Emerging technologies for management of patients with amyotrophic lateral sclerosis: from telehealth to assistive robotics and neural interfaces

J Neurol. 2022 Jun;269(6):2910-2921. doi: 10.1007/s00415-022-10971-w. Epub 2022 Jan 21.

Abstract

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, is characterized by the degeneration of both upper and lower motor neurons, which leads to muscle weakness and subsequently paralysis. It begins subtly with focal weakness but spreads relentlessly to involve most muscles, thus proving to be effectively incurable. Typically, death due to respiratory paralysis occurs in 3-5 years. To date, it has been shown that the management of ALS patients is best achieved with a multidisciplinary approach, and with the help of emerging technologies ranging from multidisciplinary teleconsults (for monitoring the dysphagia, respiratory function, and nutritional status) to brain-computer interfaces and eye tracking for alternative augmentative communication, until robotics, it may increase effectiveness. The COVID-19 pandemic created a spasmodic need to accelerate the development and implementation of such technologies in clinical practice, to improve the daily lives of both ALS patients and caregivers. However, despite the remarkable strides that have been made in the field, there are still issues to be addressed. This review will be discussed on the eureka moment of emerging technologies for ALS, used as a blueprint not only for neurodegenerative diseases, examining the current technologies already in place or being evaluated, highlighting the pros and cons for future clinical applications.

Keywords: Amyotrophic lateral sclerosis; Brain-computer interface; Clinical management; Emerging technologies; Eye tracking; Internet of things; Motor neuron diseases; Robotics; Telemedicine.

Publication types

  • Review

MeSH terms

  • Amyotrophic Lateral Sclerosis* / therapy
  • COVID-19*
  • Humans
  • Motor Neurons
  • Pandemics
  • Telemedicine*