For the past several months, Rune Labs had the pleasure of participating at several international conferences and thought leadership events. It was an honor to connect with leaders in the space of precision neurology and learn about the cutting-edge research individuals and organizations presented. Our lead neuroscientists represented at three different influential conferences, including: the DBS Think Tank in Orlando Florida, WSSFN in Incheon, Korea, and the MDS Congress in Madrid, Spain. 

The 2022 Deep Brain Stimulation (DBS) Think Tank

Inspired by the article highlighting the careers of critical women who contributed to the development of functional neurosurgery, the theme of this year’s think tank was “Women in Neuromodulation.” 

Alongside several industry partners, we presented our preliminary research findings in precision neurology and care delivery tool, StrivePD, during the Industry Blitz session. In the first half of our presentation, Ro’ee Gilron, Lead Neuroscientist, explained how we looked at one patient who was continuously monitored for an entire year before getting a DBS implant and after. In comparison to standard clinical scales used today, our dataset presented a full picture of a patient’s progress with Parkinson’s disease. We saw the variability in tremor fluctuation throughout the year, whereas standard clinical tremor scores capture a small subset of variability. For this case study, we found that both tremor and average beta oscillations in the subthalamic nucleus reduced as tremor increased during routine clinical care. Taken together, both findings demonstrate that pairing neurophysiology data with objective data can improve clinician decision-making for both stimulation and medication titration. 

‍

In the second half of our presentation, Hannah Timm, Account Executive, shared how our precision neurology tool, StrivePD, enables clinicians to use real-world patient data to make informed decisions to treat and manage their Parkinson’s patients. Our platform connects different sources of data – including passively collected brain signals from a DBS implant and motor symptoms detected by an Apple Watch – to paint a holistic picture of a patient and their symptoms. By pulling up StrivePD during clinical visits, clinicians can make use of basal ganglia local field potential (LFP) data, thanks to sensors embedded in commercial DBS devices, providing in-depth, detailed information that can help them develop personalized Parkinson’s care. Rune’s software and modeling system ingests multimodal data into routine clinical care to make decisions around DBS including programming, patient selection, and adaptive DBS.

WSSFN: Wearable data and DBS optimization

From discussions on DBS for psychiatry to the future of DBS and neuromodulation, WSSFN brought in great knowledge from industry leaders and facilitated rich discussions and panel sessions. 

Ro’ee Gilron also had the opportunity to present our findings on real-world monitoring of Parkinson’s disease neurophysiology paired with wearable sensors during DBS optimization. For this poster presentation, we evaluated two patients with Parkinson’s disease implanted with sensing-enabled DBS electrodes into the subthalamic nucleus (STN). We collected LFPs  during early at-home titration of DBS stimulation amplitudes in 10 minute intervals over a 30-50 day period. These patients were also asked to wear an Apple Watch and to self-report their medications and symptoms via the StrivePD application. We evaluated the effect of changes in stimulation amplitude on STN LFP and objective clinical metrics such as tremor and dyskinesia. 

We found that both patients showed a decrease in LFP beta-band power with increased stimulation amplitude contralateral to the more-affected side. In one patient, we observed a “stimulation asymptote” beyond which further increases in amplitude did not decrease LFP power. A decrease in tremor but not dyskinesia as measured by the wearable device was also observed with increased stimulation amplitude.

This study validated dose-dependent effects of therapeutic stimulation on neurophysiology and objective outcomes, such as tremor, during everyday activities and over prolonged periods of time at home.

MDS Congress: Real-world monitoring and the correlation of Parkinson’s symptoms

The MDS Congress brought leaders from near and far. It was wonderful to connect with clinicians, researchers, and industry leaders on current research and approaches for the diagnosis and treatment of movement disorders, specifically Parkinson’s. 

Lead Neuroscientist, Witney Chen, presented her poster highlighting the utility of remote patient monitoring using a combination of brain sensing and object outcome measurement in the management of Parkinson’s disease patients with DBS devices. Our aim was to use combined metrics to characterize patient symptomatology and to inform patient care. We evaluated three patients from three different centers with concurrent STN physiology, Apple Data, and StrivePD self-reported data. 

We analyzed over two months of neurophysiology per patient, including passively-recorded power band trends and actively-recorded, patient-triggered frequency spectra, in conjunction with wearable-generated symptom labels and patient self-report. We validated previous findings indicating correlations between basal ganglia physiology and tremor and dyskinesia. We also observed physiological modulation in response to medication and circadian fluctuations.

We concluded that initial experiences with real-world monitoring in DBS patients identifies neurophysiological correlations of Parkinson’s symptoms, medication intake, and sleep. Equipping patients with wearable monitors (Apple Watch) and self-reported tools (StrivePD) provides important context for longitudinal neural recordings, which furthers our ability to characterize patient states between clinical visits.

What is next? 

We are excited to continue to build the momentum and attend several other leading conferences and events in the neuroscience space the rest of the year. It was empowering to see the representation these conferences brought, and we are grateful to have connected with our long-time partners and new partners.  

Let us know if you’ll be attending any future conferences and want to connect. Email us at info@runelabs.io for more information, or check out www.strivepd.group to learn more about our care delivery tool, StrivePD.