Sensors to be used in Fort Gordon PTSD study

Whether motion sensors in a patient's room can help chart recovery from traumatic brain injury or post-traumatic stress disorder, and perhaps one day aid in diagnosis, is the focus of a study at Fort Gordon.

The fort's Telemedicine and Advanced Technology Research Center, Dwight D. Eisenhower Army Medical Center and GE Global Research are conducting the $2.7 million study in conjunction with Medical College of Georgia's Center for Telehealth.

The study will employ GE's QuietCare system, which uses motion detectors to record activity, such as sleep patterns, that can be analyzed and compared with what patients are reporting themselves, said Dan Cleary of GE, the principal investigator for the project.

"OK, this is the self-report, this is what the guy or the lady has been telling you, how they've been sleeping," he said. "Now we can actually start to quantify that."

Some nursing homes are already using the system to help spot changes in patterns of activity that could signal problems.

"You may not even know or be too concerned at first of what the pattern specifically means, just that it is something different," Cleary said. "And that person may need to see a doctor or talk to someone."

Traumatic brain injury has been referred to as the signature injury of the Iraq war, in large part because of the heavy use of improvised explosive devices against U.S. troops. Those who experienced those kinds of injuries were much more likely to experience post-traumatic stress disorder, according to a 2008 study in The New England Journal of Medicine .

The military does a good job of screening for those injuries now, said Dr. Joseph Wood, the chief of clinical investigation at Eisenhower and the project's principal investigator for the site.

"They're a clinical diagnosis, though," he said. "There's not a test per se like a blood test, say for hypothyroidism where you can say, 'Yep, they've got it.' It's somewhat subjective."

The initial aim of the study will be to see whether the sensors can provide clinically useful information about the patient's progress.

"We're hoping that these sensors will be able to give us a much richer data set and be able to see improvements, if there are improvements, be able to see it sooner," Wood said. He likened it to the use of 72-hour glucose monitors that give clinicians a broader picture than a single reading.

"With PTSD and with many other types of anxiety disorders, there is often a sleep component to that," Wood said. "So as these patients improve, their sleep improves."

Should it prove useful, it might give patterns that could aid in monitoring or even diagnosis, Cleary said. With the involvement of the telemedicine experts, that sort of system could allow for better remote monitoring of patients through a telemedicine application, making it more relevant to the general public, the researchers said.

"If we could develop some good techniques and technologies, that would allow the clinician to say, 'Hey, you guys are doing good; you're sleeping well; the readings look fine. Why don't you call me next month?' " Cleary said. "Versus, 'Hey, it looks like something is going on with you; you better come in and see me. I want to talk to you.' That kind of thing could be pretty powerful for us moving forward."

Though there is constant monitoring, there is no video or voice recording, and so far it has not raised any objections, he said.

"People don't necessarily want to be chipped or have GPSes following them around, but they don't seem to mind so much if you had a motion sensor that shows that the door opened and they went out and the door closed and they came in," Cleary said. "The technology is low-level."