Continuous, noninvasive wireless monitoring of flow of cerebrospinal fluid through shunts in patients with hydrocephalus

Siddharth R. Krishnan, Hany M. Arafa, Kyeongha Kwon, Yujun Deng, Chun Ju Su, Jonathan T. Reeder, Juliet Freudman, Izabela Stankiewicz, Hsuan Ming Chen, Robert Loza, Marcus Mims, Mitchell Mims, Kun Hyuck Lee, Zachary Abecassis, Aaron Banks, Diana Ostojich, Manish Patel, Heling Wang, Kaan Börekçi, Joshua RosenowMatthew Tate, Yonggang Huang, Tord Alden, Matthew B. Potts, Amit B. Ayer, John A. Rogers*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article number29
Journalnpj Digital Medicine
Volume3
Issue number1
DOIs
StatePublished - Dec 1 2020

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Informatics
  • Health Information Management
  • Computer Science Applications

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    Krishnan, S. R., Arafa, H. M., Kwon, K., Deng, Y., Su, C. J., Reeder, J. T., Freudman, J., Stankiewicz, I., Chen, H. M., Loza, R., Mims, M., Mims, M., Lee, K. H., Abecassis, Z., Banks, A., Ostojich, D., Patel, M., Wang, H., Börekçi, K., ... Rogers, J. A. (2020). Continuous, noninvasive wireless monitoring of flow of cerebrospinal fluid through shunts in patients with hydrocephalus. npj Digital Medicine, 3(1), [29]. https://doi.org/10.1038/s41746-020-0239-1