Neurology has an undeserving reputation as a specialty that places great emphasis on diagnosis with little in the way of intervention. However, despite great advances in management options, many chronic neurological conditions are still limited with regard to disease-modifying treatments. After the initial diagnosis, follow-up clinics can focus primarily on symptom control and rehabilitation. The latter invariably will involve the multi-disciplinary team. Therefore, it is fitting that the inaugural conference on ‘Neurorehabilitation in movement disorders’ has the tag line ‘a multi-disciplinary approach to the future’.
The recurrent theme running throughout the day was the use of technology in clinical care. Rising numbers of smart-phone users means we are increasingly using technology to maximise wellbeing. One only has to look at the vast number of apps driving the self-monitoring culture to appreciate the digital medicine revolution. Technology in healthcare is also particularly topical given some of the controversial comments regarding how technology may eventually replace the role of clinicians. Not many would agree with this view, and certainly one speaker at the conference, Suma Surendranath, was keen to stress that technology is merely aiding and not replacing clinical acumen. She presented interesting findings from a study by Parkinson UK on ‘wearable technology’. This involved a device worn around the wrist that automated the assessment of bradykinesia and dyskinesia in patients with Parkinson’s disease.
The take-home message is that big-data will not replace clinicians (indeed, we are not merely ‘data-collecting sensors’) but those receptive to technology may be able to perform their job better.
The theme of assistive technology continued with a presentation from Dr Martijin Beudel on his work developing an adaptive deep brain stimulation (DBS) system that can synergise with dopaminergic medication. He proposed that this was a smarter way of delivering treatment with fewer side-effects and less energy consumption, compared to the conventional (continuous) DBS.
It would be impossible to review all of the excellent talks given throughout the day, with diverse range of topics from functional movement disorders to rehabilitation in cerebellar dysfunction. Two particular talks stood out. One is that from Professor Monica Busse on the potential of functional and potentially disease-modifying effects of physical exercise in neurodegenerative conditions such as Huntington’s disease. Dr Anna Sadnicka’s talk on task specific dystonia gave a comprehensive overview of the pathophysiology and current therapeutic options. Her talk was brought to life with illustrative videos of musicians with this condition, and her involvement with this ‘at-risk’ group with regards to raising awareness of this condition, and educating the potential environmental risk factors that may act as triggers for disruption of fine motor control. The results from her clinical trial assessing the feasibility of delivering a tailored rehabilitative programme gives hope for novel therapeutic avenues.
To conclude, the conference brought together world experts in neurorehabilitation and delivered an educational day in an informal setting where there was good engagement and debate between the speakers and the audience. Many thanks to the organisers for this excellent meeting.