WO2022215764A1 - 경도 인지 장애와 치매 치료를 위한 디지털 장치 및 애플리케이션 - Google Patents
경도 인지 장애와 치매 치료를 위한 디지털 장치 및 애플리케이션 Download PDFInfo
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- WO2022215764A1 WO2022215764A1 PCT/KR2021/004251 KR2021004251W WO2022215764A1 WO 2022215764 A1 WO2022215764 A1 WO 2022215764A1 KR 2021004251 W KR2021004251 W KR 2021004251W WO 2022215764 A1 WO2022215764 A1 WO 2022215764A1
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- A61B5/4076—Diagnosing or monitoring particular conditions of the nervous system
- A61B5/4088—Diagnosing of monitoring cognitive diseases, e.g. Alzheimer, prion diseases or dementia
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Definitions
- the present invention relates to digital therapeutics (hereinafter referred to as DTx) for the purpose of inhibiting the progression and treating amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD).
- DTx digital therapeutics
- MCI amnestic mild cognitive impairment
- AD Alzheimer's disease
- Dementia refers to a clinical syndrome in which cognitive functions, such as memory, language, and judgment, are acquired and it is difficult to perform daily life properly. Dementia can be divided into Alzheimer's dementia, a degenerative dementia, vascular dementia caused by stroke, and other dementias caused by various causes such as trauma and drugs.
- Alzheimer's dementia is 7.07%, vascular dementia 0.83%, and other dementias 1.60%. ) is dominant.
- Mild cognitive impairment (Disease Management List code F06.7) is an intermediate stage between normal aging and dementia. Mild cognitive impairment can be classified into mild amnestic cognitive impairment mainly showing memory loss and non-amnestic mild cognitive impairment showing deterioration in cognitive function areas other than memory. Since it is known that about half of mild cognitive impairment develops into dementia, social interest in mild cognitive impairment is increasing in terms of dementia prevention.
- mild cognitive impairment with amnesia When subdividing the standardized prevalence of mild cognitive impairment (22.25%) over 65 years of age, mild cognitive impairment with amnesia was 16.69% and mild cognitive impairment without amnesia was 5.56%, and mild cognitive impairment with amnesia accounted for 3/4. In particular, since mild cognitive impairment with amnesia has a greater risk of developing dementia, more active management of mild cognitive impairment with amnesia is required even if there is no problem in daily life.
- the dementia can be treated by performing surgery in the case of dementia due to cerebral hemorrhage, brain tumor, or normal pressure hydrocephalus.
- vascular dementia due to cerebral infarction it is possible to prevent or delay the progression of the disease by removing or managing risk factors such as hypertension, diabetes, smoking, and hyperlipidemia.
- risk factors such as hypertension, diabetes, smoking, and hyperlipidemia.
- degenerative Alzheimer's disease unlike vascular dementia, it is difficult to expect a therapeutic effect with the above treatment.
- Alzheimer's treatment cases of failure or discontinuation of Alzheimer's treatment by multinational pharmaceutical companies (Pfizer's Bapineuzumab, Eli Lilly's Solanezumab, and Merck's ⁇ -secretase (BACE) inhibitor Verubecestat (Verubecestat)) ), Boehringer Ingelheim's 'BI 409306', AstraZeneca's Saracatinib, Biogen's Aducanumab, Novartis and Amgen's 'CNP520 (Umibecestat)', Roche's Crenezumab ) shows the difficulty of developing an Alzheimer's treatment, and the possibility of an innovative Alzheimer's treatment in the future is expected to be very low.
- BACE ⁇ -secretase
- CBT cognitive behavioral therapy
- the essential cognitive rehabilitation program consists of exercise therapy, reality awareness training, cognitive training therapy, recall therapy, cognitive stimulation therapy, and music therapy.
- Other cognitive stimulation programs include occupational therapy, horticultural therapy, music therapy, art therapy, and exercise therapy as optional options.
- the UK National Health Service is providing digital CBT services.
- the NHS recommends mobile applications for memory and mental health through the App Library.
- the My House of Memories app can store memory recall function and important memories according to memory-tree, memory-box, and timeline, and the Talk Around It Home app can name objects and improve word memory skills.
- the MyCognition Home app provides a brain training game based on the MyCQ test that evaluates planning, decision-making ability, memory, concentration, speed and accuracy.
- the present invention provides a mechanism for mild cognitive impairment and Alzheimer's disease through a literature review and expert review of basic scientific papers on the pathogenesis of amnesia-type mild cognitive impairment and Alzheimer's disease and related clinical trial papers. of action (hereinafter referred to as MOA), and based on this, a therapeutic hypothesis and a digital therapeutic hypothesis for the suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease were established to establish mild cognitive impairment. And an object of the present invention is to provide a digital device and application for the purpose of inhibiting the progression and treating Alzheimer's disease.
- the present invention provides a rational design of an application for clinically verifying the digital treatment hypothesis of amnesia-type mild cognitive impairment and Alzheimer's disease and implementing it as a digital therapeutic agent, and amnesia-type mild cognitive impairment based thereon.
- an object of the present invention is to provide a digital device and application for the purpose of inhibiting the progression and treating Alzheimer's disease.
- the present invention derives a pathogenesis, a therapeutic hypothesis, and a digital therapeutic hypothesis in consideration of the neuro-humoral factors of amnesia-type mild cognitive impairment and Alzheimer's disease.
- the present invention provides an improved therapeutic effect and suppresses the progression of amnesia-type mild cognitive impairment and Alzheimer's disease through repetitive performance of a digital task by a patient based on the digital treatment hypothesis of amnesia-type mild cognitive impairment and Alzheimer's disease
- the purpose is to provide digital devices and applications that can ensure reliability.
- the digital device for the treatment of mild cognitive impairment and dementia provides a digital therapeutic module for the treatment of mild cognitive impairment and dementia based on the pathogenesis and treatment hypothesis for mild cognitive impairment and dementia.
- a digital task generating unit that generates, generates a embodied digital task based on the digital therapeutic module, provides the digital task to a first user, and collects results for collecting the performance results of the first user on the digital task may include wealth.
- the digital application for the treatment of mild cognitive impairment and dementia is a digital application stored in a computer-readable medium, and based on the pathogenesis and treatment hypothesis for mild cognitive impairment and dementia, the mild cognitive impairment and the generating a digital therapeutic module for the treatment of dementia; generating a embodied digital task based on the digital therapeutic module; providing the digital task to a first user; and the first for the digital task.
- the computing device may cause the computing device to perform an operation including collecting the user's performance result.
- the pathogenesis and treatment hypothesis By deriving a digital treatment hypothesis, presenting a digital task to the patient based on it, collecting and analyzing the performance results, it is possible to suppress the progression of mild amnesia-type cognitive impairment and Alzheimer's disease and provide improved therapeutic effects.
- Figure 1a is the pathogenesis of Alzheimer's disease proposed in the present invention
- Figure 1b is the amnesia-type mild cognitive impairment and Alzheimer's disease progression inhibition and treatment hypothesis proposed in the present invention
- Figure 1c is amnesia proposed in the present invention It is a figure showing the digital treatment hypothesis of progression inhibition and treatment of mild cognitive impairment and Alzheimer's disease.
- FIG. 2 is a block diagram illustrating a configuration of a digital device for suppressing and treating amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- FIG. 3 is a diagram illustrating an input and output loop of a digital application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- FIG. 4 is a diagram illustrating a feedback loop according to a digital device and application for suppressing and treating the progression of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- FIG. 5A is a diagram illustrating a module design for implementing digital treatment in an apparatus and application for suppression and treatment of progression of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention
- FIG. 5B is an embodiment of the present invention It is a figure showing the background factors supporting the digital device and application for the suppression and treatment of mild cognitive impairment and Alzheimer's disease according to the embodiment.
- FIG. 6 is a diagram illustrating a method of designating a patient-specific digital prescription using a digital device and an application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- 7A to 7E show examples of specific tasks of each module and an output data collection method according to an embodiment of the present invention.
- FIG. 8 is a flowchart illustrating an operation of a digital application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- FIG. 9 is a flowchart illustrating a method of generating a digital task in a digital application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- FIG. 10 is a flowchart illustrating repetitively performing an operation according to feedback control in a digital application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- FIG. 11 is a diagram illustrating a hardware configuration of a digital device for suppressing and treating amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- first, second, first, or second used in various embodiments may modify various components regardless of order and/or importance, do not limit
- a first component may be referred to as a second component, and similarly, the second component may also be renamed to a first component.
- digital therapeutics are, in principle, implemented in software. Considering the clinical validation and licensing process as a therapeutic agent due to the nature of digital therapeutics, the rational design of digital therapeutics for the disease and software implementation based on them are very creative invention processes that should be protected by patents.
- the core of a digital therapeutic agent such as the present invention lies in the rational design of a digital therapeutic suitable for the treatment of the disease and the development of specific software that can be clinically verified based on the rational design.
- the digital device and application for the treatment of mild cognitive impairment and Alzheimer's disease of the present invention implemented from this point of view will be described in detail below.
- Figure 1a is the pathogenesis of Alzheimer's disease proposed in the present invention
- Figure 1b is the mild cognitive impairment and the treatment hypothesis of Alzheimer's disease proposed in the present invention
- Figure 1c is a digital of mild cognitive impairment and Alzheimer's disease proposed in the present invention
- the digital device and application for the inhibition and treatment of mild cognitive impairment and Alzheimer's disease progression of the present invention described below is a pathogenesis derived through literature review and expert review of clinical trial papers on amnestic-type mild cognitive impairment and Alzheimer's disease. It was implemented based on the treatment hypothesis.
- disease treatment analyzes a particular disease in terms of pathophysiological function and substrate to determine its starting point, progression point, and endpoint.
- indication of the disease is defined through the demographic characteristics of the disease and the statistical analysis of the disease.
- the pathogenesis is derived by analyzing the physiology of the patient corresponding to the confirmed indication, especially the neurohumoral factors, and narrowing the neurohumoral factors of the patient to the parts related to the disease.
- the digital treatment hypothesis of the present invention is a digital device and application that presents changes in patient behavior (including behavior, emotion, cognitive domain, etc.), environment improvement, and patient participation in the form of specific instructions, and collects and analyzes the performance. is implemented
- Literature search for the clinical trials described above can be performed through meta-analysis and data mining, and clinical expert feedback and in-depth review can be applied at each analysis stage.
- the present invention can extract the pathogenesis and treatment hypothesis of mild cognitive impairment and Alzheimer's disease through the process described above, and based on this, control and treat the progression of mild cognitive impairment and Alzheimer's disease by controlling neurohumoral factors providing digital devices and applications as digital therapeutics for
- the method of extracting the pathogenesis and treatment hypothesis of mild cognitive impairment and Alzheimer's disease according to the present invention is not limited to the method described above, and in addition, the pathogenesis and treatment hypothesis of the disease can be extracted through various methods .
- various risk factors of the aging process for example, age, genetic / family history, smoking and drinking, arteriosclerosis, cholesterol, serum homocysteine (homocysteine), diabetes, MCI, other factors It can lead to an imbalance of neurohumoral factors in the aging process.
- abnormality of sex steroid hormone decrease of IGF-2 (insulin-like growth factor-2), abnormality of wnt/b-catenin, BAG1, cAMP response element (CREB) -Reduction of binding protein, hypersecretion of inflammatory factors and corticosteroids such as cortisol and glucocorticoid, dopamine, noradrenaline, somatostatin ), neurohumoral factors, such as a decrease in neurohormonal secretion, inhibit neurogenesis in the hippocampus from a physiological point of view, induce inflammation in the brain tissue, and may also induce stress and depression.
- IGF-2 insulin-like growth factor-2
- wnt/b-catenin abnormality of wnt/b-catenin
- BAG1 cAMP response element (CREB) -Reduction of binding protein
- hypersecretion of inflammatory factors and corticosteroids such as cortisol and glucocorticoid
- dopamine noradrenaline
- Alzheimer's disease atrophic brain with plaque deposits, an anatomical characteristic of Alzheimer's disease.
- the brain does not function normally, and cognitive functions such as memory, language, and judgment that we observe decrease, resulting in a clinical syndrome commonly called dementia that prevents us from performing our daily activities properly.
- the treatment hypothesis for mild cognitive impairment and Alzheimer's disease is patient participation including behavioral control (life, habit, exercise, nutrition) and environmental control (setting a bright, friendly and comfortable performance environment) of the patient It relates to the inhibition and treatment of mild cognitive impairment and Alzheimer's disease by restoring the balance of neurohumoral factors through
- the digital treatment hypothesis for mild cognitive impairment and Alzheimer's disease is a digital device and application that presents a patient participation method including a change in the patient's behavior and an environment improvement in the form of a specific task, and collects and analyzes the performance.
- the digital therapeutic agent of the present invention the imbalance of neurohumoral factors in patients with amnesia-type mild cognitive impairment and Alzheimer's disease can be corrected through the digital input (task) and output (performance), thereby reducing the risk of mild cognitive impairment and Alzheimer's disease. Progression inhibition and treatment can be achieved.
- FIGS. 1A and 1B Although the pathogenesis and treatment hypothesis of mild cognitive impairment and Alzheimer's disease have been described in FIGS. 1A and 1B, the present invention is not limited thereto, and the methodology of the present invention can be applied to other types of mild cognitive impairment and dementia. There will be.
- neurohumoral factors have been described as steroid sex hormones, IGF2, wnt/b-catenin, BAG1, CREB, inflammatory factors, adrenocortical steroid hormones, and neurohormones, but these are only exemplary.
- Neurohumoral factors are not limited thereto in the pathogenesis and treatment hypothesis of mild cognitive impairment and Alzheimer's disease, and all neurohumoral factors affecting mild cognitive impairment and dementia may be considered.
- FIG. 2 is a block diagram illustrating a configuration of a digital device for suppressing and treating amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- a digital system 000 for treating mild cognitive impairment and Alzheimer's disease includes a digital task generator 010 , a sensing data collector 020 , and a performance input unit 030 . , a result analysis unit 040 , a database 050 , and a security unit 060 may be included.
- the doctor is a digital device and application for the treatment of mild cognitive impairment and Alzheimer's disease in the patient.
- Digital therapeutics can be prescribed.
- the digital task generating unit 010 provides the patient with a digital therapeutic prescription as a specific behavioral task that the patient can execute based on the interaction between neurohumoral factors and behavior/environment for mild cognitive impairment and Alzheimer's disease.
- neurohumoral factors may include steroid sex hormones, IGF2, wnt/b-catenin, BAG1, CREB, inflammatory factors, adrenocortical steroid hormones, neurohormones, and the like.
- the present invention is not limited thereto, and all neurohumoral factors that can cause amnestic-type mild cognitive impairment and Alzheimer's disease may be considered.
- the digital task generator 010 may generate a digital task based on an input from a doctor.
- the digital task generating unit 010 may generate a digital task based on information collected by the doctor diagnosing the patient (the first user).
- the digital task generator 010 may generate a digital task based on information received from the patient.
- the information received from the patient may include the patient's basal factors, medical information, and digital therapeutics literacy.
- the underlying factors may include the patient's activity (activity), heart rate, sleep, meal (nutrition and calories), and the like.
- the medical information may include an electronic medical record (EMR) of a patient, a family history, genetic vulnerability, genetic susceptibility, and the like.
- EMR electronic medical record
- the ability to understand digital therapeutics may include the accessibility and acceptance posture of patients with respect to digital therapy tasks and devices.
- the digital task generator 010 may generate a digital module by using virtual parameters by reflecting the pathogenesis and treatment hypothesis for mild cognitive impairment and Alzheimer's disease.
- virtual parameters may be derived with respect to nerve regeneration, anti-inflammatory, anti-stress, and anti-depression in the hippocampus in consideration of the patient's environmental, behavioral, emotional and cognitive aspects. This will be described later in detail with reference to FIG. 5 .
- the digital task generator 010 generates a digital task specifically designed for a patient to obtain a therapeutic effect, and provides the task to the patient.
- the digital task generator 010 may generate a specific digital task for each digital therapeutic module.
- the sensing data collection unit 020 and the performance input unit 030 may collect the patient's performance results for the digital task provided through the digital task generator 010 . Specifically, it consists of a sensing data collection unit 020 that senses the patient's adherence to the digital task and a performance input unit 030 that allows the patient to directly input performance results for the digital task, and the digital task Outputs the results of the replotting for .
- the result analysis unit 040 may collect and report the patient's behavioral compliance or participation at a preset period to the outside. Therefore, the doctor can continuously monitor the performance of the digital task through the application even if the patient does not visit the clinic.
- the database 050 may store data on a pathogenesis, a treatment hypothesis, a digital task provided to a user, and a performance result of the user for mild cognitive impairment and Alzheimer's disease.
- the database 050 is shown to be included in the digital device 000 for treating mild cognitive impairment and Alzheimer's disease, but the database 050 may be provided in an external server.
- the digital task generator 010 may generate a patient-customized digital task for the current session by reflecting the patient's digital task provided in the previous session, its output value, and evaluation.
- mild cognitive impairment and Alzheimer's disease in consideration of amnestic-type mild cognitive impairment and neurohumoral factors in the progression of Alzheimer's disease
- pathogenesis, treatment hypothesis, and digital treatment hypothesis for the disease By deriving the pathogenesis, treatment hypothesis, and digital treatment hypothesis for the disease, presenting a digital task to the patient based on this and collecting and analyzing the performance results to suppress the progression of amnesia-type mild cognitive impairment and Alzheimer's disease and improve It can provide a therapeutic effect.
- FIG. 3 is a diagram illustrating an input and output loop of a digital application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- a digital application for treating mild cognitive impairment and Alzheimer's disease provides a corresponding digital prescription to a patient in the form of a task, and the performance result for the digital task is applied as an output can be re-entered into
- Digital tasks presented to the patient may include specific behavioral tasks and control of the patient's environment. As shown in FIG. 3 , the digital task may include performance environment setting, lifestyle, learning, exercise, and affirmation/achievement modules. However, this is only an example and the digital task according to the present invention is not limited to these modules.
- the patient's performance results on digital tasks include: 1) task-performing login/logout information, 2) adherence information sensed in the form of passive data such as exercise, stress-related heart rate, and oxygen saturation changes, and 3) It consists of direct input information of patient performance results.
- FIG. 4 is a diagram illustrating a feedback loop according to a digital device and application for suppressing and treating the progression of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- FIG. 4 it is shown that the above-described single feedback loop of FIG. 3 is repeatedly performed a plurality of times to control neurohumoral factors, thereby achieving suppression and treatment of mild cognitive impairment and Alzheimer's disease.
- the first digital task and performance result are given as input values and output values in a single loop, but when executing N times, the input and output values generated in this loop are reflected using the feedback process of the loop for the next loop. Inputs can be adjusted to create new digital assignments. By repeating this feedback loop, a patient-specific digital task can be derived while maximizing the therapeutic effect.
- the digital task and task performance result of the patient provided in the previous round (eg, round N-1)
- the data can be used to calculate the patient's digital task and performance results for the current round (eg, N rounds). That is, the digital task in the next loop may be generated based on the patient's digital task and task performance results calculated in the previous loop.
- various algorithms and statistical models may be used for the feedback process as needed.
- FIG. 5A is a diagram illustrating a module design for implementing digital treatment in an apparatus and application for suppression and treatment of progression of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention
- FIG. 5B is an embodiment of the present invention It is a figure showing the background factors supporting the digital device and application for the treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to the embodiment.
- each module is a basic design unit of a digital therapeutic agent implemented as an actual digital device or application and a set of specific tasks.
- the neurohumoral factors derived from the pathogenesis and treatment hypothesis for mild cognitive impairment and Alzheimer's disease are steroid sex hormones, IGF2, wnt/b-catenin, BAG1, CREB, inflammatory factors, It may be a corticosteroid hormone, a neurohormone.
- mild steroid sex hormone balance For the treatment of mild cognitive impairment and Alzheimer's disease, mild steroid sex hormone balance, increased IGF-2 secretion, wnt/b-catenin balance, increased BAG1 and CREB secretion, decreased inflammatory factors and adrenocortical steroid hormone secretion, and increased neurohormonal secretion It is necessary to resolve the imbalance of the neurohumoral factors that are the pathogenesis of cognitive impairment and Alzheimer's disease.
- each neurohumoral factor was mapped to a digital therapeutic module using virtual parameters such as nerve regeneration, anti-inflammatory, anti-stress and anti-depression in the hippocampus. Then, a specific digital task for each module was created based on the converted module.
- the digital task may include performance environment settings and modules (lifestyle, learning, exercise, affirmation/achievement module) that can be output through monitoring.
- this is merely an example, and the module according to the present invention is not limited thereto.
- background factors may be considered together in the module design of a digital device and application for treating mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- the background factor is a factor necessary for the correction of clinical trial results in the process of verifying the clinical effectiveness of the digital mild cognitive impairment and Alzheimer's disease treatment according to the present invention.
- basal factors may include activity, heart rate, sleep, meal (nutrition and calories), etc.
- medical information includes EMR prepared when the patient visits the hospital, It may include family history, genetic vulnerability and susceptibility, and the ability to understand digital therapy may include patient access to digital therapy tasks and devices and acceptance posture.
- FIG. 6 is a diagram illustrating a method of designating a patient-specific digital prescription using a digital device and an application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- Figure 6 (A) shows a prescription process through a routine patient-physician interview
- Figure 6 (B) shows a method in which a doctor designates a digital prescription customized for a patient through analysis of a plurality of digital tasks and their performance results. indicates.
- FIG. can adjust the types of modules and tasks for each module for the treatment of mild cognitive impairment and Alzheimer's disease by reviewing them.
- Figure 7a shows the execution environment setting according to an embodiment of the present invention
- 7b ⁇ 7e shows an example of a specific task of each module and an output data collection method according to an embodiment of the present invention.
- each module can be configured by putting game elements in it.
- each module is a basic design unit and a set of specific tasks in a digital device and application implemented for the prevention and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease.
- FIG. 7A an example of a specific task of setting a performance environment and a method of collecting output data are shown.
- the performance environment setting may be included in the configuration of the digital task generating unit 010 of FIG. 2 .
- the other modules shown in FIGS. 7B to 7E are performed in a bright, friendly and comfortable environment set in the execution environment setting 7a.
- Brightness setting includes setting the brightness environment of the digital task performance environment using the illuminance sensor or IoT lighting, and the living environment can be created so that exposure is at least 16 hours a day in a bright environment.
- Familiarity setting is an app environment where the patient can perform memory and recall in a familiar and familiar environment when executing the learning, affirmation and achievement module (e.g., music that the patient enjoyed listening to in the past, Contents that can help the patient to recall, such as famous scenes, famous lines, family photos, documentary photos, etc.) and setting a place where the patient can feel friendly during the task performance process may be included.
- affirmation and achievement module e.g., music that the patient enjoyed listening to in the past, Contents that can help the patient to recall, such as famous scenes, famous lines, family photos, documentary photos, etc.
- setting a place where the patient can feel friendly during the task performance process may be included.
- the relaxation setting is an app environment in which the patient can perform tasks in a comfortable environment (e.g., background pictures, music, tone, etc.) to help reduce the patient's stress. content that can be set) and setting up a place that provides comfort during the task performance process.
- a comfortable environment e.g., background pictures, music, tone, etc.
- modules 7B to 7E show examples of specific tasks of each module and an output data collection method according to an embodiment of the present invention.
- modules it may include lifestyle, learning, exercise, and affirmation/achievement modules.
- the lifestyle module may be included in the configuration of the digital task generating unit 010 of FIG. 2 .
- New experiences and travel tasks may include trips to unfamiliar places to experience new environments once a week or every two weeks.
- New experiences and trips (tasks) may consist of recording (performing) using a journal or various digital media.
- the sex hormone balance task aims to restore the rapid imbalance of steroid sex hormones due to aging or menopause.
- hormone replacement therapy HRT
- severe diets that cause rapid fat loss should be avoided as much as possible.
- Restoring sex hormone balance through a meal that reflects nutritional balance may consist of diet record and nutritional evaluation (performation).
- the learning module may be included in the configuration of the digital task generator 010 of FIG. 2 .
- the task of the learning module may include a behavioral task in which familiar things are continuously repeated and remembered and brought out in a comfortable atmosphere.
- the performance of the first user may be performed in the form of a game record or a log book for memory improvement and learning.
- a task in a learning module may audibly induce relaxing music, or induce a patient to smell good.
- the physical exercise module may be included in the configuration of the digital task generating unit 010 of FIG. 2 .
- the exercise module may consist of a series of behavioral instructions performing 20 minutes of acute exercise regularly (3 times/week).
- the performance result is collected by the sensing data collection unit 020 using a biofeedback (measuring EEG, ECG, EMG, EDG, etc.) device or a general-purpose sensor (measuring activity, HR, etc.) or Alternatively, the method includes a method in which the patient directly uses the performance input unit 030 to input.
- the exercise task of the present invention may be configured by applying mutatis mutandis exercise therapy widely used by doctors or exercise therapists according to the age and physical condition of the patient.
- the first user may write an exercise log, check a heart rate, or perform an action task through a personal training (PT) coach.
- PT personal training
- the affirmation/achievement module may be included in the configuration of the digital task generating unit 010 of FIG. 2 .
- the affirmation/achievement module may include tasks that promote the release of dopamine through the patient's task performance and a sense of achievement in completing the task.
- the task achievement task is a task that gives a task and makes the patient feel a sense of accomplishment through the achievement.
- the task may be updated according to the patient's participation period and may include a game capable of inducing voluntary participation.
- the specific form of the game can be variously configured such as learning, finding hidden or other pictures, and quizzes.
- the part implemented in the form of a quiz among the affirmation/achievement modules can be expected to have an additional effect of increasing the patient's ability to understand health information and to understand digital treatment. Improving the ability to understand such health information and digital therapeutics is an essential element for maintaining patient participation in treatment and improving performance.
- the first user may perform the task in a manner such as self-feedback or self-reward, or compensation through the relationship between the patient and the doctor.
- the digital treatment according to the present invention requires long-term continuous patient participation, and during this period, the positive/accomplishment module is praised ( reward) tasks.
- the patient's active participation in treatment in the praise task can be fed back with a sense of accomplishment through trust and reward between patient-caregiver and patient-doctor.
- each of the modules and corresponding digital tasks shown in FIGS. 7A to 7E are merely exemplary, and the present invention is not limited thereto, and the digital tasks provided to the patient may be set in various ways depending on the case.
- FIG. 8 is a flowchart illustrating an operation of a digital application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- a digital application for the treatment of mild cognitive impairment (MCI) and Alzheimer's disease is first, based on the pathogenesis and treatment hypothesis for mild cognitive impairment and Alzheimer's disease, mild cognitive impairment and a digital therapeutic module for the treatment of Alzheimer's disease (S810).
- a digital therapeutic module for the treatment of Alzheimer's disease S810.
- neurohumoral factors for mild cognitive impairment and Alzheimer's disease eg, steroid sex hormones, IGF2, wnt/b-catenin, BAG1, CREB, inflammatory factors, adrenocortical steroid hormones, neurohormones
- a digital therapeutic module may be generated based on an input from a doctor.
- the digital therapeutic module may be generated based on the information collected by the doctor by diagnosing the patient and the prescription result prepared based on the information.
- the digital therapeutic module may be generated based on information received from the patient (eg, underlying factors, medical information, digital therapeutic comprehension ability, etc.).
- Step S820 a embodied digital task may be generated based on the digital therapeutic module.
- Step S820 is a hypothetical parameter regarding the patient's environment and behavioral aspects (eg, nerve regeneration in the hippocampus, anti-inflammatory, anti-stress, anti-depressant, etc.) for the pathogenesis and treatment hypothesis for mild cognitive impairment and Alzheimer's disease. can be applied to create a digital therapeutic module. Since this has been described with reference to FIG. 5 , a detailed description thereof will be omitted.
- the digital task may be generated for at least one of the performance environment setting, lifestyle, learning, exercise, and affirmation/achievement module.
- the execution environment setting and description of the specific digital task for each module are the same as those described with reference to FIGS. 7A to 7E .
- the digital task may be provided to the patient (S830).
- the digital task is related to behavior, emotion, cognition, etc. It is a digital task that can monitor the patient's task compliance using a sensor, such as lifestyle and physical exercise, or a digital task in which the patient directly inputs the performance result. can be provided as
- the patient's performance results for the digital task may be collected ( S840 ).
- the patient's compliance with the digital task may be monitored, or the performance result of the digital task may be collected by the patient inputting the performance result for the digital task.
- the steps of generating a digital task and collecting the patient's performance results for the digital task are repeated multiple times according to a feedback loop.
- the step of generating the digital task may generate the digital task of the patient for the current session based on the patient's digital task provided in the previous session and the collected performance result data for the patient's digital task.
- mild cognitive impairment and Alzheimer's disease are The pathogenesis, treatment hypothesis, and digital treatment hypothesis for the disease are derived, and the digital task is presented to the patient based on this, and the results of the performance are collected and analyzed to suppress the progression of mild cognitive impairment and Alzheimer's disease. It can provide a therapeutic effect.
- digital device and application for the treatment of mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention have been described only in terms of mild cognitive impairment and Alzheimer's disease treatment, but the present invention is not limited thereto.
- Digital treatment may be performed in substantially the same manner as described above for diseases other than Alzheimer's disease.
- FIG. 9 is a flowchart illustrating a method of generating a digital task in an application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- step S810 and S820 in FIG. 8 the process of creating a module and a detailed digital task for the treatment of mild cognitive impairment and Alzheimer's disease based on the pathogenesis and treatment hypothesis for mild cognitive impairment and Alzheimer's disease (steps S810 and S820 in FIG. 8 ) and FIG. 5 are detailed descriptions of the process.
- step S910 first, pathogenesis and treatment hypotheses for mild cognitive impairment and Alzheimer's disease may be input.
- the pathogenesis and treatment hypothesis of mild cognitive impairment and Alzheimer's disease may be derived in advance through literature review and expert review of systematic clinical trials for mild cognitive impairment and Alzheimer's disease, as described above.
- the neurohumoral factors of mild cognitive impairment and Alzheimer's disease predicted through step S920 are derived from steroid sex hormones, IGF2, wnt/b-catenin, BAG1, CREB, inflammatory factors, adrenocortical steroid hormones, neurohormones, etc. can be Since these neurohumoral factors have been described in detail with reference to FIG. 5 , detailed descriptions thereof will be omitted.
- a digital therapeutic module may be generated by corresponding virtual parameters to predicted neurohumoral factors.
- the virtual parameter serves as a converter that converts the neurohumoral factor of mild cognitive impairment and Alzheimer's disease into a digital therapeutic module, and as shown in FIG. It is the process of establishing a physiological relationship.
- a detailed digital task may be generated based on the generated digital therapeutic module ( S940 ).
- the specific digital task may be generated by the performance environment setting, lifestyle, learning, exercise, and affirmation/achievement modules described with reference to FIGS. 7A to 7E .
- FIG. 10 is a flowchart illustrating repetitively performing an operation according to feedback control in a digital application for suppression and treatment of amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- step S1020 the digital task creation and performance result collection by the application for the treatment of mild cognitive impairment and Alzheimer's disease are performed N times.
- the pathogenesis and treatment hypothesis of mild cognitive impairment and Alzheimer's disease may be input (S1010).
- the digital task and performance result data provided in the previous round S1020. If the currently being performed is the first, step S1020 may be omitted because there is no previous data.
- a digital task for the current session may be generated based on the input pathogenesis and treatment hypothesis, the digital task provided in the previous session, and performance result data (S1030). Then, the user's performance results for the generated digital task may be collected (S1040).
- step S1050 it is determined whether the current round is N times or more. If the current number of times is less than N times (NO), the process may return to step S1020 and repeat steps S1020 to S1040. On the other hand, when the current number of times is N times or more (YES), that is, when the digital task creation and execution result collection process is performed N times, the feedback operation may be terminated.
- FIG. 11 is a diagram illustrating a hardware configuration of a digital device for suppressing and treating amnesia-type mild cognitive impairment and Alzheimer's disease according to an embodiment of the present invention.
- hardware 600 of a digital device for treating mild cognitive impairment and Alzheimer's disease includes a CPU 610, a memory 620, an input/output I/F 630, and a communication device.
- I/F 640 may be included.
- the CPU 610 executes a digital program for treating mild cognitive impairment and Alzheimer's disease stored in the memory 620, and processes various data for digital mild cognitive impairment and Alzheimer's disease treatment, and digital mild cognitive impairment and Alzheimer's disease. It may be a processor that performs functions related to treatment. That is, the CPU 610 may execute the digital program for the treatment of mild cognitive impairment and Alzheimer's disease stored in the memory 620 to perform the functions of each configuration shown in FIG. 2 .
- the memory 620 may store a digital program for treating mild cognitive impairment and Alzheimer's disease.
- the memory 620 stores data used for the treatment of digital mild cognitive impairment and Alzheimer's disease included in the aforementioned database 050, for example, the patient's digital task, task performance result, and patient's medical information. may include
- a plurality of such memories 620 may be provided as needed.
- the memory 620 may be a volatile memory or a non-volatile memory.
- RAM random access memory
- DRAM dynamic random access memory
- SRAM static random access memory
- non-volatile memory ROM, PROM, EAROM, EPROM, EEPROM, flash memory, or the like may be used. Examples of the above-listed memories 620 are merely examples and are not limited to these examples.
- the input/output I/F 630 is an interface that connects between an input device (not shown) such as a keyboard, mouse, and touch panel, and an output device, such as a display (not shown), and the CPU 610 to transmit and receive data. can provide an input device (not shown) such as a keyboard, mouse, and touch panel, and an output device, such as a display (not shown), and the CPU 610 to transmit and receive data. can provide an input device (not shown) such as a keyboard, mouse, and touch panel, and an output device, such as a display (not shown), and the CPU 610 to transmit and receive data. can provide
- the communication I/F 640 is a configuration capable of transmitting and receiving various data with a server, and may be various devices capable of supporting wired or wireless communication. For example, it is possible to receive various data related to the above-described digital behavior-based treatment from an external server provided separately through the communication I/F 640 .
- the computer program according to an embodiment of the present invention is recorded in the memory 620 and processed by the CPU 610, so that it may be implemented as a module that performs each functional block shown in FIG. 2, for example. have.
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Abstract
Description
Claims (20)
- 경도 인지 장애(mild cognitive impairment, MCI) 및/또는 치매(dementia)에 대한 발병 기전(mechanism of action, MOA)과 치료 가설(hypothesis)에 기초하여, 상기 경도 인지 장애와 상기 치매의 치료를 위한 디지털 치료제 모듈을 생성하고, 그 디지털 치료제 모듈에 기초하여 구체화된 디지털 과제를 생성하고, 상기 디지털 과제를 제1 사용자에게 제공하는 디지털 과제 생성부; 및상기 디지털 과제에 대한 상기 제1 사용자의 수행 결과를 수집하는 결과 수집부를 포함하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 1에 있어서,상기 디지털 과제 생성부는 상기 경도 인지 장애 및/또는 치매에 대한 신경체액적 요인에 기초하여 상기 디지털 치료제 모듈을 생성하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 2에 있어서,상기 신경체액적 요인에는 스테로이드 성호르몬(sex steroid hormone), IGF-2(insulin-like growth factor-2), wnt/b-catenin, BAG1, CREB(cAMP response element-binding protein), 염증 인자(inflammation factors), 부신피질 스테로이드 호르몬(corticosteroids), 신경 호르몬 중 적어도 하나 이상이 포함되고,상기 부신피질 스테로이드 호르몬은 코르티졸(cortisol), 글루코코르티코이드(glucocorticoid)를 포함하고,상기 신경 호르몬은 도파민(dopamine), 노르아드레날린(noradrenaline), 소마토스타틴(somatostatin)을 포함하는, 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 1에 있어서,상기 디지털 과제 생성부는 제2 사용자로부터의 입력에 기초하여 상기 디지털 치료제 모듈을 생성하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 1에 있어서,상기 디지털 과제 생성부는 상기 제1 사용자로부터 수신한 정보에 기초하여 상기 디지털 치료제 모듈을 생성하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 5에 있어서,상기 제1 사용자로부터 수신한 정보는 상기 제1 사용자의 기저 요인, 의료 정보 및 디지털 치료제 이해능력 중 적어도 어느 하나를 포함하며,상기 기저 요인은 상기 제1 사용자의 활동량(activity), 심박수, 수면 및 식사(영양과 열량)를 포함하고,상기 의료 정보는 상기 제1 사용자의 EMR(electronic medical record), 가족력, 유전적 취약성(genetic vulnerability) 및 유전적 감수성(genetic susceptibility)을 포함하고,상기 디지털 치료제 이해능력은 디지털 치료제 및 장치에 관한 상기 제1 사용자의 접근성과 수용자세를 포함하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 1에 있어서,상기 디지털 과제 생성부는 상기 경도 인지 장애와 상기 치매에 대한 발병 기전과 치료 가설에 대해 가상 매개변수를 적용하여 상기 디지털 치료제 모듈을 생성하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 7에 있어서,상기 가상 매개변수는 상기 제1 사용자의 해마(hippocampus)에서의 신경 재생(neurogenesis), 항염증(anti-inflammation), 항스트레스(anti-stress) 및 항우울증(anit-depression) 중 적어도 하나에 관하여 도출되는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 1에 있어서,상기 디지털 과제 생성부는 수행 환경 설정, 라이프 스타일, 학습, 운동 및 긍정·성취 중 적어도 하나에 대응하는 디지털 치료제 모듈과 해당 디지털 과제를 생성하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 9에 있어서,상기 수행 환경 설정에 대한 디지털 과제는 상기 제1 사용자에 대한 밝기 환경 설정, 앱 환경 설정과, 장소 설정을 통해 친근하고 편안한 과제 수행 환경을 제공하는 것을 포함하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 9에 있어서,상기 라이프 스타일에 대한 디지털 과제는 상기 제1 사용자에 대한 새로운 경험 및 여행 제공, 성호르몬 균형 회복 중 적어도 하나를 포함하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 9에 있어서,상기 학습에 대한 디지털 과제는 상기 제1 사용자의 연상 학습, 기억 인지 치료 중 적어도 하나를 포함하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 9에 있어서,상기 운동에 대한 디지털 과제는 상기 제1 사용자의 미리 설정된 시간 동안의 급성 운동을 포함하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 9에 있어서,상기 긍정·성취에 대한 디지털 과제는 상기 제1 사용자에 대한 과업 성취 과제 제공, 임무 부여 및 자발적 참여 유도 중 적어도 하나를 포함하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 1에 있어서,상기 결과 수집부는 상기 디지털 과제에 대한 상기 제1 사용자의 준수도를 모니터링 하거나, 상기 디지털 과제에 대해 상기 제1 사용자가 직접 입력하도록 함으로써 상기 디지털 과제에 대한 수행 결과를 수집하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 청구항 1에 있어서,상기 디지털 과제 생성부에 의한 상기 디지털 과제의 생성과 상기 결과 수집부에 의한 상기 제1 사용자의 상기 디지털 과제 수행 결과의 수집은 피드백 루프에 따라 복수 회 반복하여 수행되며,상기 디지털 과제 생성부는 이전 회 차에서 제공된 상기 제1 사용자의 디지털 과제와 상기 결과 수집부에 의해 수집된 상기 제1 사용자의 상기 디지털 과제에 대한 수행 결과 데이터에 기초하여 현재 회 차에 대한 상기 제1 사용자의 디지털 과제를 생성하는 경도 인지 장애 및 치매 치료를 위한 디지털 장치.
- 경도 인지 장애와 치매에 대한 발병 기전과 치료 가설에 기초하여 상기 경도 인지 장애와 상기 치매의 치료를 위한 디지털 치료제 모듈을 생성하는 단계;상기 디지털 치료제 모듈에 기초하여 구체화된 디지털 과제를 생성하는 단계;상기 디지털 과제를 제1 사용자에게 제공하는 단계; 및상기 디지털 과제에 대한 상기 제1 사용자의 수행 결과를 수집하는 단계를 포함하는 동작을 컴퓨팅 장치로 하여금 수행하도록 하는 컴퓨터 판독 가능 매체에 저장된 경도 인지 장애 및 치매 치료를 위한 디지털 애플리케이션.
- 청구항 17에 있어서,상기 디지털 치료제 모듈을 생성하는 단계는 상기 경도 인지 장애와 상기 치매에 대한 신경체액적 요인에 기초하여 상기 디지털 치료제 모듈을 생성하는 것인 컴퓨터 판독 가능 매체에 저장된 경도 인지 장애 및 치매 치료를 위한 디지털 애플리케이션.
- 청구항 17에 있어서,상기 디지털 치료제 모듈을 생성하는 단계는 상기 경도 인지 장애 및/또는 상기 치매에 대한 발병 기전과 치료 가설에 대해 상기 제1 사용자의 해마에서의 신경 재생, 항염증, 항스트레스 및 항우울증 중 적어도 하나에 관한 가상 매개변수를 적용하여 상기 디지털 치료제 모듈을 생성하는 것인 컴퓨터 판독 가능 매체에 저장된 경도 인지 장애 및 치매 치료를 위한 디지털 애플리케이션.
- 청구항 17에 있어서,상기 디지털 과제를 생성하는 단계는 수행 환경 설정, 라이프 스타일, 학습, 운동 및 긍정·성취 중 적어도 하나에 대한 디지털 과제를 생성하는 것인 컴퓨터 판독 가능 매체에 저장된 경도 인지 장애 및 치매 치료를 위한 디지털 애플리케이션.
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