Robot allows 'remote presence' in programming brain and spine stimulators

Technology can help increase access to experts as use of neuromodulation grows, suggests Neurosurgery

2013-01-16

(Press-News.org) Philadelphia, Pa. (January 16, 2013) – With the rapidly expanding use of brain and spinal cord stimulation therapy (neuromodulation), new "remote presence" technologies may help to meet the demand for experts to perform stimulator programming, reports a study in the January issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The preliminary study by Dr. Ivar Mendez of Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, Canada, supports the feasibility and safety of using a remote presence robot—called the "RP-7"—to increase access to specialists qualified to program the brain and spine stimulators used in neuromodulation.

Robot Lets Experts Guide Nurses in Programming Stimulators Dr. Mendez and his group developed the RP-7 as a way of allowing experts to "telementor" nonexpert nurses in programming stimulator devices. Already widely used for Parkinson's disease and severe chronic pain, neuromodulation is being explored for use in other conditions, such as epilepsy, severe depression, and obsessive-compulsive disorder.

In this form of therapy, a small electrode is surgically placed in a precise location in the brain or spine. A mild electrical current is delivered to stimulate that area, with the goal of interrupting abnormal activity. As more patients undergo brain and spine stimulation therapy, there's a growing demand for experts to program the stimulators that generate the electrical current.

The RP-7 is a mobile, battery-powered robot that can be controlled using a laptop computer. It is equipped with digital cameras and microphones, allowing the expert, nurse, and patient to communicate. The robot's "head" consists of a flat-screen monitor that displays the face of the expert operator.

The RP-7 also has an "arm" equipped with a touch-screen programmer, which the nurse can use to program the stimulator. The expert can "telestrate" to indicate to the nurse the correct buttons to push on the programming device.

Access to Specialists in the Next Room—or Miles Away In the preliminary study, patients with neuromodulation devices were randomly assigned to conventional programming, with the expert in the room; or remote programming, with the expert using the RP-7 to guide a nurse in programming the stimulator. For the study, the expert operators were simply in another room of the same building. However, since the RP-7 operates over a conventional wireless connection, the expert can be anyplace that has Internet access.

On analysis of 20 patients (10 in each group), there was no significant difference in the accuracy or clinical outcomes of remote-presence versus conventional programming. No adverse events occurred with either type of session.

The remote-presence sessions took a little more time: 33 versus 26 minutes, on average. Patients, experts, and nonexpert nurses all gave high satisfaction scores for the programming experience.

"This study demonstrated that remote presence can be used for point-of-care programming of neuromodulation devices," Dr. Mendez and coauthors write. The study provides "proof of principle" that the RP-7 or similar devices can help to meet the need for experts needed to serve the rapidly expanding number of patients with neuromodulation therapies.

The researchers have also started a pilot study using a new mobile device, called the RP-Xpress. About the size of a small suitcase, the RP-Xpress is being used to perform long-distance home visits for patients living hundreds of miles away, using existing local cell phone networks. Dr. Mendez and colleagues conclude, "We envision a time, in the near future, when patients with implanted neuromodulation devices will have real-time access to an expert clinician from the comfort of their own home."

### About Neurosurgery Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.

About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion). END

ELSE PRESS RELEASES FROM THIS DATE:

Breast Cancer Message Board study finds frequent discussion of drug side effects, stopping therapy

2013-01-16

PHILADELPHIA -- In the first study to examine discussion of drug side effects on Internet message boards, researchers from the Perelman School of Medicine at the University of Pennsylvania found that breast cancer survivors taking the commonly prescribed adjuvant therapy known as aromatase inhibitors (AIs) often detailed in these forums troublesome symptoms resulting from the drugs, and they were apt to report discontinuing the treatment or switching to a different drug in the same class. The findings are published online this week in the journal Pharmacoepidemiology and ...

Sustainable reinforcement for concrete has newly discovered benefits

2013-01-16

Fashionable people may turn up their noses at jute — the cheap fiber used to make burlap, gunny sacks, twine and other common products — but new research is enhancing jute's appeal as an inexpensive, sustainable reinforcement for mortar and concrete. The study appears in ACS' journal Industrial & Engineering Chemistry Research. Subhasish B Majumder and colleagues note that there has been a resurgence of interest in using economical, sustainable natural fibers, rather than steel or synthetic fibers, to reinforce the cement compositions used to make concrete and mortar, ...

Development of the first way to make large amounts of promising anti-cancer substance

2013-01-16

Scientists are reporting development of the first practical way to make large amounts of a promising new anti-cancer substance that kills cancer cells differently than existing medicines. Their article on synthesis of the substance, and tests demonstrating its effectiveness in the laboratory, appears in ACS' Journal of Medicinal Chemistry. Isamu Shiina and colleagues explain that the substance, AMF-26, showed promise against certain forms of cancer in laboratory studies, fostering excitement about its potential for development as a new anti-cancer drug. That excitement ...

Attempts to correct 'death panel' myth may backfire

2013-01-16

Philadelphia, Pa. (January 16, 2012) – Efforts to correct false beliefs about health care reform may backfire, depending on individuals' political views and level of knowledge, suggests a study in the February issue of Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. In the study, more politically knowledgeable people with positive views of Sarah Palin were likely to harden their opposition to the Affordable Care Act (ACA) when presented with information debunking Palin's "death panel" claim, according to the study ...

New biomarker may help in detecting gliomas, reports Neurosurgery

2013-01-16

Philadelphia, Pa. (January 16, 2013) – Researchers using sophisticated genetic testing techniques have identified a promising new biomarker for diagnosis of glioma—the most common type of malignant brain tumor, reports the January issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. The biomarker ELTD1 "may serve as an additional biomarker for gliomas in preclinical and clinical diagnosis of gliomas," according to the study by Rheal A. Towner of Oklahoma ...

Promising new finding for therapies to treat persistent seizures in epileptic patients

2013-01-16

LOS ANGELES (Jan. 16, 2013) – In a promising finding for epileptic patients suffering from persistent seizures known as status epilepticus, researchers reported today that new medication could help halt these devastating seizures. To do so, it would have to work directly to antagonize NMDA receptors, the predominant molecular device for controlling synaptic activity and memory function in the brain. "Despite the development of new medications to prevent seizures, status epilepticus remains a life-threatening condition that can cause extensive brain damage in the patients ...

Using snail teeth to improve solar cells and batteries

2013-01-16

RIVERSIDE, Calif. (www.ucr.edu) — An assistant professor at the University of California, Riverside's Bourns College of Engineering is using the teeth of a marine snail found off the coast of California to create less costly and more efficient nanoscale materials to improve solar cells and lithium-ion batteries. The most recent findings by David Kisailus, an assistant professor of chemical and environmental engineering, details how the teeth of chiton grow. The paper was published today (Jan. 16) in the journal Advanced Functional Materials. It was co-authored by several ...

Developed new method to diagnose hereditary breast and ovarian cancer

2013-01-16

Researchers of the Catalan Institute of Oncology (ICO) at the Bellvitge Biomedical Research Institute (IDIBELL) have developed and validated a new method to diagnose hereditary breast and ovarian cancer syndrome based on mass sequencing of BRCA1 and BRCA2 genes. The model is based on a genetic and bioinformatic analysis which has been proved very effective. The new protocol has been described in an article published in the European Journal of Human Genetics. In recent years, new advances in sequencing techniques have involved the development of new platforms for nucleic ...

Dynamic Motivational Author, Speaker & Veteran Deborah L. Parker Keynotes Leesburg Virginia's Martin Luther King March & Program, "Moving the Dream Forward For All of Us" January 21

2013-01-16

Deborah L. Parker remembers the evening of April 4, 1968. In her rural Waverly Virginia home with no indoor plumbing, on the way to the laundromat with her mother, it seemed as if the world stopped. The headline of the evening news: Dr. Martin Luther King Jr. has been assassinated. What happens to the dream? Deborah wondered. She was poor, black, and a good student in a segregated Sussex County. Her mother was a single parent of four and they lived with her maternal grandparents in a shotgun style house on a wooded back road. But her mother was determined and her grandparents ...

Migraine with aura may lead to heart attack, blood clots for women

2013-01-16

SAN DIEGO – Women who have migraines with aura, which are often visual disturbances such as flashing lights, may be more likely to have problems with their heart and blood vessels, and those on newer contraceptives may be at higher risk for blood clots, according to two studies released today that will be presented at the American Academy of Neurology's 65th Annual Meeting in San Diego, March 16 to 23, 2013. The first study showed that migraine with aura is a strong contributor to the development of major cardiovascular events such as heart attack and stroke. The Women's ...

Robot allows 'remote presence' in programming brain and spine stimulators

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: