Neuromodulation is one of the most exciting trends in neurosurgery and neurology. According to the North American Neuromodulation Society: “By definition, neuromodulation is a therapeutic alteration of activity either through stimulation or medication, both of which are introduced by implanted devices.” It includes techniques such as deep brain stimulation (DBS), spinal stimulation therapies, and drug delivery devices. These therapies have been a boon for patients with intractable diseases such as Parkinson’s, bipolar disorder, pain, incontinence, and gastroparesis.
One of the downsides of neuromodulation is that stimulation adjustment can only be done by those with considerable expertise. This is an issue since neuromodulation therapies are widely expanding, requiring more and more practitioners to be familiar with the technique to meet patient demand. Now, researchers at the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, Canada, have used a remote presence robot, called the RP-7, to increase access to specialists qualified to program the brain and spine stimulators used in neuromodulation. Led by Dr. Ivar Mendez, the researchers published their findings in the January issue of Neurosurgery.
The benefit of the robot was to allow expert nurses to teleconference with nonexpert nurses on how to operate the devices. These remote sessions, compared to standard sessions without the robot, showed no difference in the accuracy or clinical outcomes of programming and had higher user satisfaction. However, the remote sessions did take slightly longer to than normal sessions – 33 minutes vs 26 minutes
According to a press release:
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.
Original article in Neurosurgery: Point-of-Care Programming for Neuromodulation: A Feasibility Study Using Remote Presence