Consumer-grade wearables offer promising opportunities for remote patient monitoring (RPM) in neurological disorders, yet their clinical application remains uncertain. In this exploratory analysis, we draw on prospective observational trials using smartwatches in patients with multiple sclerosis, myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, and migraine, who were monitored for 6 to 24 months. Through detailed clinical case narratives, we illustrate both the potential and the limitations of RPM in neurology. Wearable-generated data successfully captured early, clinically meaningful changes, such as the onset of a myasthenic exacerbation, and supported patient engagement in identifying individual triggers, including for migraine. However, external influences such as holidays, infections, or mobility aid use confounded activity signals, underscoring the importance of contextual interpretation. While wearables can enhance neurological care, their integration into clinical workflows is challenged by limited validation and interpretability. Realising their potential requires robust validation in clinical settings and the development of interoperable RPM platforms supported by close collaboration between clinicians, engineers, and patients.
Keywords: multiple sclerosis; myasthenia gravis; neurology; remote patient monitoring; wearable.
Smartwatches and fitness trackers are increasingly used to monitor health, but how helpful are they for people with neurological conditions? In this study, we followed patients with multiple sclerosis, myasthenia gravis, chronic inflammatory polyneuropathy, and migraine for up to two years using everyday wearables. By looking at real-life cases, we found that these devices can detect important changes in health, such as early signs of worsening symptoms. They also helped some patients better understand their condition and identify possible triggers, like for migraines. However, the data from wearables can be misleading—for example, during vacations, infections, or when using mobility aids—so it’s important to interpret the results carefully. To truly benefit patients, these tools need to be better tested in clinical settings and integrated into easy-to-use systems that support doctors and patients working together.
© The Author(s) 2026.