Smart phone apps for dementia assessment right at a patient’s bedside, self-hypnosis programs from mobile phones when migraines strike, detailed 3-D animation of brain and nerve pathways in therapy planning, consistent use of home videos for greater accuracy in epilepsy diagnosis, and e-learning platforms for initial and continuing training with continual self-improvement routines. These are just a few examples of how innovative IT can be used in neurology for the benefit of patients and physicians. Participants in the Meeting of the European Neurological Society in Prague considered the potential and pitfalls of this technological revolution in neurological practice.
“Modern IT and the smart phone revolution in particular have opened up whole new horizons for neurologists and for neurological patients and their families. These possibilities range from simplified methods for informing and educating patients to reminders to take medicine or self-hypnosis by mobile phone in the case of migraine attacks. Today, neurologists can make quick assessments of their patients’ dementia status by laptop or take epileptic fits documented in home videos into account in diagnosis and therapy.
They are supported in diagnosis by digitalised migraine or epilepsy journals kept by their patients and benefit from the advantages of remote learning programs, which are constantly improved.” Dr Hannah Cock from St George’s University in London reported on all these trends on Monday at the 22nd Meeting of the European Neurological Society (ENS). More than 3,000 experts from around the world are gathering in Prague for this large-scale scientific event. Dr Cock: “Our next step has to be to spread the word on these new options and to integrate them consistently into everyday clinical routines so broad use can be made of these improved methods of diagnosis and therapy.”
Self-therapy and reminders for patients
New smart phone apps are already simplifying patients’ lives today in all kinds of ways. For instance, memory aids such as migraine and epilepsy journals help patients keep exact, up-to-date records on bouts of their diseases. The records, in turn, help physicians to adjust the therapy more precisely. Or there are improved versions of the kind of pill reminder methods that have long been used. The new methods can be programmed to contain complex rules involving a large number of different medicines taken in different cycles of administration-effective protection against over-taxed patients receiving incorrect medication or under-medication.
Migraine patients can now also take along a therapy program with them on their mobile phone. Dr Cock:
“It is a self-hypnosis program called ‘Alleviate Migraine’ from the ‘iCan Hypnosis’ series. It is supposed to catch or alleviate headache attacks in their initial stage. This technology opens up whole new dimensions of use for patients because it can be applied virtually anytime and anywhere.”
Everything for physicians, from dementia diagnosis to patient information
Neurologists benefit in that innovative programs make more and more aspects of their field available in pocket-size form over I-Phone or Android at any time. “For example, standardised grading tools allow a direct assessment of the severity of dementia by having patients perform certain tasks on a touch screen and then rating their performance in real time. Applications such as the Sylvius MR Atlas of the Human Brain, the Nerve Whiz or the ECG Guide help physicians demonstrate to patients where the problem is, or where treatment will be directed,” Dr Cock noted.
“It used to be sometimes difficult to explain a patient for example exactly which bit of the brain needed an operation. Now I can do that vividly and in 3-D with Brain Tutor 3D on my phone or tablet PC, on the ward or in clinic. This is a quantum leap forward in patient education.”
Home video facilitates epilepsy diagnosis
Home videos can be taken almost anywhere now. This option makes the work of neurologists much easier and their treatments more effective. “When family members of patients who, for example, have epilepsy, certain movement disorders or sleep disorders are instructed to record events relating to these maladies we have solved one of our biggest problems, namely, the reliability of these witnesses’ accounts. They often do not know which details of an attack matter to us and in many cases they put their memories to paper a long time after the fact and with a corresponding lack of accuracy,” Dr Cock explained. “We should make our colleagues aware of these possibilities, too, and integrate them into everyday routines with suitable training for family members.”
ebrain Project: Self-learning remote program of study in clinical neurosciences
Among the most significant advantages of the Internet is that information is available independent of location and can be prepared in multimedia form. These advantages are used by the ebrain Project, the most ambitious neuroscience e-learning platform ever. It already has 10,000 registered users, including medical students, doctors in training, and existing specialists in clinical neuroscience fields including neurology, neurosurgery, neuropsychiatry, neurophysiology and more.
Dr Cock: “ebrain is an initiative of the British Joint Neurosciences Council. It is co-funded by ENS and available across Europe. It makes available the entire state of the art in today’s neurosciences, divided into 550 lessons that each take a handy 20 minutes to do.” Dr Cock is one of four clinical leads for the project, together with Prof Simon Shorvon from University College London, Prof Simon Thompsom from Leed Teaching Hospitals NHS Trust and Prof Thomas Berger from Innsbruck Medical University.
Dr Cock: “We are proud of the wealth of multimedia material that presents the technical expertise much more vividly than many pages of instructions could and thus opens the way to a completely new and holistic learning experience. ebrain is more than an electronic text book – with new features such as case of the month, and webinars also being introduced through 2012. Course participants interested in obtaining their electronic certificate for the lessons they have completed are also required to give feedback, which we then use to constantly optimise the program.”