researchers were particularly struck by the fact that CDT analysis was typically based on the person’s final drawing rather than on the process as a whole.

Enter the Anoto Live Pen, a digitizing ballpoint pen that measures its position on the paper upwards of 80 times a second, using a camera built into the pen. The pen provides data that are far more precise than can be measured on an ordinary drawing, and captures timing information that allows the system to analyze each and every one of a subject’s movements and hesitations. Research at Lahey Hospital and Medical Center and CSAIL produced novel software for analyzing this version of the test, producing what the team calls the digital Clock Drawing Test (dCDT). Source: Could a digital pen change how we diagnose brain function?

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