A comprehensive wireless neurological and cardiopulmonary monitoring platform for pediatrics

Neurodevelopment in the first 10 years of life is a critical time window during which milestones that define an individual’s functional potential are achieved. Comprehensive multimodal neurodevelopmental monitoring is particularly crucial for socioeconomically disadvantaged, marginalized, historically underserved and underrepresented communities as well as medically underserved areas. Solutions designed for use outside the traditional clinical environment represent an opportunity for addressing such health inequalities. In this work, we present an experimental platform, ANNE EEG, which adds 16-channel cerebral activity monitoring to the existing, USA FDA-cleared ANNE wireless monitoring platform which provides continuous electrocardiography, respiratory rate, pulse oximetry, motion, and temperature measurements. The system features low-cost consumables, real-time control and streaming with widely available mobile devices, and fully wearable operation to allow a child to remain in their naturalistic environment. This multi-center pilot study successfully collected ANNE EEG recordings from 91 neonatal and pediatric patients at academic quaternary pediatric care centers and in LMIC settings. We demonstrate the practicality and feasibility to conduct electroencephalography studies with high levels of accuracy, validated via both quantitative and qualitative metrics, compared against gold standard systems. An overwhelming majority of parents surveyed during studies indicated not only an overall preference for the wireless system, but also that its use would improve their children’s physical and emotional health. Our findings demonstrate the potential for the ANNE system to perform multimodal monitoring to screen for a variety of neurologic diseases that have the potential to negatively impact neurodevelopment.Author summary: Neurodevelopment refers to an ensemble of multifaceted processes by which humans develop the neural pathways underlying age-appropriate functional potential. Monitoring cerebral activity via scalp electroencephalography (EEG) can serve as a noninvasive and sensitive tool to probe brain functioning and inform measures of neurodevelopment as well as evaluate various disabilities and neurologic disease such as epilepsy–which affects millions of children with a disproportionate prevalence in developing countries. At present there is a lack of neurodevelopmental monitoring systems that feature both cerebral and cardiopulmonary monitoring. We present a novel wireless monitoring system that adds EEG measurements to an existing USA FDA-cleared wearable sensors platform that measures cardiac activity, blood oxygenation, motion, and skin temperature. In this paper, we demonstrate the system’s ability to record high-quality cerebral neonatal and pediatric activity in a variety of clinical and research environments, including in a low-middle income country (LMIC) setting. Moreover, this system paired with limb and chest sensors, has the potential to perform clinical-grade comprehensive neurodevelopmental monitoring in a child’s naturalistic environment. Potential use cases range from evaluating for neurologic disease at a medical clinic to brief at-home neurodevelopmental screening.