Epidermal electronics for noninvasive, wireless, quantitative assessment of ventricular shunt function in patients with hydrocephalus

Siddharth R. Krishnan, Tyler R. Ray, Amit B. Ayer, Yinji Ma, Philipp Gutruf, Kun Hyuck Lee, Jong Yoon Lee, Chen Wei, Xue Feng, Barry Ng, Zachary A. Abecassis, Nikhil Murthy, Izabela Stankiewicz, Juliet Freudman, Julia Stillman, Natalie Kim, Grace Young, Camille Goudeseune, John Ciraldo, Matthew Christopher Tate & 3 others Yonggang Huang, Matthew Bryan Potts, John A Rogers

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Hydrocephalus is a common and costly neurological condition caused by the overproduction and/or impaired resorption of cerebrospinal fluid (CSF). The current standard of care, ventricular catheters (shunts), is prone to failure, which can result in nonspecific symptoms such as headaches, dizziness, and nausea. Current diagnostic tools for shunt failure such as computed tomography (CT), magnetic resonance imaging (MRI), radionuclide shunt patency studies (RSPSs), and ice pack–mediated thermodilution have disadvantages including high cost, poor accuracy, inconvenience, and safety concerns. Here, we developed and tested a noninvasive, skin-mounted, wearable measurement platform that incorporates arrays of thermal sensors and actuators for precise, continuous, or intermittent measurements of flow through subdermal shunts, without the drawbacks of other methods. Systematic theoretical and experimental benchtop studies demonstrate high performance across a range of practical operating conditions. Advanced electronics designs serve as the basis of a wireless embodiment for continuous monitoring based on rechargeable batteries and data transmission using Bluetooth protocols. Clinical studies involving five patients validate the sensor’s ability to detect the presence of CSF flow (P = 0.012) and further distinguish between baseline flow, diminished flow, and distal shunt failure. Last, we demonstrate processing algorithms to translate measured data into quantitative flow rate. The sensor designs, fabrication schemes, wireless architectures, and patient trials reported here represent an advance in hydrocephalus diagnostics with ability to visualize flow in a simple, user-friendly mode, accessible to the physician and patient alike.

Original languageEnglish (US)
Article numberaat8437
JournalScience Translational Medicine
Volume10
Issue number465
DOIs
StatePublished - Oct 31 2018

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Ventricular Function
Hydrocephalus
Cerebrospinal Fluid
Thermodilution
Ice
Dizziness
Standard of Care
Radioisotopes
Nausea
Headache
Catheters
Hot Temperature
Tomography
Magnetic Resonance Imaging
Physicians
Safety
Costs and Cost Analysis
Skin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Krishnan, Siddharth R. ; Ray, Tyler R. ; Ayer, Amit B. ; Ma, Yinji ; Gutruf, Philipp ; Lee, Kun Hyuck ; Lee, Jong Yoon ; Wei, Chen ; Feng, Xue ; Ng, Barry ; Abecassis, Zachary A. ; Murthy, Nikhil ; Stankiewicz, Izabela ; Freudman, Juliet ; Stillman, Julia ; Kim, Natalie ; Young, Grace ; Goudeseune, Camille ; Ciraldo, John ; Tate, Matthew Christopher ; Huang, Yonggang ; Potts, Matthew Bryan ; Rogers, John A. / Epidermal electronics for noninvasive, wireless, quantitative assessment of ventricular shunt function in patients with hydrocephalus. In: Science Translational Medicine. 2018 ; Vol. 10, No. 465.
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abstract = "Hydrocephalus is a common and costly neurological condition caused by the overproduction and/or impaired resorption of cerebrospinal fluid (CSF). The current standard of care, ventricular catheters (shunts), is prone to failure, which can result in nonspecific symptoms such as headaches, dizziness, and nausea. Current diagnostic tools for shunt failure such as computed tomography (CT), magnetic resonance imaging (MRI), radionuclide shunt patency studies (RSPSs), and ice pack–mediated thermodilution have disadvantages including high cost, poor accuracy, inconvenience, and safety concerns. Here, we developed and tested a noninvasive, skin-mounted, wearable measurement platform that incorporates arrays of thermal sensors and actuators for precise, continuous, or intermittent measurements of flow through subdermal shunts, without the drawbacks of other methods. Systematic theoretical and experimental benchtop studies demonstrate high performance across a range of practical operating conditions. Advanced electronics designs serve as the basis of a wireless embodiment for continuous monitoring based on rechargeable batteries and data transmission using Bluetooth protocols. Clinical studies involving five patients validate the sensor’s ability to detect the presence of CSF flow (P = 0.012) and further distinguish between baseline flow, diminished flow, and distal shunt failure. Last, we demonstrate processing algorithms to translate measured data into quantitative flow rate. The sensor designs, fabrication schemes, wireless architectures, and patient trials reported here represent an advance in hydrocephalus diagnostics with ability to visualize flow in a simple, user-friendly mode, accessible to the physician and patient alike.",
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Krishnan, SR, Ray, TR, Ayer, AB, Ma, Y, Gutruf, P, Lee, KH, Lee, JY, Wei, C, Feng, X, Ng, B, Abecassis, ZA, Murthy, N, Stankiewicz, I, Freudman, J, Stillman, J, Kim, N, Young, G, Goudeseune, C, Ciraldo, J, Tate, MC, Huang, Y, Potts, MB & Rogers, JA 2018, 'Epidermal electronics for noninvasive, wireless, quantitative assessment of ventricular shunt function in patients with hydrocephalus' Science Translational Medicine, vol. 10, no. 465, aat8437. https://doi.org/10.1126/scitranslmed.aat8437

Epidermal electronics for noninvasive, wireless, quantitative assessment of ventricular shunt function in patients with hydrocephalus. / Krishnan, Siddharth R.; Ray, Tyler R.; Ayer, Amit B.; Ma, Yinji; Gutruf, Philipp; Lee, Kun Hyuck; Lee, Jong Yoon; Wei, Chen; Feng, Xue; Ng, Barry; Abecassis, Zachary A.; Murthy, Nikhil; Stankiewicz, Izabela; Freudman, Juliet; Stillman, Julia; Kim, Natalie; Young, Grace; Goudeseune, Camille; Ciraldo, John; Tate, Matthew Christopher; Huang, Yonggang; Potts, Matthew Bryan; Rogers, John A.

In: Science Translational Medicine, Vol. 10, No. 465, aat8437, 31.10.2018.

Research output: Contribution to journalArticle

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T1 - Epidermal electronics for noninvasive, wireless, quantitative assessment of ventricular shunt function in patients with hydrocephalus

AU - Krishnan, Siddharth R.

AU - Ray, Tyler R.

AU - Ayer, Amit B.

AU - Ma, Yinji

AU - Gutruf, Philipp

AU - Lee, Kun Hyuck

AU - Lee, Jong Yoon

AU - Wei, Chen

AU - Feng, Xue

AU - Ng, Barry

AU - Abecassis, Zachary A.

AU - Murthy, Nikhil

AU - Stankiewicz, Izabela

AU - Freudman, Juliet

AU - Stillman, Julia

AU - Kim, Natalie

AU - Young, Grace

AU - Goudeseune, Camille

AU - Ciraldo, John

AU - Tate, Matthew Christopher

AU - Huang, Yonggang

AU - Potts, Matthew Bryan

AU - Rogers, John A

PY - 2018/10/31

Y1 - 2018/10/31

N2 - Hydrocephalus is a common and costly neurological condition caused by the overproduction and/or impaired resorption of cerebrospinal fluid (CSF). The current standard of care, ventricular catheters (shunts), is prone to failure, which can result in nonspecific symptoms such as headaches, dizziness, and nausea. Current diagnostic tools for shunt failure such as computed tomography (CT), magnetic resonance imaging (MRI), radionuclide shunt patency studies (RSPSs), and ice pack–mediated thermodilution have disadvantages including high cost, poor accuracy, inconvenience, and safety concerns. Here, we developed and tested a noninvasive, skin-mounted, wearable measurement platform that incorporates arrays of thermal sensors and actuators for precise, continuous, or intermittent measurements of flow through subdermal shunts, without the drawbacks of other methods. Systematic theoretical and experimental benchtop studies demonstrate high performance across a range of practical operating conditions. Advanced electronics designs serve as the basis of a wireless embodiment for continuous monitoring based on rechargeable batteries and data transmission using Bluetooth protocols. Clinical studies involving five patients validate the sensor’s ability to detect the presence of CSF flow (P = 0.012) and further distinguish between baseline flow, diminished flow, and distal shunt failure. Last, we demonstrate processing algorithms to translate measured data into quantitative flow rate. The sensor designs, fabrication schemes, wireless architectures, and patient trials reported here represent an advance in hydrocephalus diagnostics with ability to visualize flow in a simple, user-friendly mode, accessible to the physician and patient alike.

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