TechDoctor Inc. Research Results on Multiple Sclerosis Published in International Journal "Journal of Neuroimmunology"

- Joint research with National Hospital Organization Hokkaido Medical Center -Wearable device data shows potential as complementary indicators for monitoring disease progression in MS patients

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TechDoctor Inc. (CEO: Kazumichi Minato, Headquarters: Chuo-ku, Tokyo; hereinafter "TechDoctor") is pleased to announce that research results on multiple sclerosis (MS) conducted jointly with National Hospital Organization Hokkaido Medical Center (Location: Sapporo, Hokkaido) have been published in the international neuroimmunology journal "Journal of Neuroimmunology" November 22, 2025 issue. 

This research demonstrates the potential of daily physiological data obtained from wearable devices to serve as complementary indicators for monitoring disease progression in MS patients.

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BACKGROUND

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Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system, characterized by acute neurological symptom attacks and progressive decline in neurological function (Jakimovski et al., 2024). Brain atrophy in MS is an important indicator of disease progression, reflecting neurodegeneration and is associated with physical function deterioration, cognitive impairment, and decreased quality of life (Bermel and Bakshi, 2006; Miyazaki et al., 2022; Mowry et al., 2009).

Furthermore, it has been reported that brain volume decreases even without clinical relapses (Akaishi et al., 2024b; Cree et al., 2019; Yokote et al., 2018), increasing the need for early and non-invasive biomarkers that can track disease activity and neurodegeneration with higher sensitivity at stages before subjective symptoms appear (Comi et al., 2024; Scalfari et al., 2024).

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RESEARCH OVERVIEW

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This research was conducted with the cooperation of the Department of Neurology at Hokkaido Medical Center, targeting 30 MS patients (23 relapsing-remitting, 5 secondary progressive, 2 primary progressive).

Device: Google Fitbit Inspire3
Duration: Up to 30 days
Parameters Acquired: 29 items including sleep indicators, cardiac autonomic 
nervous indicators, and activity levels
MRI Indicators: Brain volume, T2 lesion volume (T2LV), C2/3 cervical spinal 
cord cross-sectional area (CSA)
Questionnaires: Japanese version of Pittsburgh Sleep Quality Index (PSQI), 
Japanese version of Fatigue Severity Scale (FSS)
Analysis Method: Correlations between parameters obtained from sensors and 
neuroimaging measurements were evaluated using correlation analysis adjusted for age and sex The analysis results described in the paper abstract are as follows:

● 1. Relationship between deep sleep proportion and MRI indicators

Higher proportion of deep sleep was associated with:
- Smaller T2 lesion volume (T2LV) (ρ = −0.46)
- Larger C2/3 cervical spinal cord cross-sectional area (CSA) (ρ = 0.59)

→ Sleep quality, particularly "deep sleep," may be related to the extent of MS lesions on MRI.

● 2. Heart rate variability during sleep (coefficient of variation of RR intervals)

- Associated with brain volume (ρ = 0.41)
→ Autonomic nervous indicators may be related to central nervous system atrophy.

● 3. Relationship between daytime activity/heart rate indicators and spinal 

     cord atrophy

All of the following were associated with C2/3 cervical spinal cord cross-sectional area:

- Daytime minimum heart rate (ρ = −0.44) and range (ρ = 0.41)
- Step count (ρ = 0.64)
- Total metabolic equivalents (METs) (ρ = 0.54)

→ Daily data on physical activity and heart rate may be related to cervical spinal cord atrophy.

ρ: Spearman's partial correlation coefficient adjusted for age and sex

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SIGNIFICANCE AND FUTURE PROSPECTS

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This research demonstrates the potential for physiological data routinely obtained from wearable devices to reflect neuropathology in multiple sclerosis (MS) patients, suggesting promise as a new method for capturing signs of pathological changes non-invasively and continuously.

The confirmation that familiar indicators such as deep sleep, autonomic nervous function, and daytime activity levels may be related to the degree of brain and spinal cord atrophy and lesions represents an important first step in bridging "daily changes" that are difficult to capture with conventional clinical examinations to medical care.

In the future, it will be necessary to clarify the extent to which these physiological indicators can contribute to early detection of MS and improved accuracy of disease monitoring through verification in larger patient populations and longitudinal follow-up studies.

The establishment of digital biomarkers utilizing wearable data is expected to lead to the creation of new medical models with less burden on patients, and TechDoctor will continue to work toward clinical application and social implementation while collaborating with research institutions.

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PUBLICATION DETAILS

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Journal: Journal of Neuroimmunology
Publisher: Elsevier B.V.
Paper Title: Wearable-based physiological monitoring and brain magnetic resonance imaging metrics in multiple sclerosis: A feasibility study
DOI: 10.1016/j.jneuroim.2025.578819
URL: https://doi.org/10.1016/j.jneuroim.2025.578819

Full Citation:

Miyazaki Y, Yokote H, Fujimori J, Sakurai K, Hagiwara A, Fujino S, Fukami T, Takahashi E, Miyagishi M, Uwatoko M, Sugimura Y, Amino I, Akimoto S, Izumi K, Minato K, Minami N, Niino M. Wearable-based physiological monitoring and brain magnetic resonance imaging metrics in multiple sclerosis: A feasibility study. 

Journal of Neuroimmunology. 2025 Nov 22;410:578819.

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RESEARCHER COMMENT

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In neurological diseases including multiple sclerosis, there has been a challenge that evaluation at the time of medical visits alone cannot sufficiently grasp the patient's daily condition. In this study, we demonstrated that physiological function measurements in daily life using wearable devices may reflect the degree of neurological damage in multiple sclerosis. In the future, by combining this method with conventional examinations, we hope to establish a new monitoring method that captures disease conditions more accurately and connects to better medical care.

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ABOUT NATIONAL HOSPITAL ORGANIZATION HOKKAIDO MEDICAL CENTER

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National Hospital Organization Hokkaido Medical Center has a tertiary emergency medical center and meets the needs of acute care medicine in the region, while also handling policy medical care for intractable neurological diseases, muscular dystrophy, and severe physical and intellectual disabilities, as well as tuberculosis medical care, covering not only Sapporo City but the entire Hokkaido region. It is also a medical institution that responds to psychiatric physical complications. Additionally, it has been designated by Hokkaido as a "Difficult Disease Medical Care Cooperation Base Hospital" and has been entrusted with the "Hokkaido Transition Period Medical Support System Development Project," establishing a transition period medical center. Furthermore, it has received designation from Sapporo City as a "Dementia Disease Medical Center" and is active in a wide range of activities. In this way, Hokkaido Medical Center fulfills its role as a member of the 140 hospitals of the National Hospital Organization, an independent administrative agency, and in cooperation with regional medical institutions and administrative agencies.

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ABOUT TECHDOCTOR INC.

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TechDoctor Inc. operates under the vision "Towards an era where data improves well-being," developing and promoting social implementation of "digital biomarkers**" that derive health-related insights from daily sensing data collected by wearable devices and other means. We aim to realize AI-driven medicine based on data in collaboration with medical, pharmaceutical, food-related companies, and research institutions.

CEO: Kazumichi Minato
Chief Medical Officer: Keisuke Izumi
Headquarters: Kyobashi Ed-Grand 4F, 2-2-1 Kyobashi, Chuo-ku, Tokyo
Founded: June 21, 2019
Business: Development and operation of digital biomarker development platform 
"SelfBase," provision of digital medical solutions
URL: https://www.technology-doctor.com/

** About Digital Biomarkers

Digital biomarkers are indicators for continuously and objectively evaluating the presence or absence of disease, changes in disease status, and treatment effects based on daily biometric data obtained from smartphones, wearable devices, and other sources.

While traditional biomarkers were primarily "point data" measured temporarily at medical institutions, digital biomarkers are characterized by the ability to continuously acquire "line data" from daily life. Based on indicators such as exercise, sleep, and heart rate, they are expected to be used for early disease detection, treatment monitoring, and as new endpoints in drug development. 

Development has been progressing overseas since around 2019, and attention is also increasing in Japan.