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

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.; Abecassis, Z.; Banks, A.; Ostojich, D.; Patel, M.; Wang, H.; Börekçi, K.; Rosenow, J.; Tate, M.; Huang, Y.; Alden, T.; Potts, M. B.; Ayer, A. B.; Rogers, J. A.

NPJ Digit Med. 2020 Mar 21; 3:29

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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