New app helps physicians treat patients with Parkinson’s disease

Christopher Butson has a background in engineering, but he currently works as an associate professor and researcher in the departments of neurology and neurosurgery at the Medical College of Wisconsin in Wauwatosa. A lot of the work done in Butson’s lab is transitional, he said.

Neuropotential LLC

Innovation: iPhone application that monitors body tremors and movement in patients with Parkinson’s disease

www.neuropotential.org

“My expertise lies in developing new technologies and then getting those technologies bedside for physicians and patients,” Butson said.

Butson and his engineering colleague, Sanket Jain, have created a smart phone application, known as Motor, designed to provide real-time motion monitoring of movement disease patients, particularly Parkinson’s disease patients. Butson leads Neuropotential LLC, which was created in 2008 as the business entity for Motor. Clinical trials for the application are being done at the Medical College.

“We’re still in clinical stages,” Butson said. “But we’ve collected a lot of promising data so far.”

The application is available in the iTunes application store and runs on a traditional iPhone or iPod Touch. Patients are instructed to wear the iPod touch throughout the day either on their arm or on their hip.

“It has a very easy to use interface,” Butson said. “It’s designed for movement disease patients, so it has three large command buttons and has built in functionality that ignores the occasional stray button presses.”

Patients are instructed to put on the iPod Touch in the morning, start recording and occasionally hit the ‘Event’ button either when medication is taken or a particular movement episode occurs, Butson said.

“Parkinson’s is a very complex disease, and one with a lot of variability between patients,” Butson said. “One patient might have completely different symptoms than another, so treatment options vary widely between patients as well.”

Currently, physicians around the world utilize the Unified Parkinson’s Disease Rating Scale to assess symptoms and conditions of patients with movement diseases.

“It can be somewhat challenging,” Butson said. “Patients with Parkinson’s disease will come in maybe once a year or every six months and with any luck there is a caregiver with them who will try to reconstruct the time since their last visit.”

Patients and caregivers will rate their disease movements and tremors on the Unified Parkinson’s Disease Rating Scale from 0 to 4, a zero being no tremor and a four being the worst tremor they’ve experienced, Butson said.

“It’s all very subjective, and with a four-numbered scale it’s a 33 percent increment in between numbers. It isn’t very sensitive.”

Butson and his colleagues wanted to find a way to provide quantitative data that could help physicians when making treatment decisions, he said.

“The Motor application utilizes the accelerometer in the iPhone or the iPod touch to accurately record body movement in Parkinson’s patients,” Butson said. “It sends the information to our server via a Wi-Fi signal, where we can generate quantitative reports on the patient’s movement history over any given period of time.”

For the past two years, Butson and a team of researchers at the Medical College of Wisconsin have been working with patients to test the application.

“We’ve collected a lot of good data in the pilot that demonstrates the feasibility of the application,” he said.

According to Butson, patients with Parkinson’s disease are often very involved in their treatment.

“Even if they aren’t technology savvy, they seem to be very engaged with this application,” Butson said.

The application will buffer and store up to two weeks of data and will upload the information to a server as soon as a wireless connection is detected, Butson said.

Butson hopes that the reports generated from the data collected by the application will provide useful information that could be used to determine levels and variations of treatment for patients with movement diseases.

The next step for Butson and his team is to publish the data and deploy the research with a system of patients and the physicians who work with them.

“Up until now, there hasn’t been a way to accurately know a patient’s movement and tremor history to an almost absolute degree,” Butson said. “Parkinson’s is a very complex disease and it can be quite difficult for a patient to accurately reconstruct from memory their motor symptoms over a period of time. This application can provide a real-time monitoring of their movement, which could influence the physician’s diagnosis and treatment.”

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