Anticipatory Medical Devices

In a famous advertising campaign from the late 1980s, an elderly woman lies on the floor near her walker and calls out: "I've fallen and I can't get up." By pushing a button on the device that she wears around her neck, the woman is able to summon help. Today, the Anticipatory Medical Device platform has a vision for a similarly portable, wireless device – essentially, a medical PDA that could be worn on a belt. But this one would be so attuned to the body's signals that it could detect a life-threatening event, like a fall, before it happens, and stimulate nerves and muscles to restore normal balance and movement. Other devices would prevent the heart from going into an arrhythmia, or cause insulin to be released inside the body to ward off diabetic shock.

 

From static to dynamic medicine

Growing evidence shows that far from being flat or predictable, a healthy body's output signals are noisy and complex. Heartbeats, for instance, are surprisingly variable – much more like the variation of a musical score than the steady beat of a metronome. That complexity allows for a nimble response to the body's ever-changing natural rhythms.

Conversely, any loss of complexity in heartbeat, breathing rate, or brain electrical activity may indicate impending trouble and offer untapped opportunities for medical diagnosis and therapy. Wyss scientists are developing new computational techniques that reveal subtle variations in these physiological rhythms, which could indicate pending clinical problems ranging from frailty in the elderly to heart arrhythmias and breathing problems in intensive care patients. These predictive diagnostics could be integrated with miniaturized, wearable devices that deliver physical, magnetic, electrical, optical, or chemical stimuli to the body, thus "rebooting" and restoring a healthy, normal state.

Avoiding falls

Human balance relies on complex feedback from the senses that govern the body's mechanical stability. But with aging and diseases such as diabetes and Parkinson's, sensory functions can fail, dulling the stimulations that keep healthy people steady on their feet.

Wyss Institute faculty have discovered that random vibrations too gentle to be felt can prime the sensory system and restore stability. Wireless devices in shoes can deliver these vibrations, essentially "jazzing" up the foot's sensory experience and boosting nerve cell sensitivity to external signals. Studies show that elderly people using these devices walk with greater stability and confidence. Similar approaches can also be used to treat stroke victims or to increase touch sensitivity in the feet of patients with diabetes.

Preventing Infant Apnea

Another research project aims to prevent infant apnea, a pause in breathing that can be life-threatening and is especially common in premature infants. The condition is believed to be caused by underdeveloped brain wiring in the circuits that control breathing and results in oxygen deprivation, which can kill or produce lifelong developmental problems. Wyss scientists are exploring breathing and heart-rate patterns that can predict when an at-risk infant will stop breathing. By applying gentle stimulation through the infant's mattress when such a pattern is detected, it may be possible to enhance sensitivity of sensory receptors and other cells in the lung and other tissues, normalize breathing, and limit the risk of a potential catastrophe.

Initial target applications

• Gait control in young and old
  ·Shoe insoles that restore normal gait in the elderly
  ·Leg orthotics that normalize gait in children with cerebral palsy
   
• Prevention of life-threatening events in premature infants
  ·Anticipatory rebooting device in the NICU
  ·Portable wireless devices that can go home with premature infants