Abstract Details

Title Telerehabilitation for Neurological Disability with Remotely Supervised Transcranial Direct Current Stimulation (RS-tDCS)

Topic Neuro-rehabilitation

Presentation(s) P7 - Poster Session 7 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-008

Objective To demonstrate the feasibility of delivering telerehabilitation paired with transcranial direct current stimulation (tDCS) to patients at home.

Background Effective rehabilitation for cognitive and motor recovery requires multiple training sessions for optimal benefit. tDCS is an emerging noninvasive brain stimulation technique that may be used to improve rehabilitative outcomes and reduce symptom burden across a variety of CNS disorders. The burden of time and travel is often a barrier for patients to attend outpatient rehabilitation. A telerehabilitation protocol was developed to remotely supervise patients in real time via videoconference to complete at-home training exercises paired with tDCS treatment (RS-tDCS).

Design/Methods Feasibility and compliance rates were compared across RS-tDCS in patients according to age, level of neurological disability, and cognitive and motor functioning. We also tested when patients could independently place the tDCS headset and operate the device without supervision, in order to enable extended treatment regimens.

Results To date, our program has delivered n=4,031 RS-tDCS sessions to a total of n=239 patients, ranging in age from 18 to 71 years, with conditions including multiple sclerosis (MS), Parkinson’s disease, and other CNS disorders. RS-tDCS was safe and well-tolerated without serious adverse events. Procedures were feasible for patients with advanced neurologic impairment (e.g., MS EDSS scores up to 8.0), moderate cognitive impairment (SDMT z scores ≤-3.0) and limited upper extremity function. Completion rates for at-home training averaged 95.6%, 92.4%, 91.1% for 5, 10 and 20 training sessions, respectively, and individual cases have completed up to 60 sessions. In the subsample studied (n=50), independent tDCS headset placement and device operation was achieved after an average of 4 RS-tDCS sessions.

Conclusions Telerehabilitation with tDCS is feasible for at-home delivery, improves training compliance and completion when compared to outpatient visits, and is feasible for a variety of patients with neurological-related disability.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Matthew Lustberg	No disclosure on file
Michael Shaw	No disclosure on file
	No disclosure on file
Pamela Best	Ms. Best has nothing to disclose.
Martin Malik	Martin Malik has nothing to disclose.
	No disclosure on file
Allan George	Mr. George has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.

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