Hospital launches remote monitoring intervention for neurology patients

MedTech News: Deep brain stimulation (DBS) has advanced treatment options for a variety of neurologic and neuropsychiatric conditions including Parkinson’s Disease, essential tremor and dystonia.

Hollywood Private Hospital neurologist Dr Julian Rodrigues and neurosurgeon A/Prof Steve Lewis are at the forefront of adopting the latest technological innovations such as intraoperative CT (computed tomography), remote brain stimulator programming and directional DBS, now with sensing capability.

DBS requires surgery to implant a medical device – a neurostimulator – that sends electrical signals to areas of the brain responsible for movement. The three DBS system manufacturers are Medtronic, Abbott (formerly St. Jude Medical) and Boston Scientific.

From 1 November 2022, a new MBS item was introduced to fund the remote programming of DBS for Parkinson’s disease, essential tremor and dystonia. Remote DBS programming has become especially relevant in the setting of the COVID-19 pandemic when telemedicine technologies underwent rapid expansion to safely deliver healthcare.

According to Abbott Medical, Australia is the first country in the world to reimburse clinicians fully for remote therapy at the same level as in person.

Hollywood is the only site in WA using remote programming of DBS, which allows Dr Rodrigues to assess patients over live video and adjust their implanted DBS device for better symptom control. 

“I can offer treatment to patients living 20 km away, or over 2000 km away, from the comfort of their own home. It’s a Godsend for movement-impaired patients who sometimes struggle to attend regular appointments.”

Research has found that the remote programming of DBS can be beneficial, useful and help reduce the issue of distance for access to healthcare.

In a study funded by Abbott and published in 2022, results revealed that more than a third of Parkinson’s Disease (PD) patients cannot easily get to a clinic for various reasons, and more than a quarter reported difficulty contacting their clinic for advice. There was overall satisfaction with the DBS remote programming telehealth interface and the majority of patients reported that remote tele-programming visits are similar in quality to in-person visits.

In 2017, Hollywood was the first hospital in WA to implant a directional DBS lead system which enables stimulation of minute areas of the brain more precisely. 

The benefits of directional DBS can include reduction in side effects from overstimulation and better symptom control.

“It essentially downloads brain signals. By interpreting these signals, I am hopeful we can predict more specifically where to stimulate, reducing the trial and error aspect. The data collecting capabilities of DBS recordings have exciting prospects in terms of analysing abnormal brain rhythms and developing automated treatment algorithms using AI [artificial intelligence],” Dr Rodrigues said. 

Scientists predict DBS recordings could shape future therapeutics, including the ongoing development of adaptive and intuitive DBS.

Hollywood Director of Medical Services, John Maxwell, said it is a priority for the hospital to offer novel technologies to help improve patient outcomes.

“We are thrilled to support our neurologists as they embrace new techniques and medical innovations,” Dr Maxwell said.

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