Digital Medicine & Wearable Technology

Author: John Zao

Coauthor(s): See above:

Status: Completed Work

Funding Acknowledgment: National Institutes of Health

Detecting Glaucoma With a Portable Brain-Computer Interface for Objective Assessment of Visual Function Loss

Problem: This proposal addresses a critical unmet need in the field of glaucoma, which is the lack of portable and objective effective ways of assessing visual function in the disease. Glaucoma is a progressive neurodegenerative disease affecting the optic nerve. It is estimated that the disease affects more than 70 million individuals worldwide with approximately 10% being bilaterally blind, which makes it the leading cause of irreversible blindness in the world. However, as the disease can remain asymptomatic until it is severe, the number of affected individuals is likely to be much larger than the number known to have it. Population-level survey data indicate that only 10% to 50% of the individuals are aware they have glaucoma.
NGoggle’s Solution: NGoggle is developing a wearable, non-invasive neurodiagnostic headset that integrates an electroencephalogram EEG) system and a head-mounted display that wirelessly monitors the electrical brain activity associated with visual field stimulations. This device, the nGoggle®, consists of a portable Brain Computer Interface (BCI) integrated with a head-mounted display. The device contains a display headset system-on-module, equipped with an embedded processor, assorted input/output interfaces, and a dual-band wireless capability. The proprietary neuroheadset system also includes proprietary subsystems including: (1) a robust Artifact Removal System (ARS) for high-fidelity EEG acquisition for real-time assessment of the brain states; (2) a Deep Learning based system of EEG feature extraction and classification for identifying neurodegenerative disease-specific biomarkers to a disease condition; and (3) prep-free electrode-sensor design for active wear.
Discovery: We presented the development and initial validation of the nGoggle® for objectively assessing visual field deficits using multifocal steady-state visual evoked potentials (mfSSVEPs). We tested the ability of nGoggle® measurements to discriminate glaucomatous from healthy eyes, as well as repeatability of the results.
The findings from this study were published in JAMA Ophthalmology. Our results showed that the nGoggle® could automatically, without a subject’s manipulation, discriminate eyes with glaucomatous neuropathy from healthy eyes objectively and accurately. Additionally, measurements from the nGoggle® showed adequate test-retest repeatability.

Nakanishi M, Wang Y, Jung T, Zao JK, Chien Y, Diniz-Filho A, Daga FB, Lin Y, Wang Y, Medeiros FA. Detecting Glaucoma With a Portable Brain-Computer Interface for Objective Assessment of Visual Function Loss. JAMA Ophthalmol. 2017;135(6):550-557.