High Tech Medicine: App to Improve Outcomes from Deep Brain Stimulation

The Clinical and Translational Science Institute (CTSI) of Southeast Wisconsin has awarded a $25,000 “Innovations in Healthcare Delivery Pilot Model Grant” to develop a clinical decision support system to manage patients receiving deep brain stimulation for Parkinson’s disease.

Christopher R. Butson, PhD, associate professor of neurology and neurosurgery, psychiatry & behavioral medicine at the Medical College of Wisconsin, is the primary investigator of the grant.

Deep brain stimulation (DBS) has been shown to have great potential to improve the lives of patients with a variety of neurological conditions, and is an established therapy for Parkinson’s disease. However, a persistent problem in DBS is the extensive and costly time necessary to choose stimulation settings after the electrode leads are implanted. This process is necessary to assure that patients are receiving the best therapeutic benefit from DBS with minimal side effects. However, recent studies from the Butson lab show that this time can be drastically reduced: preliminary data from a iPad-based clinical decision support system showed that programming time was reduced by more than 99% (from four hours to less than two minutes). With the CTSI grant, Dr. Butson’s research team plans to prospectively evaluate the clinical decision support system in the Movement Disorders Clinic at Froedtert Hospital. In this study, patients will be randomized after DBS surgery to standard care or selection of DBS settings using the iPad decision support system.

Ultimately, this project will result in a decision support system for DBS that will be provided on mobile devices to providers. This is expected to reduce the burden of patients and families, and could improve access for DBS patients who have difficulty traveling to major surgery centers for post-operative care. Data gathered during this project will be used in a future project to develop a patient-centered approach to DBS programming where therapy is tailored to each patient’s individual symptoms.

The “Innovations in Healthcare Delivery” grants are supported by the Medical College Physicians, MCW’s physician practice group caring for adult patients, and the CTSI. The fundamental goal is to stimulate innovative pilot projects that promise to measurably and meaningfully improve delivery of healthcare in terms of clinical quality, patient experience, value and efficiency.

CTSI is part of a national consortium of top medical research institutions. Working together, the CTSI institutions are committed to improve human health by streamlining science, transforming training environments and improving the conduct, quality and dissemination of clinical and translational research. The CTSI program is led by the National Center for Advancing Translational Sciences, part of the National Institutes of Health.