Handbook of Digital Technologies in Movement Disorders

1st Edition - January 20, 2024
Imprint: Academic Press
Editors: Roongroj Bhidayasiri, Walter Maetzler
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 9 9 4 9 4 - 1
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 9 4 9 5 - 8

Handbook of Digital Technologies in Movement Disorders aims to unite these factors to provide a comprehensive guide to patient focused treatments for movement disorders. Sections… Read more

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Handbook of Digital Technologies in Movement Disorders aims to unite these factors to provide a comprehensive guide to patient focused treatments for movement disorders. Sections cover an introduction to digital technologies, concepts, and terminologies, review various perspectives on technology in movement disorders, including patient and medical professionals, and present technologies used in detecting, measuring progression, and determining response to treatments. Additional chapters review the technology used in various treatments of movement disorders, including assistive and robotic technologies. Finally, the last section examines the challenges with technology, including privacy and other ethical issues. Over the past few years, there have been fundamental changes in the diagnosing and treating patients with chronic diseases, significantly affecting management of neurological movement disorders. In addition, the health and fitness sector developed several devices to better classify, track, and potentially treat chronic diseases. Both handling and interpreting these large datasets has been revolutionized, by machine and deep learning approaches, leading to new and more effective therapies, resulting in longer survival rates.

Cover image
Title page
Table of Contents
Copyright
Dedication
List of contributors
Preface
Acknowledgments
Part I. Digital technologies: The primer
Chapter 1. We are living in the Parkinson's pandemic: how can multi-stakeholders utilize digital technologies effectively?
Parkinson's disease as a prototypical hypokinetic disorder: recognized for more than 200 years we now know more and more about it
Living in the era of a double (Parkinson and COVID-19) pandemic: an upcoming global challenge
There is no one size-fits-all solution with differences in each region, country, society, and system: where do digital technologies stand?
There are things that we know about PD and movement disorders, and there are also many unknowns, but we should balance the use of digital technologies to find the answers to what we know we want to know and what matters to patients
Toward a real-life implementation of clinically relevant multi-modal digital markers
Conclusion
Chapter 2. Embracing the promise of artificial intelligence to improve patient care in movement disorders
Introduction
Clinical reasoning in movement disorders: Neurologist's view
Toward the simulation of neurologist's clinical reasoning in movement disorders
Toward a better way for neurologists to onboard artificial intelligence: AI as assistant, monitor, coach, and teammate
Toward postCOVID-19 pandemic conditions: how artificial intelligence impacts movement disorders care and research
Neurologists and artificial intelligence: the two paths joining together
Part II. Different stakeholders' perspectives on technology in movement disorders
Chapter 3. Medical professional's viewpoint and clinical adoption
Current need for digital health technology-based tools in movement disorders
Applications of digital health technology-based tools in movement disorders and current role in clinical practice
Clinical needs and potential future applications of digital health technology-based tools
Critical appraisal of digital health technology for movement disorder diseases
Chapter 4. Applying technologies to unmet clinical needs in movement disorders
Introduction
Unmet clinical need #1: accurately diagnosing, characterizing, measuring, and monitoring movement disorders (“deep phenotyping”) and the disease modification conundrum
Unmet clinical need #2: non-motor disability, wellbeing, and integrated care
Unmet clinical need #3: lack of proper incentives in healthcare reimbursement models
Unmet clinical need #4: access to subspecialty care and advanced treatments in movement disorders
Unmet clinical need #5: home-bound segment of the movement disorder patient population
Unmet clinical need #6: the need to adopt artificial intelligence
Conclusions
Chapter 5. Drug development for movement disorders: using digital measures for decision making
Introduction
Supporting drug development
Regulatory decision making
Future directions
Conclusions
Chapter 6. Novel analytics in the management of movement disorders
The need for robust data management infrastructure
Extracting meaningful information from a continuous stream of data
Using analytics for early diagnosis of movement disorder
Opportunities for prognosis of clinical endpoints
Daily life management of movement disorder: Parkinson's disease
Recommendations and future trends
Part III. Technologies in movement disorders: Detecting disease, monitoring symptoms and treatment response, and measuring progression
Chapter 7. Digital outcomes: potentials and clinical considerations
Digital outcomes: potentials and clinical considerations
The potential of digital outcomes
Chapter 8. Technologies for identification of prodromal movement disorder phases and at-risk individuals
Introduction
Prodromal Parkinson’s disease
Premanifest Huntington’s disease
Other prodromal and premanifest movement disorders
Conclusions
Chapter 9. Toward digitalization of clinical rating scales
History of the development of rating scales and the transition from paper to electronic
Digital data collection: evolution and applications
Methodological advantages of using electronic rating scales
Regulatory implications
Practical steps for implementing a rating scale in an electronic format
Digitalization of rating scales in movement disorders: real case studies
Conclusions
Chapter 10. Patient diaries in movement disorders: opportunities and limitations
Introduction
Disease state diaries: what are they?
Existing disease diaries in movement disorders: the Parkinson’s disease experience
Caveats of existing diaries: granularity, contextual, and clinimetric limitations
E-diaries: more than just a change in format
E-diaries: modular development approach
E-diaries: application in other movement disorders
Conclusions
Chapter 11. Wearables for diagnosis and predicting clinical milestones
Introductory overview
Supporting diagnosis
Predicting clinical milestones
Summary of evidence for the utility of sensors to support diagnosis and prediction of milestones for Parkinson's disease
Application to other movement disorders
Conclusion
Chapter 12. Applications and wearables for disease monitoring
The added value of technologies in monitoring movement disorders
Evaluation of general mobility and gait
Digital evaluation of balance and postural instability
Evaluation of upper limb movements and motor dexterity
Evaluation of involuntary movements
Digital measures in Parkinson's disease
Digital progression markers of PD
Longitudinal studies evaluating motor fluctuations and potential response to treatments and interventions
Digital assessment in other movement disorders and symptoms: atypical parkinsonism, Huntington disease and tremor
Monitoring nonmotor symptoms in PD and other movement disorders
Multimodal digital assessment in movement disorders: from research use to clinical practice
Chapter 13. Nonwearable stationary systems for movement disorders
Introduction
The importance of movement disorder assessment
Overview of nonwearable stationary systems
Stationary systems' modalities
State-of-the-art for stationary systems in movement disorders
Discussion
Potential applications and impact
Conclusion
Chapter 14. Technologies for the management of hyperkinetic movement disorders
Introduction
Technological advances in the field of HMD
Which types of devices are being used?
Technological devices from the patients' perspective
Are devices safe?
Implications for clinical practice
Implications for clinical research
What is still missing and future directions
Conclusion
Part IV. Technologies in movement disorders: Therapeutic innovations
Chapter 15. Engaging multi-stakeholders to develop a great digital assistive technology that Parkinson's disease patients love, value, and use to improve motor aspects of daily living
Introduction
Assistive technologies: Related terminologies, and definitions
The scope and landscape of digital assistive technologies in a world of disabilities in Parkinson's disease
Digital assistive technologies for orofacial function
Digital assistive technologies for upper limb function
Digital assistive technologies for mobility
Digital assistive technologies for sleep
Conclusion
Chapter 16. Robotics and exoskeletons: Are we close to daily clinical implementation?
Societal drivers
Clinical drivers
Technical drivers
Clinical implementation in movement disorders
Conclusion
Chapter 17. Closed-loop systems
Introduction on the closed-loop systems and the roles of digital technologies in movement disorders
Why is a closed-loop needed?
Closing the loop in neuromodulation
Closed-loop system for other neuromodulation modalities (e.g., pumps)
Future of closed-loop systems
Part V. Challenges and future directions
Chapter 18. (Re)configuration of digital health records to optimize diagnosis and therapy
Electronic health records: Present and future perspectives
mHealth for movement disorders
Implementation of digital health records from different sources
Privacy and other caveats
Conclusion
Chapter 19. Overcoming our shared challenge: reducing climate change burdens and improving movement disorders management through digital technology
Introduction
Climate change: a threat to human wellbeing and the health of our planet—why it matters
Climate change and Parkinson's disease: what you need to know?
The other side of the coin: how health care contributes to climate change
Digital health technologies: the nexus of climate crisis and healthcare
The digital health paradox: a double-edged sword?
COVID-19 pandemic: a blessing in disguise?
Future direction
Disease burden
Prevention and risk reduction
Diagnosis, treatment, and care
Chapter 20. Harmonization of data sets: basic principles and ethical aspects
Introduction
What are the main considerations regarding data acquisition, data management, data sharing and its ownership?
What are the main sources of health information?
Who owns the biomedical and healthcare data and how it may be shared?
What are the possible study designs in biomedical and health research?
What is big data?
What is data harmonization?
What are the applications of big data analysis and data harmonization in health research?
What are the approaches to data harmonization?
What are the main problems, barriers and solutions for the implementation of data harmonization?
What are examples of big data studies/data harmonization in the field of movement disorders?
Which general ethical guidelines should be followed in big data/data harmonization studies?
How privacy and confidentiality are important in data harmonization?
Why informed consent is important in relation to data harmonization?
What precautions should be taken while forming an international collaboration and transfer of biospecimens?
How important is to inform the research results to individual/groups who participated in the study?
How the benefit may be shared among the participants?
Is there any role of ethics committee in data harmonization study?
Conclusion
Glossary
Index

Roongroj Bhidayasiri

Professor Bhidayasiri graduated in medicine from Chulalongkorn University, Thailand, in 1993, receiving membership of the Royal College of Physicians of London and Ireland in 1998 and certified by the American Board of Psychiatry and Neurology in 2005. He was awarded the fellowship of the Royal College of Physicians of London in 2008 and the Royal College of Physicians of Ireland in 2010.

Professor Bhidayasiri established the Chulalongkorn Centre of Excellence for Parkinson’s Disease, the tertiary care centre affiliated with Chulalongkorn University, providing multidisciplinary care for patients with PD, tremor, dystonia, and various forms of movement disorders in Thailand. His research interests are in data science and technology-based objective assessment, with several of the devices he has developed with his team adopted for clinical use, including a diagnostic tremor algorithm, a nocturnal device for monitoring nocturnal hypokinesia, a tremor suppression glove, a PD shoe, and a PD anti-choking mug. Importantly, adjustable laser-guided walking stick has been taken on nationwide by the Ministry of Social Development and Human Security of Thailand for patients with freezing of gait, with established cost-effectiveness. He is currently working with various stakeholders to implement national digital screening for PD, and nationwide lifestyle preventive strategies focusing on the mantra “Eat, Move, Sleep”.

Professor Bhidayasiri serves as the Specialty Chief Editor for the section Neurotechnology in Frontiers in Neurology and Associate Editor of Journal of Parkinson’s Disease. He published the first American Academy of Neurology practice parameters for tardive syndromes with Stan Fahn, and also three international textbooks, with his first “Neurological Differential Diagnosis”, being one of the best-selling neurological textbooks on amazon.com in 2005. A Lancet review called it “a pearl of a book for any clinician who is asked to assess patients with symptoms and signs, suggestive of neurological disorders”. The other two books are International Neurology (endorsed by the World Federation of Neurology), and Movement Disorders: A Video Atlas. In addition, he has authored over 230 peer-reviewed publications and has filed 17 patent and petty-patent applications on algorithms, wearable sensors, and assistive devices.

Professor Bhidayasiri has received both a National Distinguished Researcher in Medical Sciences Award and the President’s Distinguished Service Award from the MDS in 2015, and a Leader in Innovation Fellowship Award from the Royal Academy of Engineering (UK) in 2016. He is also a member of the Academy of Science of the Royal Society of Thailand, a past chair of the Asian-Oceanian section of the International Parkinson and Movement Disorder Society (MDS-AOS) and currently an international executive committee member of the MDS.

Affiliations and expertise

Chulalongkorn Comprehensive Movement Disorders Center, Chulalongkorn University Hospital, Bangkok, Thailand

Walter Maetzler

Prof. Maetzler, Full Professor for neurogeriatrics and Deputy Director of the neurology department of the University Hospital in Kiel, Germany. His main clinical interest is Parkinson’s disease and other neurological disorders associated with functionally relevant movement and cognitive disabilities. He leads a research group focusing on the analysis and validation of mobile sensor technology in supervised (“lab- or clinic-based”) and unsupervised (“home-based, daily life”) assessments of older adults and neurodegenerative diseases. He is involved as principal investigator, chief clinical investigator and work package leader in multiple international projects investigating the potential of mobile sensor technology to improve our understanding of disease progression and treatment response in chronic conditions, such as Parkinson’s disease. Currently, he serves as the co-chair of the technology task force of the Movement Disorders Society and as an advisory board member of the Critical Path for Parkinson’s (CPP) Consortium. He has co-authored about 300 articles in international peer-review journals and is Chief Editor of Neurogeriatrie – ICF-basierte Diagnose und Behandlung (https://www.springer.com/de/book/9783662573570) and Associate Editor of the Journal Geriatric Care.

Affiliations and expertise

Full Professor for neurogeriatrics and Deputy Director of the neurology department of the University Hospital in Kiel, Germany.

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