A research project related to detecting emotions in people with autism eventually found use for helping epileptics.

Qmed Staff

The wearables of the future can do a lot more than track steps. A number of startups and university researchers are working on developing clinically relevant wearables that can do everything from monitor hydration to blood pressure to detect medical problems such as seizures. To learn more about the latter, we reached out to an MIT researcher who has helped develop a wrist-worn device to detect and potentially prevent seizures in epileptics.

MIT professor Rosalind Picard was interested in seeing if she could measure emotion, so she built a technology to do that. She had the idea that the technology could be helpful in treating people with autism when an autistic friend told her that their biggest problem is not understanding other people's feelings, it is that many people  misunderstand our their feelings, says Rosalind Picard, a professor at MIT and the co-founder and chief scientist at Empatica, which has developed the Embrace wristband technology. "I asked what it was we were misunderstanding and she said: 'we have huge stress and anxiety that people don't see.'" (She discusses this anecdote in the video below.) After hearing that, Picard set out to focus on developing technology to make it easier to detect stress levels, which could then be help communication for people with autism.

Qmed: What kind of a need is there for a technology like this for patients suffering from epilepsy and other similar disorders?

Picard: You wouldn't build a house today without a smoke detector. Seizures are like little electrical fires in your brain, and while sometimes they are small and nobody notices them, at other times they can generalize across the brain and cause the person to lose consciousness and have convulsive movements. More people die every year in the United States after having a seizure than die from house fires. If somebody is there when they have a seizure, then they are significantly less likely to die. Almost anybody can help. Simply asking the patient if they are OK, or turning them over, may restart breathing that a seizure has stopped. Just being there to check on somebody could save their life. People who have had at least one grand mal seizure in the last year have the highest risk of death from a seizure, which could strike at any point, unannounced. Thus, there is a huge need to have an alert--a kind of "seizure smoke detector" that can bring somebody to check on you if you have a seizure.

Our sensor measures autonomic changes that are otherwise unseen. Sometimes they correspond to a person's experience of stress, but it's more specific and more consistent than that-closer to anxiety and a fight-or-flight response, and active anticipation, than to "stress." For example, what we measure can also go up when your favorite sports team is close to scoring but it hasn't happened yet. (People's experiences of stress can be very inconsistent and not well described by then; the sensor is much more objective).

Qmed: What were some of the biggest design challenges you faced when developing this kind of technology, and how were you able to overcome them?

Picard: There have been huge challenges. We are packing new kinds of sensing and processing technology that is enormously advanced inside a tiny package. Nobody has ever done several of the things we're doing. Manufacturing to scale with the performance and reliability we need--also because we have very limited resources (tiny team, very little funding)--has been extremely difficult. 

Qmed: How big of a role do you think wearable technologies like this will play in the future when it comes to different treatment therapies?

Picard: Right now we cannot make any medical claims about our product because Empatica is in the middle of filing for FDA clearance.  However, I can speak generally. I think the role for wearables is going to be much bigger than most people expect, especially in conditions involving neurology and psychiatry.  Wearables can provide objective measures of human behavior that are significantly better than what the field of medicine has had before.  Using Empatica's sensor made for researchers, we are also learning how regions deep in the brain, involved in emotion, memory, and attention, map to measures we can obtain from the skin.  Wearables are already enabling scientists to see patterns that most people never knew existed. 

Qmed: Finally, I know the future can be difficult to predict, but how soon do you think we could see this kind of technology on the market and commonly used to improve patient care? Are there any plans for the technology to be enhanced or evolve in the near future?

Picard: Empatica shipped beta units to the first subset of our customers with epilepsy last Friday. The scientific and technological capability has been ready for some time, but there are a million other pieces that take much longer that we'd like, not because they're hard, but because of very little funding for medical device companies, taxes against medical device makers (even against tiny start-up companies who aren't even established), and other challenges that make it super-hard to get a product to market efficiently on a shoestring budget. I don't think the U.S. government understands the barriers they have erected or they would definitely be more supportive; hopefully, some day, they'll fix things and make it easier (and lower cost -- which will lower healthcare costs) to enable new technology to help improve lives. 

There are lots of cool new ways we can continue to evolve and enhance the technology. We are working on many at MIT.  Wearables will revolutionize medicine; someday our grandchildren will say: "Tell me, how did people personalize medicine before wearables?"

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