ORIGINAL RESEARCH article

Front. Neurol.

Sec. Dementia and Neurodegenerative Diseases

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1588992

Reliable Monitoring of Respiratory Function with Home Spirometry in People Living with Amyotrophic Lateral Sclerosis

Provisionally accepted
Julian  PellerJulian Peller1*Marcos  Alberto TrevisanMarcos Alberto Trevisan2,3Gaston  BujiaGaston Bujia1Felipe  AguirreFelipe Aguirre1Diego  Edgar ShalomDiego Edgar Shalom2,3Alan  TaitzAlan Taitz4Stephanie  HenzeStephanie Henze1Silviya  BastolaSilviya Bastola1Jason  OsikJason Osik5Ryan  ShewcraftRyan Shewcraft5Peng  JiangPeng Jiang5Joel  SchwartzJoel Schwartz5Terry  Heiman-PattersonTerry Heiman-Patterson6Michael  ShermanMichael Sherman7Matthew  F WippermanMatthew F Wipperman8Oren  LevyOren Levy8Guofa  ShouGuofa Shou9Karl  SillayKarl Sillay1Lyle  OstrowLyle Ostrow6Ernest  FraenkelErnest Fraenkel10James  BerryJames Berry11Indu  Navar BinghamIndu Navar Bingham1Esteban  RoitbergEsteban Roitberg1,12
  • 1EverythingALS, Seattle, California, United States
  • 2Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Física., Buenos Aires, Argentina
  • 3CONICET - Universidad de Buenos Aires, Instituto de Física Interdisciplinaria y Aplicada (INFINA), Buenos Aires, Argentina
  • 4SRI International, Menlo Park, California, United States
  • 5Bristol Myers Squibb, Cambridge, United States
  • 6Department of Neurology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
  • 7Department of Medicine, MCG-Hearst Health, Drexel University College of Medicine, Philadelphia, United States
  • 8Regeneron Pharmaceuticals, Inc., Tarrytown, New York, United States
  • 9Eli Lilly and Company, Boston, United States
  • 10Department of Biological Engineering, School of Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
  • 11Sean M. Healey and AMG Center for ALS, Massachusetts General Hospital & Harvard Medical Schoo, Boston, United States
  • 12Escuela de Ciencia y Tecnología, Universidad Nacional de General San Martín, Buenos Aires, Buenos Aires, Argentina

The final, formatted version of the article will be published soon.

Monitoring respiratory function is essential for assessing the progression of Amyotrophic Lateral Sclerosis (ALS) and planning interventions. Using spirometry data from the Radcliff Study (a fully remote, longitudinal, exploratory study with a cohort of 67 pALS) we demonstrate that flexible coaching, combined with a quality control analysis that excludes values of `0' and timepoints with failed measurement trials, produces consistent remote spirometry results. Our findings indicate that home-measured Slow Vital Capacity (SVC) and Forced Vital Capacity (FVC) evolve similarly and progress linearly over the study period (7.7 ± months). This remains true in both slow and fast progressor subpopulations. This observed linearity in respiratory trajectories supports the potential for early, accurate estimation of progression, reinforcing the feasibility of less frequent monitoring without compromising assessment precision, and reducing the burden on both pALS and the healthcare system. Furthermore, our results align with reported in-clinic pulmonary tests, validating remote monitoring as a means to promote more equitable and accessible clinical trial designs.

Keywords: Home spirometry, Amyotrofic Lateral Sclerosis (ALS), pulmonary function test, Proctoring, Telemedicine

Received: 06 Mar 2025; Accepted: 26 May 2025.

Copyright: © 2025 Peller, Trevisan, Bujia, Aguirre, Shalom, Taitz, Henze, Bastola, Osik, Shewcraft, Jiang, Schwartz, Heiman-Patterson, Sherman, Wipperman, Levy, Shou, Sillay, Ostrow, Fraenkel, Berry, Navar Bingham and Roitberg. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Julian Peller, EverythingALS, Seattle, California, United States

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.