Associations between smartphone keystroke dynamics and cognition in MS

Abstract

Objective Examine the associations between smartphone keystroke dynamics and cognitive functioning among persons with multiple sclerosis (MS). Methods Sixteen persons with MS with no self-reported upper extremity or typing difficulties and 10 healthy controls (HCs) completed six weeks of remote monitoring of their keystroke dynamics (i.e., how they typed on their smartphone keyboards). They also completed a comprehensive neuropsychological assessment and symptom ratings about fatigue, depression, and anxiety at baseline. Results A total of 1,335,787 keystrokes were collected, which were part of 30,968 typing sessions. The MS group typed slower ( P < .001) and more variably ( P = .032) than the HC group. Faster typing speed was associated with better performance on measures of processing speed ( P = .016), attention ( P = .022), and executive functioning (cognitive flexibility: P = .029; behavioral inhibition: P = .002; verbal fluency: P = .039), as well as less severe impact from fatigue ( P < .001) and less severe anxiety symptoms ( P = .007). Those with better cognitive functioning and less severe symptoms showed a stronger correlation between the use of backspace and autocorrection events ( P < .001). Conclusion Typing speed may be sensitive to cognitive functions subserved by the frontal–subcortical brain circuits. Individuals with better cognitive functioning and less severe symptoms may be better at monitoring their typing errors. Keystroke dynamics have the potential to be used as an unobtrusive remote monitoring method for real-life cognitive functioning among persons with MS, which may improve the detection of relapses, evaluate treatment efficacy, and track disability progression.

Multiple Sclerosis in the Digital Health Age: Challenges and Opportunities - A Systematic Review

“…During a typing analysis with a custom on-screen smartphone keyboard, the MS group had slower typing speed, which was also associated with processing speeds. 109 Furthermore, PwMS with better cognitive function showed a higher correlation between backspace and autocorrection events. 109 .…”

“…109 Furthermore, PwMS with better cognitive function showed a higher correlation between backspace and autocorrection events. 109 . Hilty et al found an association between heart rate variability and disease severity in PwMS through 24-hour monitoring with a wearable device 110 .…”

Objective Evaluation of Active Interactions between the Operator and Display Screen Equipment Using an Innovative Acquisition System

“…On the other hand, a promising research field is the study of the interaction with digital devices in neurodegenerative pathologies, such as Parkinson’s disease [ 41 ] or multiple sclerosis [ 42 ]. In fact, according to new research data, tap speed (how quickly one types on a smartphone keyboard) may be a useful tool for monitoring multiple sclerosis severity [ 43 , 44 ]. Thus, we cannot exclude the application of the prospective analysis of operator–VDU interaction with our system to promote early diagnosis of neurodegenerative alterations.…”

A Review on Smartphone Keystroke Dynamics as a Digital Biomarker for Understanding Neurocognitive Functioning

“…Even with mild disease severity and with a shorter disease duration in patients with MS, distinctions between controls and patients were already apparent. Another study also examined the relationship between keystroke dynamics and cognitive functioning in participants with MS [ 48 ]. They found that typing speed and use of the backspace key along with autocorrection events correlated with a better cognitive functioning and less severe symptoms.…”