Embodiments of the invention relate to sensors, for example wearable sensors, for detecting acute stroke, and methods of using the sensors.
Approximately 15.3 million strokes occur annually worldwide and about one third are fatal. Stroke is the second leading cause of death and accounts for significant disability, institutionalization, and health care cost. Strokes increase exponentially with advanced age, and, of course, the population ages. Strokes occur more frequently in African Americans, Native Americans and elderly women.
Risk factors for stroke include carotid disease, hypertension, atrial fibrillation, diabetes, smoking and sleep apnea. Men with moderate-to-severe sleep apnea had an almost threefold increased risk of ischemic stroke. Obstructive sleep apnea is among the most common chronic disorders in adults, occurring in 4% of middle-aged men and 2% of middle-aged women.
In the last decade, treatment of acute ischemic stroke caused by embolization from a carotid plaque or from atrial fibrillation has improved dramatically as a result of the use of local lytic agents and mechanical thrombectomy. These methods have allowed the recovery by patients that would previously have had a bad prognosis.
Time is often of the essence when attempting to reperfuse the brain tissue threatened by i schemia. In general, the opportunity to reverse a stroke exists within 3 hours of its occurrence. Today, patients can often be treated within three hours of the onset of the stroke and the success rate of this timely intervention is high. However, when the stroke occurs while the patient sleeps, it is likely that, by the time it is discovered, the patient cannot be treated until well after this 3 hour window of opportunity.
About one third of ischemic strokes occur during sleep. Embodiments of the present invention propose to solve this problem by allowing for detection of a stroke during sleep, thereby permitting immediate treatment.
There are at least 5 million patients in the United States with atrial fibrillation, which carries with it a 1 in 4 risk of cerebral emboli during the lifetime. Patients with severe carotid stenosis, patent foramen ovale, carotid dissections and shaggy aortas are also prone to develop ischemic cerebral emboli. Embodiments of the present invention can be particularly helpful for these high-risk patients.
Unilateral arm paralysis is the most common manifestation of stroke. When a stroke occurs during sleep, there is cessation of the spontaneous and repeated electrical activity of muscles that occurs at frequent intervals. An object of embodiments of the present invention is to detect this cessation of electrical and muscle activity that takes place as soon as a stroke occurs and implement an automatic alarm system that will permit a curative intervention. This can be accomplished by detecting the absence of this periodic electrical and muscular activity transcutaneously by means of, for example, electromyography (EMG) electrodes. In one embodiment shown in
In the embodiment of
The sensors 4 are connected to a transmitter 2 (
The microcontroller 20 can send the processed EMG signals to computing device 22 wirelessly using receiver/transmitter 21 and receiver/transmitter 23. This wireless transmission can be any type of wireless transmission, including wife or Bluetooth®. Alternatively, the microcontroller 20 can send the processed signals to computing device 22 by cable 24.
The computing device 22 is configured to analyze (e.g., by a software program) the EMG signals to determine the presence of a stroke. In the embodiment described above, if the computing device 22 determines that the EMG signals show an absence of electrical or muscular activity for an established period of time, a stroke is detected and the computing device 22 can automatically initiate an alarm system. For example, it can sound an audible alarm by, for example, placing a phone call to the patient's home. The microcontroller can also, or alternatively, alert emergency services.
Intervention within the three-hour window significantly increases the probability of recovery. Within this window, the earlier the patient is brought to the interventional suite, the lower the risk of intracerebral bleeding during rescue.
A typical night's sleep includes approximately four to five periods of what is called rapid eye movement (REM) when dreams occur. This REM typically comprises 20-25% of total sleep time in adults (about 90-120 minutes). During REM, brain activity is similar to the brain activity that occurs while awake, but there is paralysis of muscular activity that prevents movement during dreams.
An embodiment of the present invention provides a mechanism to distinguish the absence of signals representing electrical and muscle activity caused by REM from that caused by a stroke. In this embodiment, described below with respect to
While the embodiment of
Number | Date | Country | |
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62107110 | Jan 2015 | US |