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Shali RK, Setarehdan SK, Seifi B. Functional near-infrared spectroscopy based blood pressure variations and hemodynamic activity of brain monitoring following postural changes: A systematic review. Physiol Behav 2024; 281:114574. [PMID: 38697274 DOI: 10.1016/j.physbeh.2024.114574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/03/2024] [Accepted: 04/26/2024] [Indexed: 05/04/2024]
Abstract
Postural change from supine or sitting to standing up leads to displacement of 300 to 1000 mL of blood from the central parts of the body to the lower limb, which causes a decrease in venous return to the heart, hence decrease in cardiac output, causing a drop in blood pressure. This may lead to falling down, syncope, and in general reducing the quality of daily activities, especially in the elderly and anyone suffering from nervous system disorders such as Parkinson's or orthostatic hypotension (OH). Among different modalities to study brain function, functional near-infrared spectroscopy (fNIRS) is a neuroimaging method that optically measures the hemodynamic response in brain tissue. Concentration changes in oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin (HHb) are associated with brain neural activity. fNIRS is significantly more tolerant to motion artifacts compared to fMRI, PET, and EEG. At the same time, it is portable, has a simple structure and usage, is safer, and much more economical. In this article, we systematically reviewed the literature to examine the history of using fNIRS in monitoring brain oxygenation changes caused by sudden changes in body position and its relationship with the blood pressure changes. First, the theory behind brain hemodynamics monitoring using fNIRS and its advantages and disadvantages are presented. Then, a study of blood pressure variations as a result of postural changes using fNIRS is described. It is observed that only 58 % of the references concluded a positive correlation between brain oxygenation changes and blood pressure changes. At the same time, 3 % showed a negative correlation, and 39 % did not show any correlation between them.
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Affiliation(s)
- Roya Kheyrkhah Shali
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.
| | - Seyed Kamaledin Setarehdan
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Behjat Seifi
- Faculty of Medical Science, University of Tehran, Tehran, Iran
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2
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Burma JS, Roy MA, Kennedy CM, Labrecque L, Brassard P, Smirl JD. A systematic review, meta-analysis, and meta-regression amalgamating the driven approaches used to quantify dynamic cerebral autoregulation. J Cereb Blood Flow Metab 2024:271678X241235878. [PMID: 38635887 DOI: 10.1177/0271678x241235878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Numerous driven techniques have been utilized to assess dynamic cerebral autoregulation (dCA) in healthy and clinical populations. The current review aimed to amalgamate this literature and provide recommendations to create greater standardization for future research. The PubMed database was searched with inclusion criteria consisting of original research articles using driven dCA assessments in humans. Risk of bias were completed using Scottish Intercollegiate Guidelines Network and Methodological Index for Non-Randomized Studies. Meta-analyses were conducted for coherence, phase, and gain metrics at 0.05 and 0.10 Hz using deep-breathing, oscillatory lower body negative pressure (OLBNP), sit-to-stand maneuvers, and squat-stand maneuvers. A total of 113 studies were included, with 40 of these incorporating clinical populations. A total of 4126 participants were identified, with younger adults (18-40 years) being the most studied population. The most common techniques were squat-stands (n = 43), deep-breathing (n = 25), OLBNP (n = 20), and sit-to-stands (n = 16). Pooled coherence point estimates were: OLBNP 0.70 (95%CI:0.59-0.82), sit-to-stands 0.87 (95%CI:0.79-0.95), and squat-stands 0.98 (95%CI:0.98-0.99) at 0.05 Hz; and deep-breathing 0.90 (95%CI:0.81-0.99); OLBNP 0.67 (95%CI:0.44-0.90); and squat-stands 0.99 (95%CI:0.99-0.99) at 0.10 Hz. This review summarizes clinical findings, discusses the pros/cons of the 11 unique driven techniques included, and provides recommendations for future investigations into the unique physiological intricacies of dCA.
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Affiliation(s)
- Joel S Burma
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | - Marc-Antoine Roy
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Courtney M Kennedy
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Jonathan D Smirl
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
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3
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Leth-Olsen M, Døhlen G, Torp H, Nyrnes SA. Cerebral blood flow dynamics during cardiac surgery in infants. Pediatr Res 2024:10.1038/s41390-024-03161-z. [PMID: 38570558 DOI: 10.1038/s41390-024-03161-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND In this pilot study, we investigated continuous cerebral blood flow velocity measurements to explore cerebrovascular hemodynamics in infants with congenital heart disease undergoing cardiac surgery. METHODS A non-invasive transfontanellar cerebral Doppler monitor (NeoDoppler) was used to monitor 15 infants (aged eight days to nine months) during cardiac surgery with cardiopulmonary bypass. Numerical and visual analyses were conducted to assess trends and events in Doppler measurements together with standard monitoring equipment. The mean flow index, calculated as the moving Pearson correlation between mean arterial pressure and time averaged velocity, was utilized to evaluate dynamic autoregulation. Two levels of impaired autoregulation were defined (Mean flow index >0.3/0.45), and percentage of time above these limits were calculated. RESULTS High quality recordings were achieved during 90.6% of the monitoring period. There was a significant reduction in time averaged velocity in all periods of cardiopulmonary bypass. All patients showed a high percentage of time with impaired dynamic autoregulation, with Mean flow index >0.3 and 0.45: 73.71% ± 9.06% and 65.16% ± 11.27% respectively. Additionally, the system promptly detected hemodynamic events. CONCLUSION Continuous transfontanellar cerebral Doppler monitoring could become an additional tool in enhancing cerebral monitoring in infants during cardiac surgery. IMPACT This pilot study demonstrates the feasibility of continuous transfontanellar Doppler monitoring of cerebral blood flow velocities during cardiac surgery in infants. It also demonstrates a high proportion of time with impaired cerebral autoregulation during cardiac surgery based on the Mean flow index. Continuous transfontanellar Doppler could become a useful tool to improve cerebral monitoring and provide new pathophysiological insight.
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Affiliation(s)
- Martin Leth-Olsen
- Department of Circulation and Medical Imaging (ISB), Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
- Children's Clinic, St Olav's University Hospital, Trondheim, Norway.
| | - Gaute Døhlen
- Department of Pediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | - Hans Torp
- Department of Circulation and Medical Imaging (ISB), Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Siri Ann Nyrnes
- Department of Circulation and Medical Imaging (ISB), Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Children's Clinic, St Olav's University Hospital, Trondheim, Norway
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Ellingson CA, Singh J, Ellingson CJ, Shafiq MA, Sirant LW, Dorsch KD, Gruszecki M, Kratzig GP, Neary JP. Sport-related concussion alters cerebral hemodynamic activity during controlled respiration. J Neurophysiol 2024; 131:556-561. [PMID: 38324895 DOI: 10.1152/jn.00477.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/25/2024] [Accepted: 02/07/2024] [Indexed: 02/09/2024] Open
Abstract
Sport-related concussion (SRC) is known to disrupt neurohemodynamic activity, cardiac function, and blood pressure (BP) autoregulation. This study aims to observe changes in cerebrovascular and cardiovascular responses during controlled respiration after sustaining an SRC. University varsity athletes (n = 81) completed a preseason physiological assessment and were followed up within 5 days of sustaining an SRC. During preseason and follow-up assessments, participants' continuous beat-to-beat BP was collected by finger photoplethysmography, and right prefrontal cortex oxygenation was collected using near-infrared spectroscopy (NIRS). Participants completed 5 min of seated rest and 5 min of a 6-breaths per minute controlled breathing protocol (5 s inhale and 5 s exhale; 0.10 Hz). Wavelet transformation was applied to the NIRS and BP signals, separating them into respiratory (0.10-0.6 Hz) and cardiac (0.6-2 Hz) frequency intervals. Of the 81 participants, 74 had a usable BP signal, 43 had usable NIRS signals, and 28 had both usable BP and NIRS signals. Wavelet amplitudes were calculated and coherence between NIRS and BP on the 28 participants were assessed. There was a significant (P < 0.05) decrease in oxygenated hemoglobin amplitude from 0.062 to 0.054 Hz and hemoglobin difference amplitude from 0.059 to 0.051 Hz, both at the respiratory (0.10-0.6 Hz) frequency interval, from preseason to acute SRC, respectively. Therefore, during controlled respiration, there was a reduction in intensity at the respiratory band, suggesting a protective, reduced respiratory contribution to cerebral hemodynamic activity following acute SRC.NEW & NOTEWORTHY This study investigated cerebral hemodynamic activity following sport-related concussion. Prefrontal cortex oxygenation was assessed by near-infrared spectroscopy (NIRS) during a controlled breathing protocol. Wavelet transformation of the NIRS signals showed significant decreases in HbO2 and HbD amplitude at the respiratory frequency interval (0.10-0.6 HZ) from preseason baseline to acute concussion. These results suggest a decreased respiratory contribution to cerebral hemodynamic activity following acute concussion.
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Affiliation(s)
- Cody A Ellingson
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Jyotpal Singh
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Chase J Ellingson
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - M Abdullah Shafiq
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Luke W Sirant
- College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kim D Dorsch
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Marcin Gruszecki
- Department of Radiology Informatics and Statistics, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
- Department of Biomedical Engineering, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Gregory P Kratzig
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - J Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
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Smith RL, Ikeda AK, Rowley CA, Khandhadia A, Gorbach AM, Chimalizeni Y, Taylor TE, Seydel K, Ackerman HC. Increased brain microvascular hemoglobin concentrations in children with cerebral malaria. Sci Transl Med 2023; 15:eadh4293. [PMID: 37703350 DOI: 10.1126/scitranslmed.adh4293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/24/2023] [Indexed: 09/15/2023]
Abstract
Brain swelling is associated with death from cerebral malaria, but it is unclear whether brain swelling is caused by cerebral edema or vascular congestion-two pathological conditions with distinct effects on tissue hemoglobin concentrations. We used near-infrared spectroscopy (NIRS) to noninvasively study cerebral microvascular hemoglobin concentrations in 46 Malawian children with cerebral malaria. Cerebral malaria was defined by the presence of the malaria parasite Plasmodium falciparum on a blood smear, a Blantyre coma score of 2 or less, and retinopathy. Children with uncomplicated malaria (n = 33) and healthy children (n = 29) were enrolled as comparators. Cerebral microvascular hemoglobin concentrations were higher among children with cerebral malaria compared with those with uncomplicated malaria [median (25th, 75th): 145.2 (95.2, 190.0) μM versus 82.9 (65.7, 105.4) μM, P = 0.008]. Cerebral microvascular hemoglobin concentrations correlated with brain swelling score determined by MRI (r = 0.37, P = 0.03). Fluctuations in cerebral microvascular hemoglobin concentrations over a 30-min time period were characterized using detrended fluctuation analysis (DFA). DFA determined self-similarity of the cerebral microvascular hemoglobin concentration signal to be lower among children with cerebral malaria compared with those with uncomplicated malaria [0.63 (0.54, 0.70) versus 0.91 (0.82, 0.94), P < 0.0001]. The lower self-similarity of the hemoglobin concentration signal in children with cerebral malaria suggested impaired regulation of cerebral blood flow. The elevated cerebral tissue hemoglobin concentration and its correlation with brain swelling suggested that excess blood volume, potentially due to vascular congestion, may contribute to brain swelling in cerebral malaria.
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Affiliation(s)
- Rachel L Smith
- Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA
| | - Allison K Ikeda
- Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA
| | - Carol A Rowley
- Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA
| | - Amit Khandhadia
- Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Alexander M Gorbach
- Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Yamikani Chimalizeni
- Queen Elizabeth Central Hospital and Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Terrie E Taylor
- Queen Elizabeth Central Hospital and Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Karl Seydel
- Queen Elizabeth Central Hospital and Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Hans C Ackerman
- Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA
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Favilla CG, Mullen MT, Kahn F, Rasheed IYD, Messe SR, Parthasarathy AB, Yodh AG. Dynamic cerebral autoregulation measured by diffuse correlation spectroscopy. J Cereb Blood Flow Metab 2023:271678X231153728. [PMID: 36703572 PMCID: PMC10369149 DOI: 10.1177/0271678x231153728] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Dynamic cerebral autoregulation (dCA) can be derived from spontaneous oscillations in arterial blood pressure (ABP) and cerebral blood flow (CBF). Transcranial Doppler (TCD) measures CBF-velocity and is commonly used to assess dCA. Diffuse correlation spectroscopy (DCS) is a promising optical technique for non-invasive CBF monitoring, so here we aimed to validate DCS as a tool for quantifying dCA. In 33 healthy adults and 17 acute ischemic stroke patients, resting-state hemodynamic were monitored simultaneously with high-speed (20 Hz) DCS and TCD. dCA parameters were calcaulated by a transfer function analysis using a Fourier decomposition of ABP and CBF (or CBF-velocity). Strong correlation was found between DCS and TCD measured gain (magnitude of regulation) in healthy volunteers (r = 0.73, p < 0.001) and stroke patients (r = 0.76, p = 0.003). DCS-gain retained strong test-retest reliability in both groups (ICC 0.87 and 0.82, respectively). DCS and TCD-derived phase (latency of regulation) did not significantly correlate in healthy volunteers (r = 0.12, p = 0.50) but moderately correlated in stroke patients (r = 0.65, p = 0.006). DCS-derived phase was reproducible in both groups (ICC 0.88 and 0.90, respectively). High-frequency DCS is a promising non-invasive bedside technique that can be leveraged to quantify dCA from resting-state data, but the discrepancy between TCD and DCS-derived phase requires further investigation.
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Affiliation(s)
| | - Michael T Mullen
- Department of Neurology, 6558Temple University, Philadelphia, USA
| | - Farhan Kahn
- Department of Neurology, 6572University of Pennsylvania, Philadelphia, USA
| | | | - Steven R Messe
- Department of Neurology, 6572University of Pennsylvania, Philadelphia, USA
| | | | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, USA
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Panerai RB, Brassard P, Burma JS, Castro P, Claassen JA, van Lieshout JJ, Liu J, Lucas SJ, Minhas JS, Mitsis GD, Nogueira RC, Ogoh S, Payne SJ, Rickards CA, Robertson AD, Rodrigues GD, Smirl JD, Simpson DM. Transfer function analysis of dynamic cerebral autoregulation: A CARNet white paper 2022 update. J Cereb Blood Flow Metab 2023; 43:3-25. [PMID: 35962478 PMCID: PMC9875346 DOI: 10.1177/0271678x221119760] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cerebral autoregulation (CA) refers to the control of cerebral tissue blood flow (CBF) in response to changes in perfusion pressure. Due to the challenges of measuring intracranial pressure, CA is often described as the relationship between mean arterial pressure (MAP) and CBF. Dynamic CA (dCA) can be assessed using multiple techniques, with transfer function analysis (TFA) being the most common. A 2016 white paper by members of an international Cerebrovascular Research Network (CARNet) that is focused on CA strove to improve TFA standardization by way of introducing data acquisition, analysis, and reporting guidelines. Since then, additional evidence has allowed for the improvement and refinement of the original recommendations, as well as for the inclusion of new guidelines to reflect recent advances in the field. This second edition of the white paper contains more robust, evidence-based recommendations, which have been expanded to address current streams of inquiry, including optimizing MAP variability, acquiring CBF estimates from alternative methods, estimating alternative dCA metrics, and incorporating dCA quantification into clinical trials. Implementation of these new and revised recommendations is important to improve the reliability and reproducibility of dCA studies, and to facilitate inter-institutional collaboration and the comparison of results between studies.
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Affiliation(s)
- Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester and NIHR Biomedical Research Centre, Leicester, UK
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, and Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Joel S Burma
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Pedro Castro
- Department of Neurology, Centro Hospitalar Universitário de São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jurgen Ahr Claassen
- Department of Geriatric Medicine and Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Johannes J van Lieshout
- Department of Internal Medicine, Amsterdam, UMC, The Netherlands and Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham Medical School, Queen's Medical Centre, UK
| | - Jia Liu
- Institute of Advanced Computing and Digital Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen University Town, Shenzhen, China
| | - Samuel Je Lucas
- School of Sport, Exercise and Rehabilitation Sciences and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Jatinder S Minhas
- Department of Cardiovascular Sciences, University of Leicester and NIHR Biomedical Research Centre, Leicester, UK
| | - Georgios D Mitsis
- Department of Bioengineering, McGill University, Montreal, Québec, QC, Canada
| | - Ricardo C Nogueira
- Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe-Shi, Saitama, Japan
| | - Stephen J Payne
- Institute of Applied Mechanics, National Taiwan University, Taipei
| | - Caroline A Rickards
- Department of Physiology & Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Andrew D Robertson
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Gabriel D Rodrigues
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Jonathan D Smirl
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - David M Simpson
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
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Tas J, Eleveld N, Borg M, Bos KDJ, Langermans AP, van Kuijk SMJ, van der Horst ICC, Elting JWJ, Aries MJH. Cerebral Autoregulation Assessment Using the Near Infrared Spectroscopy ‘NIRS-Only’ High Frequency Methodology in Critically Ill Patients: A Prospective Cross-Sectional Study. Cells 2022; 11:cells11142254. [PMID: 35883697 PMCID: PMC9317651 DOI: 10.3390/cells11142254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 01/10/2023] Open
Abstract
Impairments in cerebral autoregulation (CA) are related to poor clinical outcome. Near infrared spectroscopy (NIRS) is a non-invasive technique applied to estimate CA. Our general purpose was to study the clinical feasibility of a previously published ‘NIRS-only’ CA methodology in a critically ill intensive care unit (ICU) population and determine its relationship with clinical outcome. Bilateral NIRS measurements were performed for 1–2 h. Data segments of ten-minutes were used to calculate transfer function analyses (TFA) CA estimates between high frequency oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) signals. The phase shift was corrected for serial time shifts. Criteria were defined to select TFA phase plot segments (segments) with ‘high-pass filter’ characteristics. In 54 patients, 490 out of 729 segments were automatically selected (67%). In 34 primary neurology patients the median (q1–q3) low frequency (LF) phase shift was higher in 19 survivors compared to 15 non-survivors (13° (6.3–35) versus 0.83° (−2.8–13), p = 0.0167). CA estimation using the NIRS-only methodology seems feasible in an ICU population using segment selection for more robust and consistent CA estimations. The ‘NIRS-only’ methodology needs further validation, but has the advantage of being non-invasive without the need for arterial blood pressure monitoring.
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Affiliation(s)
- Jeanette Tas
- Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands; (M.B.); (K.D.J.B.); (A.P.L.); (I.C.C.v.d.H.); (M.J.H.A.)
- School for Mental Health and Neuroscience (MHeNS), University Maastricht, 6229 HX Maastricht, The Netherlands
- Correspondence:
| | - Nick Eleveld
- Department of Neurology and Clinical Neurophysiology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (N.E.); (J.W.J.E.)
| | - Melisa Borg
- Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands; (M.B.); (K.D.J.B.); (A.P.L.); (I.C.C.v.d.H.); (M.J.H.A.)
| | - Kirsten D. J. Bos
- Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands; (M.B.); (K.D.J.B.); (A.P.L.); (I.C.C.v.d.H.); (M.J.H.A.)
| | - Anne P. Langermans
- Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands; (M.B.); (K.D.J.B.); (A.P.L.); (I.C.C.v.d.H.); (M.J.H.A.)
| | - Sander M. J. van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, (KEMTA), Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands;
| | - Iwan C. C. van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands; (M.B.); (K.D.J.B.); (A.P.L.); (I.C.C.v.d.H.); (M.J.H.A.)
- Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands
| | - Jan Willem J. Elting
- Department of Neurology and Clinical Neurophysiology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (N.E.); (J.W.J.E.)
| | - Marcel J. H. Aries
- Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands; (M.B.); (K.D.J.B.); (A.P.L.); (I.C.C.v.d.H.); (M.J.H.A.)
- School for Mental Health and Neuroscience (MHeNS), University Maastricht, 6229 HX Maastricht, The Netherlands
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9
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Pan X, Chen X, Ren L, Li Z, Chen S. Correlation of Obesity and Overweight with Cervical Vascular Function Among Healthy Populations. Diabetes Metab Syndr Obes 2022; 15:2927-2938. [PMID: 36186940 PMCID: PMC9521237 DOI: 10.2147/dmso.s383880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To study the effects of obesity and overweight on carotid vascular function among healthy populations by carotid ultrasound (CAU) and transcranial Doppler (TCD). MATERIALS AND METHODS Basic clinical characteristics, CAU and TCD parameters were collected from recruited healthy individuals. Firstly, all participants were divided into three groups: normal, overweight and obese. Then, the variability of basic clinical characteristics and lipids between the three groups was calculated. Subsequently, CAU and TCD parameters were compared between the three groups. Finally, the correlation between body mass index (BMI) and neck vascular function was analyzed. RESULTS A total of 613 healthy participants were included, of whom 241 were normal, 264 were overweight, and 108 were obese. Overweight and obesity significantly decreased systolic, diastolic and mean flow velocities in the basilar, vertebral and internal carotid arteries, but had no effect on pulsatility index. In addition, BMI was significantly negatively correlated with systolic, diastolic, and mean flow velocities in the basilar, vertebral, and internal carotid arteries, and remained correlated after adjusting for other factors. There was no effect of overweight and obesity on carotid plaques. CONCLUSION Our study revealed that overweight and obesity decreased carotid vascular flow velocity and showed a decreasing trend in vascular flow velocity with increasing BMI. Overweight and obesity appear to have no effect on carotid plaques.
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Affiliation(s)
- Xiaoyu Pan
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Xiaoyi Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Lin Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Zelin Li
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Shuchun Chen
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Correspondence: Shuchun Chen, Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China, Tel/Fax +86 31185988406, Email
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