While many breakthrough lab discoveries take years to reach the clinic, there are researchers delivering solutions aimed at supporting people living with dementia today. Prof Timothy Constandinou, at the UK DRI Centre for Care Research and Technology, is working on pioneering radar technology that is about to be deployed into people’s homes for the first time. We caught up with Tim to find out more about the potential impact of these devices, and explore his other innovations in the field of Deep Brain Stimulation.
This article is part of our ‘Deliver’ series, showcasing the UK DRI's mission to discover the causes of neurodegeneration, develop possible treatments and deliver solutions for healthy ageing.
A vision camera functioning like the human retina. It was from this project during his PhD, that Prof Timothy Constandinou first realised he could apply his engineering knowledge - driven by his long-standing passion for electronics - to understanding health and disease. Shortly after, he was no longer talking about the vision system, but about retinal implants to bypass dysfunction in the eye.
“I started talking to doctors and neuroscientists, and I really began to understand the magic of collaboration. That was my introduction into the medical space,” recalls the researcher.
Since then, for him, publishing papers is a by-product of his research; what really drives him and what he considers his main objective is “to touch people's lives, to improve their quality of life”.
In keeping with this motivation, Tim has been working for some time on two projects that support people living with dementia. One is a radar system that, when installed in someone’s home, aims to unobtrusively monitor their health and well-being. The second project is looking to improve Deep Brain Stimulation (DBS) devices that are already being used in people living with Parkinson’s Disease. Sleep disturbance and circadian disruption are common in people living with neurodegenerative conditions such as Parkinson’s disease and dementia, so the researcher is planning a pilot study to explore whether DBS devices can be leveraged to improve this.
A physiological and behavioural monitor
When it came to designing a new technological alternative that has a good chance of being adopted by people, Tim was very clear that the user’s experience should be front of mind. That is why the radar sensors he and his team developed are unobtrusive: there is no ‘Big Brother’ in the person's home, so no cameras, microphones or recordings of any kind are involved.
“We're using a radar to unobtrusively monitor how people are moving around, and to look at their physiology. From that, we're able to learn how they're doing, their quality of sleep, their movement patterns or the impact of their medication... Tracking this over a long period of time can help us monitor and study neurodegeneration in a way that currently is not possible,” he explains.
Longer term, the radar could also be configured to function like an alarm system, to indicate if someone is confused or has fallen on the floor, for example. The real advantage of this technology is that the person does not have to do anything, as the device takes care of notifying the necessary individuals so that help can be given.
This equipment developed by Tim’s Next Generation Neural Interfaces (NGNI) Lab has two especially innovative features. Firstly, the type of internal infrastructure: having radars in different rooms of the home allows for the extraction of useful data securely to the cloud. This information can then be harnessed by carers, nurses or clinicians and decisions made on whether intervention is needed.
The unobstrusive device helps monitor people's health and wellbeing
“We're not just dumping data on the cloud, but at every stage we're pulling out what we believe is informative,” he says.
Secondly, to ensure that the information extracted is valuable, the team have developed bespoke algorithms linked to the radar. For example, they are able to determine gait parameters, to find out the walking cycle of the person living with dementia, whether it is symmetrical or whether there are balance issues. It also provides insight into sleep quality and patterns, even tracking the number of bathroom visits, or trips to the kitchen to drink water, that are patterns that may indicate if the person may have a urinary tract infection.
Going beyond addressing trauma
In a separate project, the researchers are looking into improving Deep Brain Stimulation (DBS) devices in people with Parkinson’s. DBS involves implanting electrodes in the brain, which are connected to an electronic device placed under the skin in the person's chest - like a pacemaker - that controls the amount of stimulation to the brain.
Today, this type of device is useful for people affected by Parkinson's, because impulses sent by electrodes placed in the subthalamic nucleus of the brain, help to improve motor symptoms, such as tremors, caused by the disease. In other words, it is a technology that, as Tim explains, does not slow or reverse neurodegeneration, but addresses a major symptom, in this case tremor.
Tim is interested in exploring if it is possible for the same devices to disrupt or enhance other behaviours and symptoms; thus, the team is exploring how they can use DBS devices to optimise stimulation throughout the circadian cycle to reduce daytime sleepiness and improve vigilance, while maintaining the device’s primary use to manage tremors.
In addition to the potential of improving on DBS devices today, the researchers will be able to generate further insights into Parkinson's progression, which will in turn pave the way for exploring new bioelectronic interventions in neurodegeneration and dementia.
Technology already reaching the first people
Aligned with the objectives that drive him to carry out his research, Tim is thrilled that both projects have the potential to make a positive impact on people’s lives today.
In the case of the DBS device project, this is made possible through a partnership with Oxford University and the company Amber Therapeutics, that already have a DBS device in trials with people affected by Parkinson's. The main goal is to create new capabilities for the devices based on the results of these studies.
The beauty of this technology is that under clinical supervision, we can develop and test new features, without needing any new surgery. First and foremost, we need to guarantee safety, but after we gather evidence that these features work, we can reprogram the existing devices and give them new capabilities.Prof Timothy Constandinou
Meanwhile, the radar is currently awaiting CE marking - which ensures that the device meets safety and environmental protection requirements - so that it can begin to be installed in people's homes.
“Our immediate target is to deploy it to a cohort of roughly a hundred homes, so that we can start working with real life data to take it to the next level,” adds the Group Lead. This will be integrated into the Minder platform that has been developed by the Care Research and Technology Centre.
For him, the most important thing is that the device not only improves the quality of life of people affected by neurodegenerative conditions, but is also scalable, accessible and easy to install:
“This technology should not just be deployable to a few hundred, but millions of people. So it needs to be cheap; I'm not talking about hundreds, but tens of pounds. I want my research to mean something to as many people as possible,” he concludes.
Article published: 4 September 2024
Image credits: Prof Timothy Constandinou