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

Krishnan, Siddharth R;Arafa, Hany M;Kwon, Kyeongha;Deng, Yujun;Su, Chun-Ju;Reeder, Jonathan T;Freudman, Juliet;Stankiewicz, Izabela;Chen, Hsuan-Ming;Loza, Robert;Mims, Marcus;Mims, Mitchell;Lee, KunHyuck;Abecassis, Zachary;Banks, Aaron;Ostojich, Diana;Patel, Manish;Wang, Heling;Börekçi, Kaan;Rosenow, Joshua;Tate, Matthew;Huang, Yonggang;Alden, Tord;Potts, Matthew B;Ayer, Amit B;Rogers, John A;
npj digital medicine 2020 Vol. 3 pp. 29
358
krishnan2020continuousnpj

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.

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