Neurologist Justin McArthur recaps the presidential symposium on leveraging digital technologies in neurology that he hosted during the American Neurological Association 2020 Virtual Meeting. Dr. McArthur shared three examples of how neurological therapies can be improved using technology and discussed the growth of telemedicine.
Hi, I'm Dr Justin MacArthur. I'm professor and director of the Department of Neurology here, a Johns Hopkins University School of Medicine. And I'm also president of the American Urological Association, which this year is help holding its annual meeting completely virtually as part of the planning process for this. Even before the Kobe pandemic, we plan to have a symposium on leveraging digital technologies. It was my honor and pleasure to host the presidential symposium on this topic. We had some wonderful speakers, and I wanted to emphasize that the point of this symposium was to take his way beyond telly medicine. We've all seen how telly medicine. This impacted our lives both professionally and personally during the Kobe pandemic. But the point of this symposium was to see what comes next. What can we use to actually improve neurological therapeutics using digital technologies? What can we do to monitor patient's neurological performance in real time and continuously again using digital technologies? So this was the objective of the symposium and the speakers performed to that objective just wonderfully. So when we conceived of this symposium, obviously everyone was focused on telly medicine because of the cove it pandemic and it is absolutely amazing how telly medicine has, uh, use of of telly. Medicine has accelerated in the last few months. This is perhaps one of the silver linings of covert 19. But this symposium goes way beyond telemedicine. It's actually using digital therapeutics to treat neurological disorders. It's using bio senses and continuous monitoring of patients to assess performance in clinical trials. On I'm gonna give you three examples today from the symposium of where I think the future of neurology will be going. The first of the presentations was from Dr Pretty Raghavan Doctor Pretty Raghavan is an associate professor in the Department of Physical Medicine and Rehabilitation here, a Johns Hopkins. And she talked about one of her inventions, the Bat B. A T device, which is a device that's going to be used to help treat patients with stroke, particularly patients who have received a stroke that produces weakness in one arm. And the principle of this device is to combine mirrored movement whereby both sides of the brain are in trained to provide movement for a paralyzed limb with gaming technology so that this device allows the non paralyzed with strong arm to bring up, bring along the weaker arm and allow for movements gradually over a few days in a few weeks to become stronger and stronger. This is now being approved by the FDA and is now in clinical trials and in our stroke unit in the Diet building here at Johns Hopkins Hospital. Ah, second speaker was Dr Adam Garzelli from UCSF, where he runs a lab called Neuro Escape. This is focused on animation, game gaming techniques and study of movement and motion. And what Dr Garzelli has done, and what he talked about during our symposium was the first and only prescription treatment. Truly a digital therapeutic that's delivered via a video game. This'll just recently being cleared and approved by the FDA for the treatment of Children with a D. H D. And the Endeavor Devices, a tablet based video game that in controlled clinical trials has been shown to reduce the symptoms of a D. H. D. And it really represents, in my view, a wonderful example of how we can use experiential techniques, perhaps combined with molecular techniques i e. Pharmacology to better treat our patients with neurological disorders and devices like this and the gaming technology that goes with them will be used, in my opinion, for treating substance abuse, traumatic brain injury, potentially even forms of stroke. Three of US speakers approach the topic of clinical trials on how to improve clinical trials. Jamie Adams from the University of Rochester, Aldo Faisal from Imperial College, London, and Chang Ho Char from Novartis Industries. They really focused on how we monitor patients, performance and activity levels in a real world situation and how we can improve that to improve how clinical trials are conducted. I think Dr Cha used the great analogy. If you look at a baseball schedule, for example, the Boston Red Sox baseball schedule and you wanted to assess how the team was performing and you only looked at six games during the course of 100 and 62 game season, that really would not be a very, uh, accurate or precise measure off the performance of that baseball team. That's exactly what we do in clinical trials. We have patients come in perhaps once a month, perhaps less frequently than that on we assess their performance in an artificial setting, i e. The hospital or the lab, and we expect that to be a good measure, a reliable measure of their performance 24 7 for the rest of that time. But Dr Faisal is using machine learning and senses that are monitoring patients behavior in real time continually. So we're able to now use all of that data in clinical trials, reduce the sample size and the time that it takes to conduct a clinical trial, and this will drive us towards new neurological therapies more efficiently, more effectively and more rapidly.