Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics

Objective: Cerebral autoregulation limits the variability of cerebral blood flow (CBF) in the presence of systemic arterial blood pressure (ABP) changes. Monitoring cerebral autoregulation is important in the Neurocritical Care Unit (NCCU) to assess cerebral health. Here, our goal is to identify opt...

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Autores principales:	Thao Pham, Cristianne Fernandez, Giles Blaney, Kristen Tgavalekos, Angelo Sassaroli, Xuemei Cai, Steve Bibu, Joshua Kornbluth, Sergio Fantini
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	cerebral autoregulation cerebral blood flow near-infrared spectroscopy frequency-domain coherent hemodynamics neurocritical care Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/826892d951d2430b85c7da18a076b568
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spelling	oai:doaj.org-article:826892d951d2430b85c7da18a076b5682021-11-16T07:48:23ZNoninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics1664-229510.3389/fneur.2021.745987https://doaj.org/article/826892d951d2430b85c7da18a076b5682021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.745987/fullhttps://doaj.org/toc/1664-2295Objective: Cerebral autoregulation limits the variability of cerebral blood flow (CBF) in the presence of systemic arterial blood pressure (ABP) changes. Monitoring cerebral autoregulation is important in the Neurocritical Care Unit (NCCU) to assess cerebral health. Here, our goal is to identify optimal frequency-domain near-infrared spectroscopy (FD-NIRS) parameters and apply a hemodynamic model of coherent hemodynamics spectroscopy (CHS) to assess cerebral autoregulation in healthy adult subjects and NCCU patients.Methods: In five healthy subjects and three NCCU patients, ABP oscillations at a frequency around 0.065 Hz were induced by cyclic inflation-deflation of pneumatic thigh cuffs. Transfer function analysis based on wavelet transform was performed to measure dynamic relationships between ABP and oscillations in oxy- (O), deoxy- (D), and total- (T) hemoglobin concentrations measured with different FD-NIRS methods. In healthy subjects, we also obtained the dynamic CBF-ABP relationship by using FD-NIRS measurements and the CHS model. In healthy subjects, an interval of hypercapnia was performed to induce cerebral autoregulation impairment. In NCCU patients, the optical measurements of autoregulation were linked to individual clinical diagnoses.Results: In healthy subjects, hypercapnia leads to a more negative phase difference of both O and D oscillations vs. ABP oscillations, which are consistent across different FD-NIRS methods and are highly correlated with a more negative phase difference CBF vs. ABP. In the NCCU, a less negative phase difference of D vs. ABP was observed in one patient as compared to two others, indicating a better autoregulation in that patient.Conclusions: Non-invasive optical measurements of induced phase difference between D and ABP show the strongest sensitivity to cerebral autoregulation. The results from healthy subjects also show that the CHS model, in combination with FD-NIRS, can be applied to measure the CBF-ABP dynamics for a better direct measurement of cerebral autoregulation.Thao PhamCristianne FernandezGiles BlaneyKristen TgavalekosAngelo SassaroliXuemei CaiSteve BibuJoshua KornbluthSergio FantiniFrontiers Media S.A.articlecerebral autoregulationcerebral blood flownear-infrared spectroscopyfrequency-domaincoherent hemodynamicsneurocritical careNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cerebral autoregulation cerebral blood flow near-infrared spectroscopy frequency-domain coherent hemodynamics neurocritical care Neurology. Diseases of the nervous system RC346-429
spellingShingle	cerebral autoregulation cerebral blood flow near-infrared spectroscopy frequency-domain coherent hemodynamics neurocritical care Neurology. Diseases of the nervous system RC346-429 Thao Pham Cristianne Fernandez Giles Blaney Kristen Tgavalekos Angelo Sassaroli Xuemei Cai Steve Bibu Joshua Kornbluth Sergio Fantini Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics
description	Objective: Cerebral autoregulation limits the variability of cerebral blood flow (CBF) in the presence of systemic arterial blood pressure (ABP) changes. Monitoring cerebral autoregulation is important in the Neurocritical Care Unit (NCCU) to assess cerebral health. Here, our goal is to identify optimal frequency-domain near-infrared spectroscopy (FD-NIRS) parameters and apply a hemodynamic model of coherent hemodynamics spectroscopy (CHS) to assess cerebral autoregulation in healthy adult subjects and NCCU patients.Methods: In five healthy subjects and three NCCU patients, ABP oscillations at a frequency around 0.065 Hz were induced by cyclic inflation-deflation of pneumatic thigh cuffs. Transfer function analysis based on wavelet transform was performed to measure dynamic relationships between ABP and oscillations in oxy- (O), deoxy- (D), and total- (T) hemoglobin concentrations measured with different FD-NIRS methods. In healthy subjects, we also obtained the dynamic CBF-ABP relationship by using FD-NIRS measurements and the CHS model. In healthy subjects, an interval of hypercapnia was performed to induce cerebral autoregulation impairment. In NCCU patients, the optical measurements of autoregulation were linked to individual clinical diagnoses.Results: In healthy subjects, hypercapnia leads to a more negative phase difference of both O and D oscillations vs. ABP oscillations, which are consistent across different FD-NIRS methods and are highly correlated with a more negative phase difference CBF vs. ABP. In the NCCU, a less negative phase difference of D vs. ABP was observed in one patient as compared to two others, indicating a better autoregulation in that patient.Conclusions: Non-invasive optical measurements of induced phase difference between D and ABP show the strongest sensitivity to cerebral autoregulation. The results from healthy subjects also show that the CHS model, in combination with FD-NIRS, can be applied to measure the CBF-ABP dynamics for a better direct measurement of cerebral autoregulation.
format	article
author	Thao Pham Cristianne Fernandez Giles Blaney Kristen Tgavalekos Angelo Sassaroli Xuemei Cai Steve Bibu Joshua Kornbluth Sergio Fantini
author_facet	Thao Pham Cristianne Fernandez Giles Blaney Kristen Tgavalekos Angelo Sassaroli Xuemei Cai Steve Bibu Joshua Kornbluth Sergio Fantini
author_sort	Thao Pham
title	Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics
title_short	Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics
title_full	Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics
title_fullStr	Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics
title_full_unstemmed	Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics
title_sort	noninvasive optical measurements of dynamic cerebral autoregulation by inducing oscillatory cerebral hemodynamics
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/826892d951d2430b85c7da18a076b568
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Noninvasive Optical Measurements of Dynamic Cerebral Autoregulation by Inducing Oscillatory Cerebral Hemodynamics

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