TY - JOUR
T1 - Continuous, noninvasive wireless monitoring of flow of cerebrospinal fluid through shunts in patients with hydrocephalus
AU - Krishnan, Siddharth R.
AU - Arafa, Hany M.
AU - Kwon, Kyeongha
AU - Deng, Yujun
AU - Su, Chun Ju
AU - Reeder, Jonathan T.
AU - Freudman, Juliet
AU - Stankiewicz, Izabela
AU - Chen, Hsuan Ming
AU - Loza, Robert
AU - Mims, Marcus
AU - Mims, Mitchell
AU - Lee, Kun Hyuck
AU - Abecassis, Zachary
AU - Banks, Aaron
AU - Ostojich, Diana
AU - Patel, Manish
AU - Wang, Heling
AU - Börekçi, Kaan
AU - Rosenow, Joshua
AU - Tate, Matthew
AU - Huang, Yonggang
AU - Alden, Tord
AU - Potts, Matthew B.
AU - Ayer, Amit B.
AU - Rogers, John A.
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Hydrocephalus is a common disorder caused by the buildup of cerebrospinal fluid (CSF) in the brain. Treatment typically involves the surgical implantation of a pressure-regulated silicone tube assembly, known as a shunt. Unfortunately, shunts have extremely high failure rates and diagnosing shunt malfunction is challenging due to a combination of vague symptoms and a lack of a convenient means to monitor flow. Here, we introduce a wireless, wearable device that enables precise measurements of CSF flow, continuously or intermittently, in hospitals, laboratories or even in home settings. The technology exploits measurements of thermal transport through near-surface layers of skin to assess flow, with a soft, flexible, and skin-conformal device that can be constructed using commercially available components. Systematic benchtop studies and numerical simulations highlight all of the key considerations. Measurements on 7 patients establish high levels of functionality, with data that reveal time dependent changes in flow associated with positional and inertial effects on the body. Taken together, the results suggest a significant advance in monitoring capabilities for patients with shunted hydrocephalus, with potential for practical use across a range of settings and circumstances, and additional utility for research purposes in studies of CSF hydrodynamics.
AB - Hydrocephalus is a common disorder caused by the buildup of cerebrospinal fluid (CSF) in the brain. Treatment typically involves the surgical implantation of a pressure-regulated silicone tube assembly, known as a shunt. Unfortunately, shunts have extremely high failure rates and diagnosing shunt malfunction is challenging due to a combination of vague symptoms and a lack of a convenient means to monitor flow. Here, we introduce a wireless, wearable device that enables precise measurements of CSF flow, continuously or intermittently, in hospitals, laboratories or even in home settings. The technology exploits measurements of thermal transport through near-surface layers of skin to assess flow, with a soft, flexible, and skin-conformal device that can be constructed using commercially available components. Systematic benchtop studies and numerical simulations highlight all of the key considerations. Measurements on 7 patients establish high levels of functionality, with data that reveal time dependent changes in flow associated with positional and inertial effects on the body. Taken together, the results suggest a significant advance in monitoring capabilities for patients with shunted hydrocephalus, with potential for practical use across a range of settings and circumstances, and additional utility for research purposes in studies of CSF hydrodynamics.
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U2 - 10.1038/s41746-020-0239-1
DO - 10.1038/s41746-020-0239-1
M3 - Article
C2 - 32195364
AN - SCOPUS:85088419084
SN - 2398-6352
VL - 3
JO - npj Digital Medicine
JF - npj Digital Medicine
IS - 1
M1 - 29
ER -