Your Tax Dollars at Work: Parkinson's Researcher Develops Neurological Technologies, Supports Telemedicine

PAN will be highlighting how federally funded research, such as at the National Institutes of Health (NIH), supports researchers and their work in YOUR communities. In fact, more than 80 percent of NIH's budget goes to more than 300,000 research personnel at more than 2,500 universities and research institutions. All across America, NIH funding is creating jobs and enhancing local economies.

In order to showcase your tax dollars at work in your community, we are periodically featuring federally funded Parkinson’s researchers from across the country. This month, PAN asks Joseph P. Giuffrida, Ph.D., president and principal investigator of Great Lakes NeuroTechnologies in Cleveland, Ohio to discuss his team’s Parkinson’s research. The main objective of the research has been to design, build, and clinically assess the Kinesia technology, a platform that integrates wireless motion sensing for quantitative assessment of Parkinson’s motor features such as tremor, bradykinesia, dyskinesia, gait, and balance. The applications for the technology include automated, home-based assessments for telemedicine, as well as in clinical tools to provide visual symptom response maps during the programming of deep brain stimulation in the clinic. All data is stored in a web-based database model to integrate data across clinical centers.

Since 2005, multiple institutes at the NIH have invested more than $10 million in to this research through the SBIR program, including about $3 million in 2013. This is a unique example of how NIH funds small business and innovation in addition to the scientific research we typically highlight at universities.

This article is meant for educational purposes regarding federally funded research and the possibilities of telemedicine. PAN does not review or endorse products.

PAN: Tell me a little about the history of your Parkinson’s disease research.

JPG: Research at Great Lakes NeuroTechnologies has focused on developing medical technologies to assess Parkinson’s disease motor symptoms. When we started this research in 2004, our team recognized a need in the Parkinson’s market to provide more objective measures of symptoms such as tremor, slowed movements (bradykinesia), gait abnormalities, and side effects from treatments such as dyskinesia (involuntary, irregular movements). Providing more sensitive measures to assess Parkinson’s could improve research on new treatments.

Through our research we developed a system of patient-worn motion sensors which wirelessly transmit data to a computer called Kinesia. The computer includes software with videos that guide patients through motor assessments and algorithms which process the data into symptom severity scores. We have several research publications, which clinically validate our automated scoring algorithms versus clinician assessment.

As we progressed through the years, we recognized an additional market need, which was to assess these motor symptoms at a patient’s home through a telemedicine application. Physicians only have an opportunity to view a brief snapshot of symptoms in the clinic. However, since symptoms can often fluctuate throughout the day, it is important to capture these changes. This led us to integrating our system of motion sensors and software into a kit called Kinesia HomeView that patients could take home to complete motor assessments several times a day. The kit includes a touchscreen tablet PC, motion sensors, and broadband connectivity so that data can be sent directly from a patient’s home to the physician. Physicians and researchers use the Kinesia website to set up studies for patients and view reports and data.

The National Institutes of Health (NIH) has been incredibly supportive of our efforts to develop and commercialize this technology through the SBIR program. [The Small Business Innovation Research (SBIR) program is a highly competitive program that encourages domestic small businesses to engage in Federal Research/Research and Development that has the potential for commercialization. Through a competitive awards-based program, SBIR enables small businesses to explore their technological potential and provides the incentive to profit from its commercialization.]

PAN: Why is this research important to people with Parkinson’s?

JPG: Parkinson’s disease is a neurodegenerative disorder affecting over six million people worldwide. Individuals with Parkinson’s can be affected by tremor, slowed movements, rigidity, and gait abnormalities. After chronic use, common therapies to treat motor symptoms often cause a side effect known as dyskinesias, which are involuntary and irregular rapid movements. These daily changes in symptoms and severities, which can be difficult to assess in a short office visit, can be captured by more continuous remote monitoring with patient-worn sensors. In addition, a large portion of the Parkinson’s population currently lacks access to expert care if they have mobility issues that limit travel or do not live near specialty centers. Linking patients with movement disorder specialists through web-based systems can improve accessibility.

PAN: Why did you choose to look at your specific topic?

JPG: We chose to focus our research on Parkinson’s disease because we saw an important market need for both objective assessments, as well as tools for telemedicine. Parkinson’s disease impacts millions of people around the world and represents a growing problem. As more and more clinical trials are being launched to develop new therapies for Parkinson’s, we felt there should be better tools to assess the disease with respect to both sensitivity of symptoms, as well as capturing symptom severity more often.

Furthermore, remote assessment of Parkinson’s disease through telemedicine applications for patient care is equally important. Telemedicine sets up especially well in the Parkinson’s market for two reasons.

  1. Since patient symptoms fluctuate throughout the day it’s important to capture those changes on a more regular basis at home.
  2. Parkinson’s disease is a movement disorder that can impact mobility. This means that even people who live right down the street from a doctor may have trouble getting there. So telemedicine can improve accessibility for individuals with Parkinson’s disease both for patient care and participation in clinical trials.

PAN: What it the timeline for your research?

JPG: We currently have multiple research projects underway, each with different timelines. Some of our research projects are aimed at adding new symptoms assessments to our Kinesia platform. Those projects can take years to execute clinical trials and develop algorithms for automated assessment. Other projects are more short term, such as a project we recently launched to integrate real-time web-conferencing in our Kinesia HomeView system.

PAN: What are the possible short-term and long-term changes that could come out of your research findings?

JPG: Short term, we believe our current technology can have important implications on clinical trials for Parkinson’s disease. Providing more sensitive measures, as well as cloud-based storage of data may speed the pace of research evaluating the efficacy of new treatments. Long term, we believe that telemedicine technology through both remote sensor assessment and real-time video conferencing can have an important impact on improving accessibility to care for Parkinson’s patients.

PAN: If there was one thing you’d like people with Parkinson’s to understand about your research, what would it be?

JPG: A story we hear over and over from patients is that when they go to the doctor, the doctor doesn’t get to see how his or her symptoms really are at home. Often, this may be because patients time their medication so that they are well under control when they need to be in public and in front of their doctor. Our research focuses on developing technologies to allow clinicians to better see how Parkinson’s symptoms change during the day and affect patients at home. If clinicians have that additional information, they may be able to better adjust treatment protocols.

PAN: If there was one thing you’d like Members of Congress to understand about your research, what would it be?

JPG: Parkinson’s disease represents a growing problem in the United States with more patients needing access to care and significant costs to the healthcare system. Parkinson’s has unique features which set up incredibly well for telemedicine applications. Telemedicine applications such as Kinesia HomeView have the potential to improve patient care and decrease healthcare costs. However, to gain wide spread adoption of these technologies, reimbursement for telemedicine in general needs to move forward in the United States.

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Dr. Joseph Giuffrida received his bachelor’s in Biomedical Engineering from Case Western Reserve University in 1999, followed by his master’s in 2000 and Ph.D. in 2004. His background focuses on movement disorders with extensive experience in clinical research, new technology development, and the commercialization of medical devices. He has successfully secured and executed over 15 million dollars in programs funded by the NIH. He has authored many scholarly publications and scientific presentations. Dr. Giuffrida is currently president and principal investigator at Great Lakes NeuroTechnologies, leading the company’s growth through the research, engineering, sales and marketing, manufacturing, and administrative teams.

 

Date originally posted: November 15, 2013.