Wearable device could help 'locked-in' ALS patients communicate

purple illustration of nerves
Some "locked-in" ALS patients are able to communicate by moving their eyes or blinking, but others are completely paralyzed.

SUNY Downstate researchers have developed a wearable device that allows amyotrophic lateral sclerosis (ALS) patients who are completely “locked in” to communicate by noninvasively measuring blood flow in the brain.

ALS affects motor neurons, which relay messages from the brain or spinal cord to muscles or glands. As the disease progresses, patients lose the ability to move their muscles, which weaken and waste away, eventually leading to paralysis and death.

Patients in advanced stages of the disease may suffer from locked-in syndrome, where a patient is conscious, but who can only move his or her eyes. These patients may communicate using an electronic eye gaze system, or with a partner using a picture or letter board, according to the ALS Association.

But patients with with total locked-in syndrome are unable to move any muscles at all. There is no device on the market to help a completely “locked-in” patient communicate, the ALS Association says.

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The wearable, developed by the SUNY Downstate team and tested by researchers in Europe, uses functional near infrared spectroscopic (fNIRS) to measure changes in the oxygenation of red blood cells in the frontocentral part of the brain, according to the study.

Niels Birbaumer and researchers at the University of Tübingen in Germany and the Wyss Center for Bio and Neuroengineering in Switzerland tested the device in four patients, who were either completely “locked in” or just entering the “locked in” stage.

"The device measures the brain's hemodynamic response, using fNIRS, and the readings are then processed using specialized algorithms to recognize when a subject is responding yes or no,” said Randall Barbour, a researcher at SUNY Downstate.

SUNY Downstate has licensed the tech to NIRx Medical Technologies, and is working with NIRx and Birmbaumer to created a version of the device for home use.