Telepresence robot helps program brain and spine stimulators remotely

January 18, 2013

RP-7  telepresence device (credit: Ivar Mendez et al./Neurosurgery)

With the rapidly expanding use of brain and spinal cord stimulation therapy (neuromodulation), “remote presence” (telepresence) technologies may help to meet the demand for experts to perform stimulator programming, reports a study published in Neurosurgery.

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 telepresence robot (“RP-7″) to increase access to specialists qualified to program the brain and spine stimulators used in neuromodulation.

Neuromodulation

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 then delivered to stimulate that area, with the goal of interrupting abnormal activity.

Neuromodulation programmer (credit: Medtronic)

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 device that can be controlled using a laptop computer. It is equipped with digital cameras and microphones, allowing the expert, nurse, and patient to communicate. A flat-screen monitor that displays the face of the remote 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.

RP-Xpress home telepresence device

In a preliminary study of treating 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 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.

“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,” said Mendez.

Cell phones in a remote area, untrained nurses, kids running around, brain zappers — what could go wrong? (And why can’t the doc just control the programmer device remotely?) — Editor