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

• Main Authors: 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, KunHyuck Lee, Zachary Abecassis, Aaron Banks, Diana Ostojich, Manish Patel, Heling Wang, Kaan Börekçi, Joshua Rosenow, Matthew Tate, Yonggang Huang, Tord Alden, Matthew B. Potts, Amit B. Ayer, John A. Rogers
• Format: Article
• Language: English
• Published: Nature Publishing Group 2020-03-01
• Series: npj Digital Medicine
• Online Access: https://doi.org/10.1038/s41746-020-0239-1

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.