Apps from a Neurologist for Neurologists

Welcome to the website of 4NEURO.COM.

My name is Dr. Richard Ippisch, I am a neurologist with my own practice in Germering near Munich.

I quickly understood during my studies: Computers can do a lot of work for you, especially if you know their language.

Computer programming and neurology have one thing in common: they require solving often challenging problems. Both have thus become a passion of mine.

Today, it is above all smartphones, equipped with state-of-the-art cameras and sensors, that are predestined for medical applications in my view.

In the meantime, it has become a “hobby” of mine to develop apps for practical use in neurological everyday life.

Already scientifically proven apps:

In cooperation with the German Center for Vertigo and Balance Disorders at the University Hospital Großhadern in Munich, I have developed 2 apps that could make previously expensive examination procedures more widely available:

mVEGAS: a smartphone app for the analysis of gait disorders using video recordings of leg movement and motion sensors attached to the feet.
mVEGAS has been tested in normal subjects and in patients with ataxic movement disorders and compared to the gold standard of a “GAITRite” pressure sensor mat. The results show a very good agreement of all common temporal and spatial gait parameters. The results of the study have now been published internationally in the journal “Gait & Posture” .

mHIT: a smartphone app which captures the opposing eye movement during jerky head movements with gaze target fixation. mHIT uses high-frequency video recordings (240 frames /per second) and self-developed algorithms for pupil detection on the video images (partially blurred by the rapid head movement). The quality of the results is currently being compared in a study with the video head pulse test commonly used in the clinic.

Apps only used in own practice so far:

With mTremor, the frequency of a tremor or any other rapidly alternating movements can be measured. For this purpose, body parts are marked with a colored marker and high-frequency video recordings are made with the smartphone.  The sequential evaluation of the marker position in the video images allows the determination of a movement curve and its Fast Fourier analysis.

mSVV allows the determination of the so-called Subjective Visual Vertical. Every healthy person is able to bring an upright standing, elongated object into a vertical position, which deviates only a few degrees at the most from the physically correct vertical.  With mSVV, a corresponding pointer is brought into the subjectively vertical position by means of finger movements on the screen of a tablet. The deviation from the true vertical is measured and can provide indications of disturbances in the processing of balance stimuli.

mSDMT is the digital version of the “Symbol Digital Modalities Test” previously available only in paper form. A symbol is given for each number 1-9. The test person must then name the corresponding number for as many symbols as possible. mSDMT works with automatic speech recognition and allows the test results to be stored and evaluated.

None of the apps has been published yet and is available for other users – why?

Apps that serve the diagnosis or therapy of diseases are subject to the German Medical Device Law: “Medizinprodukterecht-Durchführungsgesetz  (MPDG)” as a so-called “medical device”. This in turn serves “…to implement and supplement the European Medical Device Regulation (EU) 2017/745 (MDR) and the EU In-vitro Diagnostics Regulation (EU) 2017/746 (IVDR).”

The word monstrosities already suggest it: the necessary certification procedures are extensive, complicated and…expensive! Personally, I am only interested in the challenges of app development, not in the bureaucratic effort required for publication. Therefore:

Cooperation partners are wanted!

If you are interested in a cooperation for the certification and distribution / marketing of the above mentioned apps or also other meaningful app developments and have the appropriate possibilities, please feel free to use the contact possibilities of our practice: