# Daily locomotor activity declines with tumor growth and disease progression in glioblastoma

## TL;DR

Tracking daily activity with wearable devices can detect glioblastoma progression earlier than MRI scans, offering a non-invasive monitoring tool.

## Contribution

Daily locomotor activity is shown to decline with tumor growth and disease progression in glioblastoma, offering a novel real-time monitoring approach.

## Key findings

- Wheel-running activity in GBM-bearing mice declined with tumor growth and preceded weight loss and circadian breakdown.
- Temozolomide treatment in the morning reduced tumor size and restored locomotion in mice.
- Daily activity in patients declined before MRI-detected progression in some cases, suggesting early detection potential.

## Abstract

Glioblastoma (GBM) is an aggressive brain tumor that often progresses despite resection and treatment. Timely and continuous assessment of GBM progression is critical to expedite secondary surgery or enrollment in clinical trials. However, current progression detection requires costly and specialized MRI examinations, which, in the absence of new symptoms or signs, are usually scheduled every 2–3 months. Here, we hypothesized that changes in daily activity are associated with GBM growth and disease progression. We found that wheel-running activity in GBM-bearing mice declined as tumors grew and preceded weight loss and circadian breakdown by over a week. Temozolomide treatment in the morning, but not evening, significantly reduced tumor size and restored daily locomotion in mice. In a pilot study of 6 patients with GBM wearing an actigraphy watch, wrist movement provided a feasible and continuous longitudinal indicator of daily activity with 1-minute resolution. After tumor resection and radiation, daily activity declined in 2 patients 19 and 55 days before detection of progression by MRI but did not change for the 4 patients with stable disease. These results suggest that daily activity tracking using wearable devices may serve as a real-time indicator and potential monitoring tool for GBM progression and treatment efficacy.

Monitoring daily activity correlates with glioblastoma growth and enables earlier progression detection, offering a real-time, non-invasive monitoring tool for glioblastoma progression to advise timely interventions.