A Predictive Model for Assessment of CSF Flow Through Ventricular Shunts

评估脑脊液流经心室分流的预测模型

• 批准号: 10455445
• 负责人: Hany Mohamed Arafa
• 金额: $ 4.34万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10455445
• 关键词: Accelerometer; Adult; Affect; Age; Algorithms; American; Brain; Catheters; Cerebral Ventricles; Cerebrospinal Fluid; Cessation of life; Childhood; Clinical; Clinical Trials; Collaborations; Collection; Coma; Consumption; Couples; Creation of ventriculo-peritoneal shunt; Data; Detection; Development; Devices; Diagnostic; Drainage procedure; Electronics; Epidermis; Evaluation; Failure; Feedback; Formulation; Generations; Geometry; Headache; Health Care Costs; Health Personnel; Health Professional; Hospitalization; Hospitals; Hydrocephalus; Image; Implant; Institutional Review Boards; Left; Live Birth; Logistic Regressions; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Mechanics; Medical Imaging; Methodology; Methods; Modality; Modeling; Monitor; Obstruction; Operative Surgical Procedures; Outcome; Pathology; Patients; Pediatric Hospitals; Physicians; Physiological; Protocols documentation; Quality of life; Radiation exposure; Research; Research Personnel; Roentgen Rays; Seizures; Series; Shunt Device; Skin; Symptoms; System; Technology; Testing; Time; Tracer; Ultrasonography; United States; Universities; Validation; Ventricular; Work; cerebrospinal fluid flow; cost; design; diagnosis standard; experience; experimental study; flexibility; implantation; improved; in vivo; innovation; insight; miniaturized sensor; mortality; novel; patient variability; pediatric patients; prediction algorithm; predictive modeling; pressure; psychologic; real time monitoring; regression algorithm; sensor; standard of care; success; tomography; wearable platform; wearable sensor technology; wireless

Project Summary Hydrocephalus is a crippling condition which caused by an aberrant draining capacity of cerebrospinal fluid (CSF) from the brain, affecting about 1-5 of every 1000 live births. This debilitating condition commonly manifests itself in frequent headaches, seizures, and comas, with death as a likely outcome when left untreated. The standard of care to alleviate this condition is ventriculoperitoneal shunting which diverts CSF away from the brain ventricles, thereby reducing excess pressure build-up. CSF diversion systems or shunts are typically rudimentary systems which contain a ventricular catheter, valve, and drainage tubing; this technology has experienced minimal innovation since the 1960s. However, shunts regularly fail and require correction surgeries due to obstructions and occlusions, leading to over 125,000 shunt revisions in the United States annually. Shunt revisions cost about 2 billion dollars in the United States annually for the nearly 1 million affected Americans. Hydrocephalus imposes a huge financial, physiological, and psychological burden on patients and their health care providers, emphasizing the urgent need to improve methods of monitoring and prediction of shunt failure. To compound this issue, existing shunt failure diagnostics are costly, invasive, and/or harmful (in the case of ex- tended radiation exposure in CT imaging). Typical shunt testing modalities include Magnetic Resonance Imaging (MRI), Coherence Tomography (CT), and X-rays. Due to patient-to-patient variability in age, pathology, shunt in- termittency, and shunt valve type, there is currently a lack of data with regards to flow dynamics in CSF diversion systems. Most research efforts have primarily focused on the development of ‘smart shunts’ which inadvertently couples complete shunt failure to sensor failure; this proposal seeks to provide accurate and real-time monitoring of CSF flow in a noninvasive manner, the success of which could directly affect the quality of life of 1 million Americans suffering with hydrocephalus and millions more around the world. This proposal will support the devel- opment of a wearable sensor platform and processing algorithm that will culminate in a predictive model of shunt failure to reduce hospital admissions and improve the quality of life for patients with hydrocephalus. Success of this proposal will yield a fully flexible, soft, and wireless system which monitors CSF diversion (Aim 1 and Aim 2), leading to a validation trial of the integrated system in long term trials of both adult and pediatric patients suffering with hydrocephalus. The completion of this work will also include the generation of a predictive model which allows researchers to study long term CSF flow dynamics through ventricular shunts (Aim 3). Ultimately, our methodology will enable us to collect a wealth of information to significantly aid healthcare professionals in the proactive treatment of the devastating symptoms of hydrocephalus.

项目摘要 脑积水是一种残酷的疾病，是由脑脊液（CSF）吞噬能力引起的 从大脑中，每1000个活着的疾病都会影响1-5个。 在未经治疗的情况下，经常出现头痛，癫痫发作和昏迷 减轻这种心室分流的护理标准，使CSF从大脑中转移。 心室，从而减少了过量的压力。 包含心室导管，阀门和排水管的系统具有经验 但是，自1960年代以来，分流器定期失败并因阻塞而需要Corgeries 和闭塞，每年在美国进行超过125,000个分流修订。 美国每年在美国近100万的美国人 强调患者和医疗保健提供者的巨大财务，生理和心理负担 迫切需要改善分流故障的监视和预测方法。 更复杂的是，现有的分流故障诊断是昂贵，侵入性和/或有害的（在事实的情况下 CT成像中的辐射暴露）。 （MRI），明天连贯性（CT）和X射线。 耗尽性和分流阀类型，目前缺乏有关CSF转移流动动态的数据 系统。 夫妻完全分流器失败了，该提案试图提供准确的实时监控 CSF流动以非侵入性的方式流动，学校可能直接影响100万的生活质量 美国人患有脑积水，世界上有数百万。 可穿戴传感器平台和处理算法的操作，该算法将在分流的预测模型中达到顶峰 未能减少霍斯疗法的入院并改善脑积水患者的生活质量。 该提案的成功将使柔软，柔软和无线的系统将监视CSF转移（AIM 1） AIM 2），导致成人和小儿专业性的长期综合系统的验证试验 遭受脑积水。 这使研究人员可以通过心室分流来研究长期的CSF流动动力学（AIM 3）。 我们的甲基化学将使我们能够收集大量信息，以极大地帮助医疗保健专业人员 积极治疗脑积水的毁灭性症状。

项目成果

Intramuscular Near-Infrared Spectroscopy for Muscle Flap Monitoring in a Porcine Model.

• DOI: 10.1055/s-0041-1732361
• 发表时间: 2022-05
• 期刊: JOURNAL OF RECONSTRUCTIVE MICROSURGERY
• 影响因子: 2.1
• 作者: Bai, Wubin;Guo, Hexia;Ouyang, Wei;Weng, Yang;Wu, Changsheng;Liu, Yihan;Zang, Hao;Jacobson, Lauren;Xu, Yameng;Lu, Di;Hu, Ziying;Li, Shuo;Arafa, Hany M.;Yang, Hany M.;Westman, Amanda M.;MacEwan, Matthew R.;Rogers, John A.;Pet, Mitchell A.
• 通讯作者: Pet, Mitchell A.

Thermally switchable, crystallizable oil and silicone composite adhesives for skin-interfaced wearable devices.

• DOI: 10.1126/sciadv.abo0537
• 发表时间: 2022-06-10
• 期刊: Science advances
• 影响因子: 13.6