JMIR Neurotechnology

Tourette syndrome is a neurological disorder that is characterized by repeated unintentional physical movement and vocal sounds, better known as tics. Cases of mild Tourette can have tics numerous times throughout the day, while severe cases may have tics every 5 to 10 seconds. At certain times, typically during high levels of stress, tics become chained in an incessant, continuous fashion—this is known as a tic attack. Tic attacks incapacitate the patient, rendering it difficult for them to move, perform daily actions, and even communicate with others. Caretakers—usually guardians, family members, or nurses—can help reduce the time tic attacks last with their presence and by providing emotional support to the patient.

Multiple sclerosis (MS), epilepsy, and depression are chronic central nervous system conditions in which remote measurement technology (RMT) may offer benefits compared with usual assessment. We previously worked with clinicians, patients, and researchers to develop 13 use cases for RMT: 5 in epilepsy (seizure alert, seizure counting, risk scoring, triage support, and trend analysis), 3 in MS (detecting silent progression, detecting depression in MS, and donating data to a biobank), and 5 in depression (detecting trends, reviewing treatment, self-management, comorbid monitoring, and carer alert).

Telemedicine practice for neurological diseases has grown significantly during the COVID-19 pandemic. Telemedicine offers an opportunity to assess digitalization of examinations and enhances access to modern computer vision and artificial intelligence processing to annotate and quantify examinations in a consistent and reproducible manner. The Myasthenia Gravis Core Examination (MG-CE) has been recommended for the telemedicine evaluation of patients with myasthenia gravis.

Many apps have been designed to remotely assess clinical status and monitor symptom evolution in persons with multiple sclerosis (MS). These may one day serve as an adjunct for in-person assessment of persons with MS, providing valuable insight into the disease course that is not well captured by cross-sectional snapshots obtained from clinic visits.

The COVID-19 pandemic led to many consultations being conducted remotely. Cognitive impairment is recognized as a potential barrier to remote health care interactions and is common and heterogeneous in Parkinson disease. Studies have shown remote consultations in Parkinson disease to be feasible, but little is known about real-life experience, especially for those with cognitive impairment. We explored the experiences and perceptions of remote consultations for people with Parkinson disease and cognitive impairment.

iReadMore is a digital therapy for people with acquired reading impairments (known as alexia) caused by brain injury or neurodegeneration. A phase II clinical trial demonstrated the efficacy of the digital therapy research prototype for improving reading speed and accuracy in people with poststroke aphasia (acquired language impairment) and alexia. However, it also highlighted the complexities and barriers to delivering self-managed therapies at home. Therefore, in order to translate the positive study results into real-world benefits, iReadMore required subsequent design innovation. Here, we present qualitative findings from the co-design process as well as the methodology.

Time spent in the prehospital phase of acute stroke care is multifactorial and has an effect on the possibilities for acute treatment. Communication between paramedics and the in-hospital stroke team directly affects time to treatment. A mutual stroke scale such as the National Institutes of Health Stroke Scale (NIHSS) may improve communication quality. The Paramedic Norwegian Acute Stroke Prehospital Project (ParaNASPP) was a stepped-wedge, randomized trial of stroke screening using NIHSS in the ambulance where the intervention was training paramedics in stroke and the NIHSS, with the use of NIHSS made into a mobile app to guide the examination and facilitate communication with the in-hospital stroke team.

Extended reality (XR) is a term that captures a variety of techniques, such as augmented reality (AR) and mixed reality (MR), which allow users to interact with virtual models in real time. This technology has an emerging role in several applications within neurosurgery. XR can be useful in enhancing how radiosurgical cases are planned. Multidisciplinary team (MDT) review is an essential part of the radiosurgery case planning process; during case discussions, patient images are reviewed, usually in 2D or 3D modifications. The current commercially available platforms for this review need improvement.