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Bridge-Disease Curriculum Transfer Enables Smartphone-Based Balance Assessment in Rare Neurologic Disorders

Eran Bamani (Massachusetts Institute of Technology), Joao Buzzatto (Massachusetts Institute of Technology), Fangqiang Ding (Massachusetts Institute of Technology), David G. Bonilla (Massachusetts Institute of Technology), Natalie E. Stec (Massachusetts Institute of Technology), Anna Hauswirth (Massachusetts Institute of Technology), Solmon Jeong (Massachusetts Institute of Technology), Taya Hamilton (The University of Western Australia), Scott Randall Plotkin (Massachusetts General Hospital), Hermano Igo Krebs (Massachusetts Institute of Technology)

IEEE Transactions on Neural Systems and Rehabilitation Engineering
DOI: 10.1109/tnsre.2026.3732658 (Health Professions)
License: CC BY

Abstract: Video-based motor assessment could enable scalable assessment of neurological function, but rare-disease applications are constrained by extreme data scarcity and poor generalization from small cohorts. We develop and evaluate a smartphone-based balance-assessment framework in NF2-related schwannomatosis (NF2-SWN), an ultra-rare disorder for which objective balance assessment is clinically valuable yet logistically challenging. At its core, a staged bridge-disease curriculum adapts a skeleton-based spatiotemporal graph model from large-scale action recognition through an intermediate Parkinson's disease domain to the target NF2-SWN cohort ( ${N}={19}$ ), decomposing one large domain shift into two more learnable transitions under leakage-proof, subject-independent evaluation. Three clinically motivated modules, bilateral asymmetry gating, temporal phase attention, and anatomical group saliency, yield interpretable, clinician-facing outputs aligned with balance assessment. Relative to direct transfer, bridge-disease transfer reduces patient-level prediction error by 40% on the Mini-BESTest total score, narrows the gap toward inter-rater agreement, and yields well-calibrated fall-risk stratification. A robustness analysis quantifies sensitivity to simulated acquisition variability, supporting a pragmatic smartphone recording protocol. Together, these results support the feasibility of privacy-preserving video-based balance assessment in NF2-SWN under extreme data scarcity.

Published on 01 Jan. 2026