Neuromuscular disorders can be defined as either acquired or inherited conditions that affect the muscles, nerves and neuromuscular junction. Diagnosis can be challenging, but the development of wearable medical sensors may be able to aid early detection.
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Although there are hundreds of different types of neuromuscular disorders, many of which have subtypes that are related to specific genetic causes, some of the most common types include muscular dystrophy, spinal muscular atrophy (SA), Charcot-Marie-Tooth (CMT) disease, mitochondrial myopathies, and metabolic myopathies.
Early Detection of Neuromuscular Disorders in Young Children
Adults with children who have been diagnosed with neuromuscular disorders often experience a financial and emotional burden as a result of their child’s condition.
Early detection of these conditions has been shown to improve caregiver stress and ensure that the appropriate management and services are incorporated into the child’s care. Furthermore, in some cases, early detection and the subsequent initiation of treatment can even slow disease progression and improve neuroplasticity to promote patient.
Despite these advantages, there are several factors that prevent the early detection of neuromuscular disorders in young children.
In fact, studies estimate that the average time between when a parent first voices concerns of their child’s development and the final diagnosis of Duchenne muscular dystrophy is around two years.
Caregiver characteristics and other socioeconomic factors, for example, can prevent young children from gaining access to special services. However, an even more significant contributor to this delay in diagnosis and the initiation of treatments is due to limitations associated with traditional neuromotor assessments.
Current Methods for Diagnosis
The current approach to diagnosing neuromuscular disorders in young children begins with neuromotor assessments, typically performed by specially trained personnel.
Unfortunately, access to these healthcare professionals is limited, as they are often only offered in tertiary medical centers or specialized facilities. In addition to requiring proximity to these facilities, these visits are often highly expensive and limited in their ability to provide much information beyond qualitative insight.
As well as collecting information on the child’s medical history, performing clinical examinations, and acquiring imaging of the child’s affected anatomical regions, several alternative strategies can also be employed to assist in a final diagnosis.
These include electroencephalography (EEG) or electromyography (EMG). Some of the limitations associated with these techniques include time-extensive requirements, the need for expensive equipment, and their limited availability outside of specialized facilities.
Another approach that many consumers will also utilize includes imaging platforms like the now-discontinued Microsoft Kinect and similar systems that track body movements.
Despite their widespread availability, these approaches lack the precision and resolution needed to adequately monitor the movement of neonates and young children.
A Miniaturized, Wireless, and Skin-integrated Sensor
There remains a significant need for readily available motion analysis systems that can monitor movements and physiological health metrics at a high resolution in infants and young children. To this end, a recent study published in the journal PNAS discusses the development of cost-effective wireless networks of miniaturized, skin-integrated sensors that digitalize both the movements and vital signs of infants.
The wireless network platform designed by the research team is otherwise known as Core Optimization for Regulation of Babies (CORB). The three main components of this platform include the collection of CORB sensors, a customized app for a smartphone or tablet, and a set of algorithms used to reconstruct recorded movements.
Each of the miniaturized sensors incorporated into this platform operates in a time-coordinated and highly synchronized fashion to record data from three-axis digital accelerometers and gyroscopes.
Importantly, the time difference between the sensors is less than one millisecond (ms), thus demonstrating the synchronicity of these sensors and their ability to provide accurate measurements.
Compared to the most advanced sensors for motion capture currently available on the market, the CORB sensors are more than three times thinner, five times light, and two times smaller in their overall volume.
An additional advantage of the CORB platform as compared to these commercialized sensors is that they are capable of monitoring movement, as well as providing precise measurements on the cardiopulmonary function and body temperature of the child.
Some of the different cardiovascular functions that are monitored with this system include cardiopulmonary and vocalization sounds, heart and respiratory rate, as well as their cycle-to-cycle variability estimates.
In their study, the researchers utilize a total of 10 devices that are placed on a model infant’s body to assess full-body motion.
These sensors were placed on the middle of the upper and lower arms, as well as the middle of the thighs and shins, chest, and forehead.
The small dimensions of the CORB system allow for sensors to be placed on highly curbed parts of the body without causing significant stress on the skin while the sensors are in use.
Conclusions and Future Outlook
The CORB platform discussed here is a collection of soft and lightweight wireless sensors that can be optimized for use in children as young as newborn infants.
For clinical purposes, the data acquired from these sensors can be transmitted to and assessed by healthcare professionals from across the world while simultaneously ensuring the privacy of the child’s results.
Although further studies need to be conducted using the sensors in both healthy subjects and children with neuromuscular disorders, the researchers anticipate that this preliminary data support the use of this device in nearly any setting and across both developed and developing countries.
Continue reading: Wireless 3D Printed Wearable Sensor to Track Health and Body Function
References and Further Reading
Lurio, J. G., Peay, H. L., & Matthews, K. D. (2015). Recognition and Management of Motor Delay and Muscle Weakness in Children. American Family Physician 91(1); 38-44. Available at: https://www.aafp.org/afp/2015/0101/p38.html.
Gillette Children's Specialty Healthcare (2022) Neuromuscular Disorders [Online]. Available at: https://www.gillettechildrens.org/conditions-care/neuromuscular-disorders.
Jeong, H., Kwak, S. S., Sohn, S., et al. (2021). Miniaturized wireless, skin-integrated sensor networks for quantifying full-body movement behaviors and vital signs in infants. Proceedings of the National Academy of Sciences of the United States of America 118(43). Available at: www.pnas.org/content/118/43/e2104925118