ALESSANDRO MANONI

PhD Graduate

PhD program:: XXXV


Thesis title: Wearable Electronics in Neurology: technological challenges and proposed solutions

In recent decades, the development of microelectronics has been fueled by Moore's Law, with emphasis on IC densification and aggressive bit integration. However, as of today, the interest is parallelly growing toward the “more than Moore” paradigm, which is based on the integration of Complementary Metal Oxide Semiconductor (CMOS) technology, radiofrequency (RF) analog and power supply circuits, and a variety of miniaturized sensors in the same chip. In the specific field of medicine, this tendency has given rise to the "Health 4.0" revolution, which is characterized by the adoption of electronic components (preferentially wearable and/or implantable) and Information Communication Technology (ICT) to assist medical diagnoses directly from the domestic environment, further promoting the strategy of telemedicine. Health 4.0 applies to many areas of health, showing a growing interest in mobile technologies and continuous remote monitoring, given their revolutionary implications. Integrated wearable devices must be comfortable, non-invasive and have a range of several hours, providing objective and continuous tracking throughout the day. This allows the doctor to have a clinical image offline or at a distance, taken in free-living conditions (during daily activities in the home environment) and reconstruct the path of pathology even down to the last detail. Research in this area is exploding because of the huge benefits that the synergy between ICT and medicine can bring, as the removal of distances and barriers between patients and physicians and the adoption of remote data analytics. These advantages range from the reduction of time spent in hospital, with a reduction in costs and the optimization of staff employment, to long periods of supervision in free living conditions., which improves patients' quality of life. The downward spiral of high demands, long lineups and short monitoring intervals often leave undiagnosed conditions, and this becomes even more true with pathologies that explicitly require days of diagnostic monitoring. Long-term ECG monitoring, for example, becomes an essential part of diagnosing paroxysmal arrhythmias and assessing possible symptoms of arrhythmias. In general, telemedicine can actively benefit conventional medicine and clinicians in two main ways, which are the current challenges of electronics in medicine, especially in neurology. The first challenge is providing patients with access to comfortable, easy-to-use, wireless and discrete home screening devices, which enables better health care and targeted hospitalizations. The second challenge is the advancement in the knowledge of pathologies. Wearables allow for objective analysis, quantitative measurements, and long-term monitoring of patients, enabling unprecedented insight into complex pathologies. In this thesis work I will describe the projects developed during my PhD, with which I tried to give my contribution to this ever growing, pervasive, and revolutionary field. The first project is about home monitoring: in collaboration with ST Microelectronics, I developed a wearable board for apnea detection called Morfea, along with its detection algorithm. Comfortably worn on the nose, light and completely wireless, Morfea has been validated against the clinical SomnoMed gold standard with the collaboration of Policlinico Umberto I. The second project is about providing more insight into pathologies: in collaboration with the electronics and neurology departments of the university of Tor Vergata, I monitored a cohort of patients affected by Type 1 Myotonic Dystrophy (DM-1) using a body area network of accelerometers from Captiks. By performing time domain and frequency domain analyses on the ankle dorsiflexion angles, I defined a novel, more accurate and quantitative severity index for DM-1, a significant step forward respect to the actual, eye-based, gold standard scale called Muscular Impairment Ranking Scale (MIRS). Finally, in the last major project, I propose an innovative approach to biopotentials sensing through electrostatic technology. In collaboration with STMicroelectronics, I adapted a commercial electrostatic sensor called ST-Qvar, originally developed for presence tracking, to perform human biopotentials acquisition. Electrostatic induction and charge transfer, the principles on which the ST-Qvar relies for acquisition, guarantee a much lower power consumption than any traditional commercial analog front end. Finally, a proof-of-concept, Qvar-based system has been validated against a SomnoMed portable PSG for rapid eye movement (REM) sleep stage detection, paving the way for long-time, domestic monitoring of sleep disorders.

Research products

11573/1631422 - 2022 - Long-Term Polygraphic Monitoring through MEMS and Charge Transfer for Low-Power Wearable Applications
Manoni, A.; Gumiero, A.; Zampogna, A.; Ciarlo, C.; Panetta, L.; Suppa, A.; Torre, L. D.; Irrera, F. - 01a Articolo in rivista
paper: SENSORS (Basel : Molecular Diversity Preservation International (MDPI), 2001-) pp. 2566- - issn: 1424-8220 - wos: WOS:000781204400001 (2) - scopus: 2-s2.0-85126982102 (2)

11573/1631546 - 2021 - A clinical and kinematic evaluation of foot drop in myotonic dystrophy type I: A pilot study
Frezza, Erica; Manoni, Alessandro; Errico, Vito; Rota, Rosario; Greco, Giulia; Goglia, Mariangela; Irrera, Fernanda; Saggio, Giovanni; Massa, Roberto - 01h Abstract in rivista
paper: JOURNAL OF THE NEUROLOGICAL SCIENCES (Elsevier BV:PO Box 211, 1000 AE Amsterdam Netherlands:011 31 20 4853757, 011 31 20 4853642, 011 31 20 4853641, EMAIL: nlinfo-f@elsevier.nl, INTERNET: http://www.elsevier.nl, Fax: 011 31 20 4853598) pp. - - issn: 0022-510X - wos: WOS:000713637303504 (0) - scopus: (0)

11573/1556253 - 2021 - Objective assessment of walking impairments in myotonic dystrophy by means of a wearable technology and a novel severity index
Saggio, G.; Manoni, A.; Errico, V.; Frezza, E.; Mazzetta, I.; Rota, R.; Massa, R.; Irrera, F. - 01a Articolo in rivista
paper: ELECTRONICS (Basel : MDPI) pp. 1-13 - issn: 2079-9292 - wos: WOS:000634339500001 (0) - scopus: 2-s2.0-85102552327 (0)

11573/1556259 - 2020 - A new wearable system for home sleep apnea testing, screening, and classification
Manoni, A.; Loreti, F.; Radicioni, V.; Pellegrino, D.; Torre, L. D.; Gumiero, A.; Halicki, D.; Palange, P.; Irrera, F. - 01a Articolo in rivista
paper: SENSORS (Basel : Molecular Diversity Preservation International (MDPI), 2001-) pp. 1-26 - issn: 1424-8220 - wos: WOS:000603312300001 (22) - scopus: 2-s2.0-85097574741 (32)

11573/1458551 - 2020 - Shedding light on nocturnal movements in parkinson’s disease: Evidence from wearable technologies
Zampogna, A.; Manoni, A.; Asci, F.; Liguori, C.; Irrera, F.; Suppa, A. - 01g Articolo di rassegna (Review)
paper: SENSORS (Basel : Molecular Diversity Preservation International (MDPI), 2001-) pp. 1-25 - issn: 1424-8220 - wos: WOS:000581749500001 (18) - scopus: 2-s2.0-85090923683 (17)

11573/1414794 - 2020 - Fifteen years of wireless sensors for balance assessment in neurological disorders
Zampogna, Alessandro; Mileti, Ilaria; Palermo, Eduardo; Celletti, Claudia; Paoloni, Marco; Manoni, Alessandro; Mazzetta, Ivan; Dalla Costa, Gloria; Pérez-López, Carlos; Camerota, Filippo; Leocani, Letizia; Cabestany, Joan; Irrera, Fernanda; Suppa, Antonio - 01a Articolo in rivista
paper: SENSORS (Basel : Molecular Diversity Preservation International (MDPI), 2001-) pp. - - issn: 1424-8220 - wos: WOS:000552737900240 (54) - scopus: 2-s2.0-85086140643 (56)

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