Research

Based on the project “Biothermofluidics for Cerebrospinal Fluid Diagnostics and Control”, the multidisciplinary research project “SmartShunt – The Hydrocephalus Project” aims at conducting the basic research necessary for the subsequent development of a smart cerebrospinal fluid (CSF) shunt for normal pressure hydrocephalus (NPH). The project is a joint collaboration between The Interface Group and the Institute for Dynamic Systems and Control of ETH Zurich.

Current treatment methods

Today, NPH is most commonly treated by the surgical placement of a ventriculoperitoneal shunt that drains CSF from the patient’s ventricular space to the peritoneal area. Current shunts rely on differential-pressure valves to control CSF drainage. Although such shunts are available and used since the 1960s, the failure rate is still very high. The three most common causes of failure are obstructions, infections and overdrainage.

Smartshunt

The ultimate goal of the Smartshunt project is the development of a new shunt system (Figure 1) that overcomes some of the aforementioned problems. This shall be achieved by using active components and adapting the shunt behavior to the current needs of the patient.

Goals of the project

• Simulation and analysis of the coupling of brain and spinal cord mechanics with CSF flow (Figure 2)
• Investigation of CSF flow and pressure in pathological cases such as hydrocephalus
• Mathematical modeling of the relevant human physiology
• Buildup of hardware-in-the-loop test bench (Figure 3) for the assessment of current and future shunts
• Development of suitable hardware components
• Determination of control strategies

Publications

1. Knobloch V, Binter C, Kurtcuoglu V, Kozerke S. Arterial, Venous, and Cerebrospinal Fluid Flow: Simultaneous Assessment with Bayesian Multipoint Velocity-encoded MR Imaging. Radiology. 2014, 270, 566-573.
2. Siyahhan B, Knobloch V, de Zélicourt D, Asgari M, Schmid Daners M, Poulikakos D, Kurtcuoglu V. Flow induced by ependymal cilia dominates near-wall cerebrospinal fluid dynamics in the lateral ventricles. Journal of The Royal Society Interface. 2014, 11(94), 20131189.
3. Bottan S, Schmid Daners M, de Zelicourt D, Fellner N, Poulikakos D, Kurtcuoglu V. Assessment of intracranial dynamics in hydrocephalus: Effects of viscoelasticity on the outcome of infusion tests. Journal of Neurosurgery. 2013;0:1-9
4. Knobloch V, Boesiger P and Kozerke S. Sparsity transform k-t principal component analysis for accelerating cine three-dimensional flow measurements. Magnetic Resonance Medicine, 2013;70:53-63. doi: 10.1002/mrm.24431
5. Bottan S, Poulikakos D, and Kurtcuoglu V. Phantom model of physiologic intracranial pressure and cerebrospinal fluid dynamics. IEEE Trans Biomed Eng, 59(6):1532–1538, 2012.
6. Knobloch V, Binter C, Gulan U, Lüthi B, Boesiger P, Kozerke S. Comparison of Velocity Vector Fields and Turbulent Kinetic Energy Measured by MRI and Particle Tracking Velocimetry in a Realistic Aortic Phantom. In: Proceedings of the 20th Annual Meeting of ISMRM, Melbourne, Australia, 2012. p 1177
7. Knobloch V, Binter C, Boesiger P, Kozerke S. Multi-Point Velocity Encoding for Simultaneous Assessment of Arterial, Venous and Cerebrospinal Flow. In: Proceedings of the 20th Annual Meeting of ISMRM, Melbourne, Australia, 2012. p 1051
8. Schmid Daners M, Bottan S, Poulikakos S, Guzzella L, and Kurtcuoglu V. Craniospinal pressure-volume dynamics in phantom models. IEEE Trans Biomed Eng, 59(12):3482 –3490, 2012.
9. Schmid Daners M, Knobloch V, Soellinger M, Boesiger P, Seifert B, Guzzella L, Kurtcuoglu V. Age-Specific Characteristics and Coupling of Cerebral Arterial Inflow and Cerebrospinal Fluid Dynamics. PLoS ONE 7(5): e37502, 2012. doi:10.1371/journal.pone.0037502
10. Tafin FU, Corvec S, Betrisey B, Zimmerli W, Trampuz A. Role of Rifampin against Propionibacterium acnes Biofilm In Vitro and in an Experimental Foreign-Body Infection Model. Antimicrob. Agents Chemother. April 2012 vol. 56 no. 4 1885-1891
11. Bottan S, Fritz A, Kurtcuoglu V, Schmid Daners M, Knobloch V, Langkammer C, Krebs N, Gloor M, Scheurer E, Scheffler K, Ropele S, Boesiger P, Poulikakos D, Soellinger M. Investigating the role of choroid plexus in CSF pulsation by combining in-vivo and post-mortem MRI. ISMRM 2011; Montreal, Canada, May 7th -13th
12. Bottan S,Poulikakos D, Kurtcuoglu V. Phantom model of intracranial pressure and cerebrospinal fluid dynamics. ISHCSF; Copenhagen, Denmark, September 4th -7th
13. Knobloch V, Boesiger P, Kozerke S. Probabilistic Streamline Estimation from Accelerated Fourier Velocity Encoded Measurements. ISMRM 2011; Montreal, Canada, May 7th -13th
14. V. Kurtcuoglu, S. Bottan, M. Schmid Daners, V. Knobloch, D. Poulikakos, M. Soellinger, L. Guzzella, P. Boesiger, B. Seifert. CSF space phantom and coupling of cerebral arterial inflow with cerebrospinal dynamics: Highlights from the SmartShunt project. 1st CSF Hydrodynamics Symposium, Zurich, Switzerland, July 8-9, 2011.
15. Kurtcuoglu V. Computational fluid dynamics for the assessment of cerebrospinal fluid flow and its coupling with the cerebral blood flow. In: K. Miller (Ed.), Biomechanics of the brain. Springer, New York, 2011.
16. Kurtcuoglu V. The SmartShunt program and the use of MRI in its planning. 1st Meeting of the International Hydrocephalus Imaging Working Group, Great Neck, New York, April 21-22, 2011
17. Tafin FU, Majic I, Belkhodja CZ, Betrisey B, Corvec S, Zimmerli W, Trampuz A. Gentamicin Improves the Activities of Daptomycin and Vancomycin against Enterococcus faecalis In Vitro and in an Experimental Foreign-Body Infection Model. Antimicrob. Agents Chemother. October 2011 vol. 55 no. 10 4821-4827
18. Knobloch V, Giese D, Boesiger P, Kozerke S. Hadamard-Transform k-t PCA for Cine 3D Velocity Vector Field Mapping of Carotid Flow. ISMRM 2010; Stockholm, Sweden, May 1th-7th
19. Siyahhan B, V. Kurtcuoglu V, Poulikakos D. SmartShunt: The Hydrocephalus Project Multi-Scale Porous Medium Model for Brain Mechanics 5th OpenFOAM Workshop, June 21-24 2010, Gothenburg
20. Knobloch V, Giese D, Boesiger P, Pedersen H, Kozerke S. Accelerating Carotid Velocity Mapping Using k-t PCA. ISMRM Workshop on Cardiovascular Flow, Function and Tissue Mechanics 2009, Sintra, Portugal, Sept. 11th-13th
21. Knobloch V, Soellinger M, Kozerke S, Boesiger P. Quantification of cervical and thoracic spinal cord displacement using cardiac triggered cine 3D DENSE. ESMRMB 2009; Antalya, Turkey, Oct. 1st-3rd