Article

Emerging Tech for Patients with Neurological Conditions

Technology that is efficient yet lacking side effects, personalized, and nonintrusive may be closer than we think for many of our neurology patients.

Modern medicine continues to perfect traditional approaches (pharmaceutics and surgery) while exploring incredible new ways to improve human health. Several emerging technologies deserve a mention for approaching common neurological conditions from uncommon perspectives.

A new sensor is being developed in San Antonio, TX by Jose Cavazos, MD, PhD, and colleagues, for people with epilepsy who have generalized tonic-clonic (GTC) seizures. Brain Sentinel® GTC Seizure Detection and Warning System has several components. A detector that adheres to the forearm skin near the bicep muscle continuously monitors surface electromyography data and analyzes it in real time. The detector then sends a signal wirelessly to a laptop that receives data and stores it online; a physician can access these data remotely. The system is intended for the ambulatory use. It allows patients to carry out daily activities as usual and alerts caregivers when GTC seizures are detected. The algorithm of seizure detection used by the system has been proven rather sensitive: it detected 95% of seizure episodes identified by videomonitoring of electroencephalogram.1 The technology is currently being evaluated in an ongoing phase III clinical trial.

Holst Centre, a European industry-academia partnership, is concurrently developing a technology with a similar functionality. HealthPatch is a small device that attaches to the chest and tracks heart activity (electrocardiogram), impedance, and body movement. Similarly to the Brain Sentinel®, it sends a signal wirelessly to a receiving device, a smartphone, for example. The data are then monitored for unusual cardiac signatures or physical activity, such as falls. Many people can be monitored simultaneously, which makes the technology suitable for use in hospitals and elder care facilities. In an attempt to integrate this technology into the daily life of someone at risk of a cardiovascular event or fall, the developers are designing the device to be flexible, washable, long lasting, and cost effective.2

[[{"type":"media","view_mode":"media_crop","fid":"46465","attributes":{"alt":"SEM™ Glove. Copyright Bioservo Technologies AB","class":"media-image media-image-right","id":"media_crop_5242982008374","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5389","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"width: 350px; height: 247px; float: right;","title":"SEM™ Glove. Copyright Bioservo Technologies AB","typeof":"foaf:Image"}}]]Indeed, a technology that is integrated, virtually unnoticeable – wearable, for instance – can greatly improve the life of someone with a disability or neurological condition. The SEM Glove is one of such products. The glove helps overcome hand weakness, which develops as a result of stroke, injury, or aging and affects millions of people around the world. An aid for those who need a stronger grip to carry out daily activities, the glove uses patented non-invasive SEM (soft extra muscle) technology.3 As the technology allows adjustments of grip strength, the glove can be customized to serve individual user’s needs. One of the users with hand weakness and spasticity found the glove particularly helpful, as it allowed him to use his weak hand but also helped relax spastic muscles. An updated version of the glove released in summer of 2015 makes it easier to use with a wheelchair.4 The glove is manufactured and distributed by Bioservo in Sweden.

GyroGear, a company based in Great Britain, is developing another glove, GyroGlove, which can help overcome hand tremor. The glove is coupled to gyroscopes, spinning disks that counter any force in an attempt to remain upright. A companion app allows tracking of progress in tremor reduction and sharing of these data with caregivers and health care providers. According to the manufacturer’s website, the technology, inspired by aerospace engineering, reduces tremors by >80%.5 GyroGlove is currently available to volunteer testers only, but it has a potential to help many people to overcome parkinsonian or other tremors.

[[{"type":"media","view_mode":"media_crop","fid":"46467","attributes":{"alt":"Path Feel. Copyright Walk with Path","class":"media-image media-image-right","id":"media_crop_5890590072635","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5390","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"width: 350px; height: 233px; float: right;","title":" Path Feel. Copyright Walk with Path","typeof":"foaf:Image"}}]]In the meantime, another group of British entrepreneurs is approaching the problem from the other end. To improve quality of life of patients with Parkinson disease, multiple sclerosis, or other conditions that affect walking, they are developing two products: Path Feel, a vibrating shoe insole, and Path Finder, a laser emitting shoe.6 Path Feel helps individuals with a sensory deficit to feel the floor better by providing active feedback in the form of vibration. Vibration also helps these individuals initiate movements. The insoles can collect data about the wearer, which can be used to better understand daily habits and needs in this population. Path Finder is a shoe that helps with foot movement and gait by providing the wearer with visual cues; this feature makes it especially helpful to people who suffer from freezing of gait. Early trials of this technology have had very encouraging results.

[[{"type":"media","view_mode":"media_crop","fid":"46468","attributes":{"alt":"Path Finder. Copyright Walk with Path","class":"media-image media-image-right","id":"media_crop_1287007942939","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5391","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"width: 350px; height: 197px; float: right;","title":" Path Finder. Copyright Walk with Path","typeof":"foaf:Image"}}]]Imagine medical technology that is efficient yet lacking side effects, fully personalized, and nonintrusive. Seems like something that belongs in the future? It may be closer than we think.

References:

1. Szabó CÁ, et al. Electromyography-based seizure detector: Preliminary results comparing a generalized tonic-clonic seizure detection algorithm to video-EEG recordings. Epilepsia. 2015;56(9):1432-1437.

2. Holst Centre in The Netherlands: Developing Smart Sensors and Flexible Electronics for Clinical Care. MedGadget Web site. http://www.medgadget.com/2015/12/holst-centre-netherlands-developing-smart-sensors-flexible-electronics-clinical-care.html. Published December 16, 2015. Accessed February 23, 2016.

3. The SEM Technology. Bioservo Web site. http://bioservo.com/en/the-sem-technology/sem-glove/. Accessed February 23, 2016.

4. New strength for weak grip [press release]. Sweden, Stockholm: Bioservo; June 15, 2015 http://bioservo.com/en/2015/06/15/press-release-stockholm-june-15-2015-new-strength-for-weak-grip/. Accessed February 23, 2016.

5. GyroGlove. GyroGear Web site http://gyrogear.co/gyroglove/. Accessed February 23, 2016.

6. Products. Walk with Path Web site. http://www.walkwithpath.com/#!products/ctzx. Accessed February 23, 2016.

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Cheryl D. Bushnell, MD, MHS, FAHA
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