Diagnostics
One of the existing options Gelinas herself has used many times is EEG (electroencephalogram) testing. What’s great about EEG is that it allows clinicians to see a snapshot of activity in the brain without requiring an invasive procedure. What’s not so great is that EEGs provide very limited information about deeper parts of the brain because the technology only allows for surface-level investigation. In practice, this means clinicians can’t home in on a specific, small area of concern and take a closer look. Another major downside of EEG testing in patients with suspected or known neurological conditions is that the duration in which you can measure brain activity is limited to around 30 minutes each time. What happens if there aren’t any symptoms or abnormalities presenting themselves at this time? Clinicians, and thus patients, are left in the dark.
MRI (magnetic resonance imaging) is another helpful tool at neuroscientists’ disposal, but this too has its limitations. “MRIs can certainly help to find abnormalities that have changed a patient’s brain structure,” explains Gelinas. “However, like EEG testing, the reports they generate are only from a snapshot in time. We also can’t rule out a neurological disorder based on MRI results alone because the test doesn’t give us any information regarding how the brain tissue is actually functioning.”
While adults can lie still for the 30 minutes necessary to gather MRI data, this is a near-impossible task for young children, which introduces anaesthesia- associated health risks to the patient. What’s more, wait times to undergo an MRI are often lengthy; machines are expensive and not easily accessible by everyone; expert personnel are required to operate and interpret MRI scans; and existing implanted devices can easily disrupt how the data is read. All in all, clinicians and patients are left feeling frustrated by the lack of reliable information at hand. In an attempt to widen the window of time in which they can observe a patient with a possible brain abnormality, clinicians often have to resort to prescribing overnight hospital stays. However, this requires numerous staff to be on hand to monitor the patient, which isn’t feasible or sustainable in the vast majority of cases.
Device limitations
There are four primary reasons why constant monitoring hasn’t been possible from a neurological standpoint: Patient discomfort, incompatibility with daily life, limited data quality, hardware and material limitations. The discomfort caused by traditional medical devices in this space has been a significant hindrance to sustained monitoring of neurological activity. Patients find these devices bulky, heavy, and irritating, which often leads to them scratching attachment sites and even dislodging the devices entirely to stop them interfering.
Practical Patient Care /
www.practical-patient-care.com
With traditional devices always getting in the way, it’s extremely difficult for patients who require constant monitoring to be compliant. Being tethered to monitoring equipment makes it almost impossible for patients to lead their normal lives and conduct everyday activities. This makes long-term observations very impractical for clinicians and researchers, as they rely on patient compliance to be able to gather data. The quality of data gathered through such monitoring devices is also far from ideal. Every time a patient scratches or dislodges a device, the data it’s collecting becomes less accurate and valuable to the clinician. For example, signals get degraded and may end up lost in translation. With a limited ability to interpret such data correctly, it’s not easy to provide appropriate and timely care plan recommendations to patients. “If the data is bad enough, it’s going to interfere with one’s ability to provide a diagnosis,” says Gelinas. A large attributing factor to the unfeasibility of constant monitoring in neurology patients has been limitations in hardware and materials used in monitoring devices. Most devices are built using rigid materials, such as silicone and metal, which are not biocompatible. This means that in order to come into contact with a patient’s bodily tissues, the materials must be encapsulated, making them uncomfortable to wear. Moreover, the cables and wires required to connect devices to external monitors further contribute to the mobility restrictions patients face while being monitored. The quest for more comfortable and unobtrusive monitoring solutions has quickly become an urgent priority for researchers, healthcare providers, and patients alike. Fortunately, times are changing, and we are now at a major turning point in long-term neuroscience monitoring. “Recently, there’s been an explosion in the wearable electronics space,” says Gelinas. “Advances in material science and engineering are bringing softer, more compatible materials into the forefront for device development.”
A softer alternative
This technological breakthrough has paved the way for comfortable, non-invasive long-term monitoring of numerous physiological parameters, including brain activity. “These new, soft devices can be affixed to a patient’s forehead or wrist with a very small form factor that can read out information wirelessly to monitor sleep patterns, monitor heart rhythms, and do basic EEG,” explains Gelinas. “So, we’re really moving in the direction of being able to monitor in real-time.”
Gelinas and her team have been spearheading research and development in long-term neuroscience monitoring for some time now. Their work primarily focuses on leveraging novel materials – in particular, organic electrons – in an effort to create high-precision
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