Wearable Multi-modality Cuffless Blood Pressure Monitoring

可穿戴多模态无袖血压监测

• 批准号: 10489962
• 负责人: QUAN ZHANG
• 金额: $ 41.74万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10489962
• 关键词: Abeta clearance; Age; Aging; Algorithms; Alzheimer disease detection; Alzheimer' s Disease; Alzheimer' s disease pathology; Alzheimer' s disease patient; Ambulatory Monitoring; Amyloid beta-Protein; Biological Markers; Blood; Blood Pressure; Blood Pressure Monitors; Blood Vessels; Brain; Cardiovascular system; Cerebrospinal Fluid; Cerebrum; Cognitive; Data; Data Set; Databases; Deposition; Development; Device or Instrument Development; Devices; Diagnosis; Disease Progression; Elderly; Electrophysiology (science); Enhancement Technology; Etiology; Evolution; Expeditions; Functional disorder; Future; General Hospitals; Goals; Gold; Head; Hemoglobin; Home; Hour; Human; Individual; International; Investigation; Laboratories; Lead; Light; Link; Lipids; Liquid substance; Massachusetts; Measurement; Methods; Monitor; Near-Infrared Spectroscopy; Nerve Degeneration; Optics; Parents; Patients; Performance; Physiologic pulse; Physiology; Play; Procedures; Process; Research; Research Personnel; Resolution; Rest; Risk; Role; Severity of illness; Sleep; Sleep Disorders; Sleep disturbances; Source; Space Flight; System; Technology; Temporal Arteries; Testing; Time; Tissues; United States National Aeronautics and Space Administration; United States National Institutes of Health; Validation; Vascular Diseases; Water; Work; algorithmic bias; base; cerebrovascular; chromophore; cognitive task; cognitive testing; data acquisition; feasibility testing; glymphatic dysfunction; glymphatic function; glymphatic system; healthy aging; immune function; improved; machine learning algorithm; multimodal data; multimodality; novel; novel diagnostics; novel strategies; novel therapeutics; public database; pulse pressure wave; recruit; sensor; sleep quality; standard measure; tonometry; tool; treatment strategy; usability; wearable device; wearable platform

Alzheimer’s disease (AD) is typically diagnosed by markers of amyloid-beta (ABeta) deposits in the brain, cerebrospinal fluid, and/or blood. So far, such hallmarks have proven insufficient for explaining the development of AD, and identifying at-risk individuals. A growing body of evidence suggests that ABeta is cleared via the glymphatic system, which is especially active during sleep, and it is now also thought that glymphatic function is driven by vascular pulsations. This is intriguing given the reliable findings of both vascular dysfunction and disordered sleep in AD patients, and together these observations suggest potential causal links between cerebrovascular status, sleep disruption, and AD progression. Indeed, reduced cerebrovascular pulsatility and changes in the blood pressure (BP) pulse wave have already shown to be related to AD severity. Currently, there is no technology suitable for long-duration (e.g. 24-hr) beat-to-beat characterization of these vascular and glymphatic dynamics in AD. If such monitoring was possible, this could help researchers investigate several extant hypotheses regarding the underlying mechanisms of AD, that ultimately could help to improve AD detection and treatment strategies. Our team at Massachusetts General Hospital has developed a wearable, multimodal cerebrovascular monitoring platform, called NINscan, which is capable of up to 24-hr use. This technology is being enhanced in our active R01 project (EB027122), using our novel superficial temporal artery tonometry (STAT) method for continuous, cuffless BP monitoring at the level of the head. This supplement proposes two specific aims. In Aim 1 we will further develop NINscan for multimodal cerebral vascular and fluid monitoring, as well as optimizing its use for ambulatory monitoring in AD. This will be accomplished by improving chromophore and depth sensitivity as well as patient usability. For Aim 2, we will conduct feasibility testing in older adults and AD patients, both in the lab and during 24-hr recordings (including daily activities and sleep). This data will allow us to conduct preliminary comparisons between healthy and patient groups on (i) BP, (ii) BP pulsatility, (iii) cerebral blood and water (glymphatic) volumes, and (iv) blood and water volume pulsatility. The data will also be added to the Physionet database being developed as part of EB027122. This supplement will lead to the most comprehensive cerebral monitoring system capable of 24-hr use, including static and dynamic BP and cerebral fluid measurements that appear key to AD. We expect that this enhanced capability will facilitate a better understanding of AD and hopefully stimulate the development of new diagnostics or therapies, as well as providing capabilities that are useful well beyond AD.

阿尔茨海默氏病（AD）通常通过脑中淀粉样蛋白β（ABeta）沉积的标志物来诊断， 脑脊液和/或血液。到目前为止，这些特征已被证明不足以解释 AD的发展，以及识别风险个体。越来越多的证据表明， 通过胶质淋巴系统，这是特别活跃的睡眠期间，现在也认为，胶质淋巴 功能由血管搏动驱动。这是有趣的，因为两个血管的可靠发现 AD患者的功能障碍和睡眠障碍，这些观察结果表明， 脑血管状态、睡眠中断和AD进展之间的联系。事实上，减少脑血管 脉动性和血压（BP）脉搏波的变化已经显示与AD严重程度相关。 目前，没有适合于这些特征的长持续时间（例如24小时）逐拍表征的技术。 血管和胶质淋巴动力学。如果这样的监测是可能的， 研究关于AD潜在机制的几个现存假设，最终可能有助于 改善AD检测和治疗策略。 我们在马萨诸塞州总医院的团队开发了一种可穿戴的多模式脑血管 监测平台，称为NINscan，能够长达24小时使用。这项技术正在得到加强， 我们的活跃R 01项目（EB 027122），使用我们的新的颞浅动脉张力测定（STAT）方法， 在头部水平连续无袖带血压监测。本补编提出了两个具体目标。在 目标1：我们将进一步开发用于多模式脑血管和液体监测的NINscan，以及 优化其用于AD的动态监测。这将通过改进发色团和 深度灵敏度以及患者可用性。对于目标2，我们将在老年人和AD中进行可行性测试 患者，无论是在实验室和24小时记录（包括日常活动和睡眠）。这些数据可以让我们 在健康组和患者组之间对（i）BP，（ii）BP脉动性，（iii） 脑血液和水（胶质淋巴）体积，和（iv）血液和水体积脉动性。数据还将 添加到作为EB 027122的一部分开发的Physionet数据库中。 这一补充将导致最全面的大脑监测系统能够24小时使用， 包括静态和动态血压和脑液测量，这似乎是AD的关键。我们期望这 增强的能力将有助于更好地理解AD，并有望刺激新的 诊断或治疗，以及提供远远超出AD的有用能力。