Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation

Abstract Neurological conditions such as traumatic brain injury (TBI) and hydrocephalus may lead to intracranial pressure (ICP) elevation. Current diagnosis methods rely on direct pressure measurement, while CT, MRI and other expensive imaging may be used. However, these invasive or expensive testin...

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Autores principales:	Rajkumar Dhar, Richard H. Sandler, Kim Manwaring, Nathan Kostick, Hansen A. Mansy
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9669ab5d95c34d8cb7b3e59a4eceafca
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spelling	oai:doaj.org-article:9669ab5d95c34d8cb7b3e59a4eceafca2021-11-14T12:19:54ZNoninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation10.1038/s41598-021-01079-82045-2322https://doaj.org/article/9669ab5d95c34d8cb7b3e59a4eceafca2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01079-8https://doaj.org/toc/2045-2322Abstract Neurological conditions such as traumatic brain injury (TBI) and hydrocephalus may lead to intracranial pressure (ICP) elevation. Current diagnosis methods rely on direct pressure measurement, while CT, MRI and other expensive imaging may be used. However, these invasive or expensive testing methods are often delayed because symptoms of elevated ICP are non-specific. Invasive methods, such as intraventricular catheter, subdural screw, epidural sensor, lumbar puncture, are associated with an increased risk of infection and hemorrhage. On the other hand, noninvasive, low-cost, accurate methods of ICP monitoring can help avoid risks and reduce costs while expediting diagnosis and treatment. The current study proposes and evaluates a novel method for noninvasive ICP monitoring using tympanic membrane pulsation (TMp). These signals are believed to be transmitted from ICP to the auditory system through the cochlear aqueduct. Fifteen healthy subjects were recruited and TMp signals were acquired noninvasively while the subjects performed maneuvers that are known to change ICP. A custom made system utilizing a stethoscope headset and a pressure transducer was used to perform these measurements. Maneuvers included head-up-tilt, head-down-tilt and hyperventilation. When elevated ICP was induced, significant TMp waveform morphological changes were observed in each subject (p < 0.01). These changes include certain waveform slopes and high frequency wave features. The observed changes were reversed by the maneuvers that decreased ICP (p < .01). The study results suggest that TMp waveform measurement and analysis may offer an inexpensive, noninvasive, accurate tool for detection and monitoring of ICP elevations. Further studies are warranted to validate this technique in patients with pathologically elevated ICP.Rajkumar DharRichard H. SandlerKim ManwaringNathan KostickHansen A. MansyNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rajkumar Dhar Richard H. Sandler Kim Manwaring Nathan Kostick Hansen A. Mansy Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation
description	Abstract Neurological conditions such as traumatic brain injury (TBI) and hydrocephalus may lead to intracranial pressure (ICP) elevation. Current diagnosis methods rely on direct pressure measurement, while CT, MRI and other expensive imaging may be used. However, these invasive or expensive testing methods are often delayed because symptoms of elevated ICP are non-specific. Invasive methods, such as intraventricular catheter, subdural screw, epidural sensor, lumbar puncture, are associated with an increased risk of infection and hemorrhage. On the other hand, noninvasive, low-cost, accurate methods of ICP monitoring can help avoid risks and reduce costs while expediting diagnosis and treatment. The current study proposes and evaluates a novel method for noninvasive ICP monitoring using tympanic membrane pulsation (TMp). These signals are believed to be transmitted from ICP to the auditory system through the cochlear aqueduct. Fifteen healthy subjects were recruited and TMp signals were acquired noninvasively while the subjects performed maneuvers that are known to change ICP. A custom made system utilizing a stethoscope headset and a pressure transducer was used to perform these measurements. Maneuvers included head-up-tilt, head-down-tilt and hyperventilation. When elevated ICP was induced, significant TMp waveform morphological changes were observed in each subject (p < 0.01). These changes include certain waveform slopes and high frequency wave features. The observed changes were reversed by the maneuvers that decreased ICP (p < .01). The study results suggest that TMp waveform measurement and analysis may offer an inexpensive, noninvasive, accurate tool for detection and monitoring of ICP elevations. Further studies are warranted to validate this technique in patients with pathologically elevated ICP.
format	article
author	Rajkumar Dhar Richard H. Sandler Kim Manwaring Nathan Kostick Hansen A. Mansy
author_facet	Rajkumar Dhar Richard H. Sandler Kim Manwaring Nathan Kostick Hansen A. Mansy
author_sort	Rajkumar Dhar
title	Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation
title_short	Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation
title_full	Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation
title_fullStr	Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation
title_full_unstemmed	Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation
title_sort	noninvasive detection of elevated icp using spontaneous tympanic membrane pulsation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9669ab5d95c34d8cb7b3e59a4eceafca
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Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation

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