Adhesive Skin Sensor Monitors Ventricular Shunt Function

A new study describes how epidermal electronics can be used for noninvasive, wireless, quantitative assessment of ventricular shunt function in patients with hydrocephalus.

Developed by researchers at Northwestern University (NU; Chicago, IL, USA) and the University of Illinois at Urbana-Champaign (UIUC; USA), the skin-mounted sensor incorporates arrays of thermal sensors and actuators in order to measure cerebral spinal fluid (CSF) flow through subdermal shunts. The sensor works by measuring thermal transport; when skin temperature is raised and excess CSF is draining properly, a characteristic heat signature is detected. But when the heat signature is missing, it means there is no CSF flow, and that the shunt has malfunctioned.

A very small rechargeable battery is built directly into the sensor, and the device is Bluetooth enabled, so it can communicate with a smartphone and deliver the readings via an Android app. The researchers conducted clinical trials in five patients in order to validated the sensor’s ability to detect presence of CSF flow within five minutes of placement on the skin, as well its ability to distinguish between baseline flow, diminished flow, and distal shunt failure. The study was published on October 31, 2018, in Science Translational Medicine.

“Hydrocephalus affects adults and children. Shunt malfunction symptoms, like headaches or sleepiness, are things kids can have for lots of reasons, like the flu,” said co-senior author neurologic surgeon Matthew Potts, MD, of NU. “So if a child has these symptoms, it's very hard to know, and every time your kid says they have a headache or feels a little sleepy, you automatically think, 'Is this the shunt?' We believe that this device can spare patients a lot of the danger and costs of this process.”

“It's a wearable device with a specific but useful mode of operation that's addressing an unmet need in clinical medicine,” said co-senior author Professor John Rogers, MD, PhD, of NU. “At the end of the day, from a patient perspective, it looks like a Band-Aid that's talking to their cellphone. There's nothing like this out there today.”

Hydrocephalus is a condition in which an excess of CSF accumulates within the ventricles and increases pressure in the brain, resulting in a life-threatening situation. But although implanted CSF shunts help relieve the pressure build-up, at least 50% of patients suffer from shunt failures and blockages within two years, requiring repeat surgeries. The costs of these emergent revision surgeries to restore CSF flow and alleviate painful symptoms present a heavy emotional and financial burden to patients, families, and healthcare facilities.

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