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）通常由大脑中淀粉样蛋白β（Abeta）沉积物的标记诊断 脑脊液和/或血液。到目前为止，这种标志已被证明不足以解释 开发AD，并确定高危个人。越来越多的证据表明Abeta被清除 通过在睡眠期间特别活跃的糖基系统，现在也认为是糖酶 功能是由血管脉动驱动的。鉴于两种血管的可靠发现，这很有趣 AD患者的功能障碍和睡眠不足，这些观察结果表明潜在的催化 脑血管状态，睡眠中断和AD进展之间的联系。确实，脑血管减少 脉动性和血压（BP）脉搏波的变化已经证明与AD严重程度有关。 当前，没有适合长期持续的技术（例如24小时）的beat-beat特征 AD中的血管和糖性动力学。如果可以进行此类监控，这可以帮助研究人员 调查有关AD的基本机制的几个额外假设，最终可能有助于 改善广告检测和治疗策略。 我们位于马萨诸塞州综合医院的团队已经开发了可穿戴的多模式脑血管 监视平台，称为NINSCAN，该平台最多可24小时使用。这项技术正在增强 我们的主动R01项目（EB027122），使用我们的新型浅表临时动脉渗透（STAT）方法 在头部水平上进行连续的无袖BP监测。该补充提案有两个具体的目标。在 目标1我们将进一步开发用于多模式脑血管和流体监测的ninscan，以及 优化其用于AD中的门诊监测的用途。这将通过改善发色团和 深度灵敏度以及患者的可用性。对于AIM 2，我们将对老年人和AD进行可行性测试 在实验室和24小时记录中的患者（包括日常活动和睡眠）。这些数据将使我们 在（i）bp上进行健康和患者组之间的初步比较，（ii）bp脉动性，（iii） 脑血液和水（Glymphatic）体积以及（iv）血液体积的脉动。数据也将 作为EB027122的一部分，可以添加到正在开发的Physionet数据库中。 这种补充剂将导致最全面的脑监测系统，能够使用24小时， 包括静态和动态BP和大脑流体测量值，这些测量似乎是AD的关键。我们期望这 增强的能力将有助于更好地理解AD，并希望刺激新的发展 诊断或疗法，以及提供远远超出AD的功能。