2026 · Annals of clinical and translational neurology · paywalled
Association Between Neurofilament Light Chain and Real-World Ambulatory Function in Progressive MS
Joseph et al.
The finding, in our words
In progressive multiple sclerosis, higher serum neurofilament light chain levels were associated with reduced daily step counts from wearables, while higher step counts were linked to lower sNfL. A ten percent increase in steps corresponded to a 0.015 decrease in sNfL z-score, suggesting rising sNfL may predict subsequent mobility decline.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
The study demonstrates that frequent collection of 10 microlitres of capillary blood, combined with wearable sensor data, enables simultaneous measurement of thousands of metabolites, lipids, cytokines and proteins, revealing individualised metabolic and inflammatory responses to dietary interventions and molecular fluctuations linked to intra-day changes in heart rate, glucose, cortisol and physical activity, supporting dynamic health profiling outside the clinic.
The study found that smartwatch-based adherence monitoring showed consistent concordance over time and may be more reliable than app or pill count methods in measuring treatment adherence in a decentralised setting. This supports the use of wearable devices as objective tools in patient-centric monitoring for decentralised clinical trials.
This review establishes that microsampling across blood, saliva, urine and stool matrices offers validated workflows and regulatory recognition for human biomonitoring comparable to conventional methods. It finds that these decentralised approaches enhance participant acceptability and enable screening in remote or low-resource settings.
In a Phase 1 crossover study of etrasimod, self-collected blood microsamples yielded pharmacokinetic exposures comparable to conventional venous sampling, both with and without participant practice sessions. Continuous wearable sensors concurrently enabled real-time remote monitoring of safety vital signs and electrocardiograms, demonstrating the viability of hybrid decentralised designs in early-phase clinical trials.
Decentralised monitoring of people with type 2 diabetes using continuous glucose monitoring and a hybrid smartwatch was feasible, with high participant retention and successful collection of glucose, heart rate, activity, sleep and GPS data via a study app.