Digital Health:
Applications to Brain Diseases & Disorders
During a time in which healthcare services continue to increase, digital health technologies can provide more cost-effective solutions to both patients and providers. These devices have demonstrated enormous potential in improving the provision of healthcare, as the enormous social and financial costs of brain diseases and disorders continue to exact a toll of billions of dollars.
The market of wearable medical technology is one of the most rapidly growing and advancing sectors in the global marketplace, now comprised of devices that have the potential to alter and enhance lifestyle, provide diagnostic and therapeutic support, and aid in injury prevention. With new evolving and transforming models in healthcare, these devices pave the way for new alternatives to traditional ways that practitioners & providers have collected data, performed diagnostic tests, and interacted with patients.
Now, popular widely-used and accessible consumer devices can potentially deliver molecular-level disease diagnosis and treatment. A smartwatch can collect all the data that intensive care manages; an ultrasound can be done for a fraction of the price with a device that plugs into a smartphone. Hundreds of apps and startups have produced, and are continuing to deliver, massive amounts of data. With the advent and proliferation of this digital technology, it is possible to make more effective and personalized healthcare the new golden standard.
These devices, which once solely focused on one single measurement (the number of steps in a day), now have the capabilities to focus on a variety of bodily measurements: heart rate, blood pressure, breathing, etc. New miniaturized sensors, wireless communication protocols, portability and data transfer abilities, are only a small sampling of the market’s proliferation. Collectively, wireless and wearable medical technologies represent a burgeoning opportunity in healthcare; a 2014 report from Soreon Research linked the emergence of wearables to the beginning of a “deep transformation of the healthcare sector.”
More recently, reviews of evidence and data have indicated that virtual reality (VR) holds potential for rehabilitation of Parkinson’s disease, the neurodegenerative disorder that has historically been managed by a combination of medication and physiotherapy. Virtual reality technology has been proposed as a new and inventive rehabilitation tool, one that can potentially optimize motor learning and replicate real-life scenarios in order to improve functional activities: an immersive, interactive experience generated by a computer.
The study assessed the effect of VR training on gait and balance, in addition to an examination of the effects of VR on motor function, daily living activities, cognitive function, and quality of life. In comparison to physiotherapy, VR demonstrated an improvement in step and stride length and balance, by stimulating movement through computer-based games. The studies further revealed that VR exercise exhibited potential advantages over traditional exercise, as individuals were able to practice in a motivating and engaging environment.
As Parkinson’s disease has significant adverse effects on quality of life and independence, VR interventions may lead to greater improvements than physiotherapy. The idea that technology can effectively curb and treat a disease that impacts millions of people globally in a host of negative and difficult ways is an innovative and exciting breakthrough, which will likely generate further findings and discoveries.
Immersive VR has also been studied for its utilization in stress release and pain reduction for patients with chronic pain, with further applications to addiction and an alternative to opioids. Researchers theorize that by distracting the mind and flooding senses with a positive experience, immersive VR will assist in pain management. Dr. Brennan M. Spiegel and a research team at the Cedars-Sinai Medical Center have experimented with virtual reality for years, creating wearable biosensors, electronic health records, patient-provider portals, and other platforms. Dr. Spiegel has developed a biosensor that has the ability to monitor digestion sounds via computer attachment, while attached to the abdominal wall, and subsequently display results and statistics on an app. The device—AbStats—has been approved by the FDA.
The team has already treated hundreds of patients with VR therapy in an innovative pilot project, allowing subjects to experience VR worlds for up to twenty minutes through aSamsung Gear headset. Participants were given the option to travel to Iceland, swim with whales in the ocean, or participate in the creation of artwork in a studio. Spiegel relates positive data results, yet many patients—particularly those within the older population—are unwilling to try it, emphasizing the digital generational divide.
Moreover, the research team’s experiment concerning pain reduction demonstrated a 24 percent decline in pain levels, among the patients who engaged in the virtual reality game that was offered. Spiegel and his colleagues are currently performing a larger, randomized and controlled trial for measuring longitudinal outcomes; the interest in VR has grown, yet the main limitation has been the allotment of time resources and equipment availability. The solution, according to Spiegel, would be a kind of ‘VR-pharmacy,’ in which there is “evidence-based, well-characterized visualizations that clinicians can pull of the shelf and ‘prescribe’ to individual patients.”
Due to the increasingly severe public health crisis, companies are now manufacturing new devices to replace addictive painkillers, and innovators are looking to technology for groundbreaking, inventive ways to tackle the increasingly critical opioid crisis—as statistics indicate that 140 people die each day from drug overdoses in the United States.
A team of researchers at the Massachusetts Institute of Technology have founded Biobot Labs, merging a research collaboration between the departments of biological engineering and urban studies and planning. The ultimate goal was to design technology that “analyzes human waste flowing through the sewers at various points throughout the system,” and to test the wastewater systems for metabolized traces of various substances in order to isolate the places with the highest concentrations of opioid—or any drug—users. Co-founder and CEO of Biobot Labs Newsha Ghaeli has stated that the goal is to shift data collection away from overdose and death, and instead focus on overdose prevention and early detection.
New clinical trials have demonstrated considerable success for a device known as a spinal cord stimulator, engineered to alleviate back pain. After implanting the experimental device under the skin at the spine base, the technology sends a mild electric current to the spinal cord’s nerve fibers. Scientists believe that the therapy, known as neuromodulation or neurostimulation, interrupts the pain signals that are carried from the nerves to the brain. While the idea was originally conceived in the 1960s, recent years have seen the technology expand and grow.
Other less-invasive devices that can be used outside the body, and do not require surgery, stimulate the peripheral nerves: the network of nerves that connect the brain and spinal cord. Cleveland-based SPR Therapeutics, which received FDA clearance last year for its device, involves a simple nonsurgical procedure in which a tiny wire is placed under the skin—near the nerves—and connected externally to the stimulator, which can be worn anywhere on the body.
As opioid use and abuse in the United States has skyrocketed, these new medical devices could offer drug-free alternatives for some patients. Michael Leong, a pain specialist at the Stanford University School of Medicine, states that the benefit of these devices is that when patients use them, they are able to fake fewer or no pharmaceuticals. “People are afraid of opioids right now. There’s a stigma. Patients don’t want to be on opioids,” he says.
Perhaps most importantly, digital devices have the potential to make an enormous impact and difference—including, but not limited to, VR. With the overall goal of improving and optimizing clinical outcomes, the digital health revolution is consistently and constantly growing.
Valued at approximately $13.2 billion for the year of 2016, the industry of wearable technology is continuing to progress, as healthcare professionals and practitioners are concentrating on the overwhelming need to monitor diseases and aging populations. Due to the advent of new wireless and Bluetooth technologies, a quickly improving infrastructure, and a mounting patient familiarity with wireless devices, the technological advancements are being embraced by the healthcare industry. In order to engineer systems that facilitate the incorporation of wearable medical devices into patients’ and physicians’ daily routines, the marriage of medicine & IT-advancements will continue to develop and strengthen.
