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Cortese L, Fernández Esteberena P, Zanoletti M, Lo Presti G, Aranda Velazquez G, Ruiz Janer S, Buttafava M, Renna M, Di Sieno L, Tosi A, Dalla Mora A, Wojtkiewicz S, Dehghani H, de Fraguier S, Nguyen-Dinh A, Rosinski B, Weigel UM, Mesquida J, Squarcia M, Hanzu FA, Contini D, Mora Porta M, Durduran T. In vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle through ultrasound-guided hybrid near-infrared spectroscopies. Physiol Meas 2023; 44:125010. [PMID: 38061053 DOI: 10.1088/1361-6579/ad133a] [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: 06/13/2023] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
Objective.In this paper, we present a detailedin vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle (SCM), obtained through ultrasound-guided near-infrared time-domain and diffuse correlation spectroscopies.Approach.A total of sixty-five subjects (forty-nine females, sixteen males) among healthy volunteers and thyroid nodule patients have been recruited for the study. Their SCM hemodynamic (oxy-, deoxy- and total hemoglobin concentrations, blood flow, blood oxygen saturation and metabolic rate of oxygen extraction) and optical properties (wavelength dependent absorption and reduced scattering coefficients) have been measured by the use of a novel hybrid device combining in a single unit time-domain near-infrared spectroscopy, diffuse correlation spectroscopy and simultaneous ultrasound imaging.Main results.We provide detailed tables of the results related to SCM baseline (i.e. muscle at rest) properties, and reveal significant differences on the measured parameters due to variables such as side of the neck, sex, age, body mass index, depth and thickness of the muscle, allowing future clinical studies to take into account such dependencies.Significance.The non-invasive monitoring of the hemodynamics and metabolism of the sternocleidomastoid muscle during respiration became a topic of increased interest partially due to the increased use of mechanical ventilation during the COVID-19 pandemic. Near-infrared diffuse optical spectroscopies were proposed as potential practical monitors of increased recruitment of SCM during respiratory distress. They can provide clinically relevant information on the degree of the patient's respiratory effort that is needed to maintain an optimal minute ventilation, with potential clinical application ranging from evaluating chronic pulmonary diseases to more acute settings, such as acute respiratory failure, or to determine the readiness to wean from invasive mechanical ventilation.
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Affiliation(s)
- Lorenzo Cortese
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Pablo Fernández Esteberena
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Marta Zanoletti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Giuseppe Lo Presti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | | | - Sabina Ruiz Janer
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
| | - Mauro Buttafava
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at PIONIRS s.r.l., I-20124 Milano, Italy
| | - Marco Renna
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at Athinoula A. Martinos Center for Biomedical Imaging, MGH, Harvard Medical School, Charlestown, MA 02129, United States of America
| | - Laura Di Sieno
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Alberto Tosi
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
| | | | - Stanislaw Wojtkiewicz
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
- Now at Nalecz Institute of Biocybernetics and Biomedical Engineering, 02-109 Warsaw, Poland
| | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | | | | | | | - Udo M Weigel
- HemoPhotonics S.L., E-08860 Castelldefels (Barcelona), Spain
| | - Jaume Mesquida
- Área de Crítics, Parc Taulí Hospital Universitari, E-08208 Sabadell, Spain
| | - Mattia Squarcia
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Neuroradiology Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
| | - Felicia A Hanzu
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Mireia Mora Porta
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), E-08010 Barcelona, Spain
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Zhao M, Zhou W, Aparanji S, Mazumder D, Srinivasan VJ. Interferometric diffusing wave spectroscopy imaging with an electronically variable time-of-flight filter. OPTICA 2023; 10:42-52. [PMID: 37275218 PMCID: PMC10238083 DOI: 10.1364/optica.472471] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/09/2022] [Indexed: 06/07/2023]
Abstract
Diffuse optics (DO) is a light-based technique used to study the human brain, but it suffers from low brain specificity. Interferometric diffuse optics (iDO) promises to improve the quantitative accuracy and depth specificity of DO, and particularly, coherent light fluctuations (CLFs) arising from blood flow. iDO techniques have alternatively achieved either time-of-flight (TOF) discrimination or highly parallel detection, but not both at once. Here, we break this barrier with a single iDO instrument. Specifically, we show that rapid tuning of a temporally coherent laser during the sensor integration time increases the effective linewidth seen by a highly parallel interferometer. Using this concept to create a continuously variable and user-specified TOF filter, we demonstrate a solution to the canonical problem of DO, measuring optical properties. Then, with a deep TOF filter, we reduce scalp sensitivity of CLFs by 2.7 times at 1 cm source-collector separation. With this unique combination of desirable features, i.e., TOF-discrimination, spatial localization, and highly parallel CLF detection, we perform multiparametric imaging of light intensities and CLFs via the human forehead.
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Affiliation(s)
- Mingjun Zhao
- Department of Radiology, New York University Langone Health, 660 First Avenue, New York, New York 10016, USA
- Department of Biomedical Engineering, University of California Davis, 1 Shields Ave, Davis, California 95616, USA
| | - Wenjun Zhou
- Department of Biomedical Engineering, University of California Davis, 1 Shields Ave, Davis, California 95616, USA
- College of Optical and Electronic Technology, China Jiliang University, Hangzhou, Zhejiang 310018, China
| | - Santosh Aparanji
- Department of Radiology, New York University Langone Health, 660 First Avenue, New York, New York 10016, USA
| | - Dibbyan Mazumder
- Department of Radiology, New York University Langone Health, 660 First Avenue, New York, New York 10016, USA
| | - Vivek J. Srinivasan
- Department of Radiology, New York University Langone Health, 660 First Avenue, New York, New York 10016, USA
- Department of Biomedical Engineering, University of California Davis, 1 Shields Ave, Davis, California 95616, USA
- Department of Ophthalmology, New York University Langone Health, 550 First Avenue, New York, New York 10016, USA
- Tech4Health Institute, New York University Langone Health, 433 1st Avenue, New York, New York 10010, USA
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Carp SA, Robinson MB, Franceschini MA. Diffuse correlation spectroscopy: current status and future outlook. NEUROPHOTONICS 2023; 10:013509. [PMID: 36704720 PMCID: PMC9871606 DOI: 10.1117/1.nph.10.1.013509] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/23/2022] [Indexed: 06/18/2023]
Abstract
Diffuse correlation spectroscopy (DCS) has emerged as a versatile, noninvasive method for deep tissue perfusion assessment using near-infrared light. A broad class of applications is being pursued in neuromonitoring and beyond. However, technical limitations of the technology as originally implemented remain as barriers to wider adoption. A wide variety of approaches to improve measurement performance and reduce cost are being explored; these include interferometric methods, camera-based multispeckle detection, and long path photon selection for improved depth sensitivity. We review here the current status of DCS technology and summarize future development directions and the challenges that remain on the path to widespread adoption.
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Affiliation(s)
- Stefan A. Carp
- Massachusetts General Hospital, Harvard Medical School, Optics at Martinos Research Group, Charlestown, Massachusetts, United States
| | - Mitchell B. Robinson
- Massachusetts General Hospital, Harvard Medical School, Optics at Martinos Research Group, Charlestown, Massachusetts, United States
| | - Maria A. Franceschini
- Massachusetts General Hospital, Harvard Medical School, Optics at Martinos Research Group, Charlestown, Massachusetts, United States
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Tagliabue S, Lindner C, da Prat IC, Sanchez-Guerrero A, Serra I, Kacprzak M, Maruccia F, Silva OM, Weigel UM, de Nadal M, Poca MA, Durduran T. Comparison of cerebral metabolic rate of oxygen, blood flow, and bispectral index under general anesthesia. NEUROPHOTONICS 2023; 10:015006. [PMID: 36911206 PMCID: PMC9993084 DOI: 10.1117/1.nph.10.1.015006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
SIGNIFICANCE The optical measurement of cerebral oxygen metabolism was evaluated. AIM Compare optically derived cerebral signals to the electroencephalographic bispectral index (BIS) sensors to monitor propofol-induced anesthesia during surgery. APPROACH Relative cerebral metabolic rate of oxygen ( rCMRO 2 ) and blood flow (rCBF) were measured by time-resolved and diffuse correlation spectroscopies. Changes were tested against the relative BIS (rBIS) ones. The synchronism in the changes was also assessed by the R-Pearson correlation. RESULTS In 23 measurements, optically derived signals showed significant changes in agreement with rBIS: during propofol induction, rBIS decreased by 67% [interquartile ranges (IQR) 62% to 71%], rCMRO 2 by 33% (IQR 18% to 46%), and rCBF by 28% (IQR 10% to 37%). During recovery, a significant increase was observed for rBIS (48%, IQR 38% to 55%), rCMRO 2 (29%, IQR 17% to 39%), and rCBF (30%, IQR 10% to 44%). The significance and direction of the changes subject-by-subject were tested: the coupling between the rBIS, rCMRO 2 , and rCBF was witnessed in the majority of the cases (14/18 and 12/18 for rCBF and 19/21 and 13/18 for rCMRO 2 in the initial and final part, respectively). These changes were also correlated in time ( R > 0.69 to R = 1 , p - values < 0.05 ). CONCLUSIONS Optics can reliably monitor rCMRO 2 in such conditions.
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Affiliation(s)
- Susanna Tagliabue
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Claus Lindner
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | | | - Angela Sanchez-Guerrero
- Vall d’Hebron University Hospital Research Institute, Neurotraumatology and Neurosurgery Research Unit, Barcelona, Spain
| | - Isabel Serra
- Centre de Recerca Matemàtica, Bellaterra, Spain
- Barcelona Supercomputing Center—Centre Nacional de Supercomputació, Spain
| | - Michał Kacprzak
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
- Nalecz Institute of Biocybernetics and Biomedical Engineering PAS, Warsaw, Poland
| | - Federica Maruccia
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
- Vall d’Hebron University Hospital Research Institute, Neurotraumatology and Neurosurgery Research Unit, Barcelona, Spain
| | - Olga Martinez Silva
- Vall d’Hebron University Hospital, Department of Anesthesiology, Barcelona, Spain
| | - Udo M. Weigel
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
- HemoPhotonics S.L., Mediterranean Technology Park, Barcelona, Spain
| | - Miriam de Nadal
- Vall d’Hebron University Hospital, Department of Anesthesiology, Barcelona, Spain
- Universidad Autònoma de Barcelona, Plaça Cívica, Barcelona, Spain
| | - Maria A. Poca
- Vall d’Hebron University Hospital Research Institute, Neurotraumatology and Neurosurgery Research Unit, Barcelona, Spain
- Universidad Autònoma de Barcelona, Plaça Cívica, Barcelona, Spain
- Vall d’Hebron University Hospital, Department of Neurosurgery, Barcelona, Spain
| | - Turgut Durduran
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
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Acharya D, Mukherjea A, Cao J, Ruesch A, Schmitt S, Yang J, Smith MA, Kainerstorfer JM. Non-Invasive Spectroscopy for Measuring Cerebral Tissue Oxygenation and Metabolism as a Function of Cerebral Perfusion Pressure. Metabolites 2022; 12:metabo12070667. [PMID: 35888791 PMCID: PMC9323243 DOI: 10.3390/metabo12070667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS) measure cerebral hemodynamics, which in turn can be used to assess the cerebral metabolic rate of oxygen (CMRO2) and cerebral autoregulation (CA). However, current mathematical models for CMRO2 estimation make assumptions that break down for cerebral perfusion pressure (CPP)-induced changes in CA. Here, we performed preclinical experiments with controlled changes in CPP while simultaneously measuring NIRS and DCS at rest. We observed changes in arterial oxygen saturation (~10%) and arterial blood volume (~50%) with CPP, two variables often assumed to be constant in CMRO2 estimations. Hence, we propose a general mathematical model that accounts for these variations when estimating CMRO2 and validate its use for CA monitoring on our experimental data. We observed significant changes in the various oxygenation parameters, including the coupling ratio (CMRO2/blood flow) between regions of autoregulation and dysregulation. Our work provides an appropriate model and preliminary experimental evidence for the use of NIRS- and DCS-based tissue oxygenation and metabolism metrics for non-invasive diagnosis of CA health in CPP-altering neuropathologies.
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Affiliation(s)
- Deepshikha Acharya
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (D.A.); (A.M.); (J.C.); (S.S.); (J.Y.); (M.A.S.)
| | - Ankita Mukherjea
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (D.A.); (A.M.); (J.C.); (S.S.); (J.Y.); (M.A.S.)
| | - Jiaming Cao
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (D.A.); (A.M.); (J.C.); (S.S.); (J.Y.); (M.A.S.)
| | - Alexander Ruesch
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA;
| | - Samantha Schmitt
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (D.A.); (A.M.); (J.C.); (S.S.); (J.Y.); (M.A.S.)
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA;
| | - Jason Yang
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (D.A.); (A.M.); (J.C.); (S.S.); (J.Y.); (M.A.S.)
| | - Matthew A. Smith
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (D.A.); (A.M.); (J.C.); (S.S.); (J.Y.); (M.A.S.)
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA;
| | - Jana M. Kainerstorfer
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (D.A.); (A.M.); (J.C.); (S.S.); (J.Y.); (M.A.S.)
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA;
- Correspondence:
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Johnson TW, Dar IA, Donohue KL, Xu YY, Santiago E, Selioutski O, Marinescu MA, Maddox RK, Wu TT, Schifitto G, Gosev I, Choe R, Khan IR. Cerebral Blood Flow Hemispheric Asymmetry in Comatose Adults Receiving Extracorporeal Membrane Oxygenation. Front Neurosci 2022; 16:858404. [PMID: 35478849 PMCID: PMC9036108 DOI: 10.3389/fnins.2022.858404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/09/2022] [Indexed: 12/03/2022] Open
Abstract
Peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) artificially oxygenates and circulates blood retrograde from the femoral artery, potentially exposing the brain to asymmetric perfusion. Though ECMO patients frequently experience brain injury, neurologic exams and imaging are difficult to obtain. Diffuse correlation spectroscopy (DCS) non-invasively measures relative cerebral blood flow (rBF) at the bedside using an optical probe on each side of the forehead. In this study we observed interhemispheric rBF differences in response to mean arterial pressure (MAP) changes in adult ECMO recipients. We recruited 13 subjects aged 21–78 years (7 with cardiac arrest, 4 with acute heart failure, and 2 with acute respiratory distress syndrome). They were dichotomized via Glasgow Coma Scale Motor score (GCS-M) into comatose (GCS-M ≤ 4; n = 4) and non-comatose (GCS-M > 4; n = 9) groups. Comatose patients had greater interhemispheric rBF asymmetry (ASYMrBF) vs. non-comatose patients over a range of MAP values (29 vs. 11%, p = 0.009). ASYMrBF in comatose patients resolved near a MAP range of 70–80 mmHg, while rBF remained symmetric through a wider MAP range in non-comatose patients. Correlations between post-oxygenator pCO2 or pH vs. ASYMrBF were significantly different between comatose and non-comatose groups. Our findings indicate that comatose patients are more likely to have asymmetric cerebral perfusion.
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Affiliation(s)
- Thomas W. Johnson
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Irfaan A. Dar
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
| | - Kelly L. Donohue
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Yama Y. Xu
- School of Arts and Sciences, University of Rochester, Rochester, NY, United States
| | - Esmeralda Santiago
- School of Arts and Sciences, University of Rochester, Rochester, NY, United States
| | - Olga Selioutski
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Mark A. Marinescu
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Ross K. Maddox
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, United States
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, United States
| | - Giovanni Schifitto
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Igor Gosev
- Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States
| | - Regine Choe
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, United States
| | - Imad R. Khan
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
- *Correspondence: Imad R. Khan,
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Vavrinsky E, Esfahani NE, Hausner M, Kuzma A, Rezo V, Donoval M, Kosnacova H. The Current State of Optical Sensors in Medical Wearables. BIOSENSORS 2022; 12:217. [PMID: 35448277 PMCID: PMC9029995 DOI: 10.3390/bios12040217] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 05/04/2023]
Abstract
Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.
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Affiliation(s)
- Erik Vavrinsky
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (N.E.E.); (M.H.); (A.K.); (V.R.); (M.D.)
- Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Sasinkova 2, 81272 Bratislava, Slovakia
| | - Niloofar Ebrahimzadeh Esfahani
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (N.E.E.); (M.H.); (A.K.); (V.R.); (M.D.)
| | - Michal Hausner
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (N.E.E.); (M.H.); (A.K.); (V.R.); (M.D.)
| | - Anton Kuzma
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (N.E.E.); (M.H.); (A.K.); (V.R.); (M.D.)
| | - Vratislav Rezo
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (N.E.E.); (M.H.); (A.K.); (V.R.); (M.D.)
| | - Martin Donoval
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (N.E.E.); (M.H.); (A.K.); (V.R.); (M.D.)
| | - Helena Kosnacova
- Department of Simulation and Virtual Medical Education, Faculty of Medicine, Comenius University, Sasinkova 4, 81272 Bratislava, Slovakia
- Department of Genetics, Cancer Research Institute, Biomedical Research Center, Slovak Academy Sciences, Dubravska Cesta 9, 84505 Bratislava, Slovakia
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Wu MM, Perdue K, Chan ST, Stephens KA, Deng B, Franceschini MA, Carp SA. Complete head cerebral sensitivity mapping for diffuse correlation spectroscopy using subject-specific magnetic resonance imaging models. BIOMEDICAL OPTICS EXPRESS 2022; 13:1131-1151. [PMID: 35414976 PMCID: PMC8973189 DOI: 10.1364/boe.449046] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 05/11/2023]
Abstract
We characterize cerebral sensitivity across the entire adult human head for diffuse correlation spectroscopy, an optical technique increasingly used for bedside cerebral perfusion monitoring. Sixteen subject-specific magnetic resonance imaging-derived head models were used to identify high sensitivity regions by running Monte Carlo light propagation simulations at over eight hundred uniformly distributed locations on the head. Significant spatial variations in cerebral sensitivity, consistent across subjects, were found. We also identified correlates of such differences suitable for real-time assessment. These variations can be largely attributed to changes in extracerebral thickness and should be taken into account to optimize probe placement in experimental settings.
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Affiliation(s)
- Melissa M. Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
| | | | - Suk-Tak Chan
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
| | - Kimberly A. Stephens
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
| | - Bin Deng
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
| | | | - Stefan A. Carp
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
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9
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Kholiqov O, Zhou W, Zhang T, Zhao M, Ghandiparsi S, Srinivasan VJ. Scanning interferometric near-infrared spectroscopy. OPTICS LETTERS 2022; 47:110-113. [PMID: 34951892 PMCID: PMC9281567 DOI: 10.1364/ol.443533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 05/24/2023]
Abstract
In diffuse optics, quantitative assessment of the human brain is confounded by the skull and scalp. To better understand these superficial tissues, we advance interferometric near-infrared spectroscopy (iNIRS) to form images of the human superficial forehead blood flow index (BFI). We present a null source-collector (S-C) polarization splitting approach that enables galvanometer scanning and eliminates unwanted backscattered light. Images show an order-of-magnitude heterogeneity in superficial dynamics, implying an order-of-magnitude heterogeneity in brain specificity, depending on forehead location. Along the time-of-flight dimension, autocorrelation decay rates support a three-layer model with increasing BFI from the skull to the scalp to the brain. By accurately characterizing superficial tissues, this approach can help improve specificity for the human brain.
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Affiliation(s)
- Oybek Kholiqov
- Department of Biomedical Engineering, University of California Davis, Davis, California 95616, USA
| | - Wenjun Zhou
- Department of Biomedical Engineering, University of California Davis, Davis, California 95616, USA
| | - Tingwei Zhang
- Department of Biomedical Engineering, University of California Davis, Davis, California 95616, USA
| | - Mingjun Zhao
- Department of Biomedical Engineering, University of California Davis, Davis, California 95616, USA
- Tech4Health Institute, NYU Langone Health, New York, New York 10010, USA
| | - Soroush Ghandiparsi
- Department of Biomedical Engineering, University of California Davis, Davis, California 95616, USA
| | - Vivek J. Srinivasan
- Department of Biomedical Engineering, University of California Davis, Davis, California 95616, USA
- Tech4Health Institute, NYU Langone Health, New York, New York 10010, USA
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10
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Li Z, Ge Q, Feng J, Jia K, Zhao J. Quantification of blood flow index in diffuse correlation spectroscopy using long short-term memory architecture. BIOMEDICAL OPTICS EXPRESS 2021; 12:4131-4146. [PMID: 34457404 PMCID: PMC8367234 DOI: 10.1364/boe.423777] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 05/30/2023]
Abstract
Diffuse correlation spectroscopy (DCS) is a noninvasive technique that derives blood flow information from measurements of the temporal intensity fluctuations of multiply scattered light. Blood flow index (BFI) and especially its variation was demonstrated to be approximately proportional to absolute blood flow. We investigated and assessed the utility of a long short-term memory (LSTM) architecture for quantification of BFI in DCS. Phantom and in vivo experiments were established to measure normalized intensity autocorrelation function data. Improved accuracy and faster computational time were gained by the proposed LSTM architecture. The results support the notion of using proposed LSTM architecture for quantification of BFI in DCS. This approach would be especially useful for continuous real-time monitoring of blood flow.
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Affiliation(s)
- Zhe Li
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing Laboratory of Advanced Information Networks, Beijing 100124, China
- Beijing Key Laboratory of Computational Intelligence and Intelligent System, Beijing University of Technology, Beijing 100124, China
- Zhe Li and Qisi Ge contributed equally to this work
| | - Qisi Ge
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing Laboratory of Advanced Information Networks, Beijing 100124, China
- Beijing Key Laboratory of Computational Intelligence and Intelligent System, Beijing University of Technology, Beijing 100124, China
- Zhe Li and Qisi Ge contributed equally to this work
| | - Jinchao Feng
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing Laboratory of Advanced Information Networks, Beijing 100124, China
- Beijing Key Laboratory of Computational Intelligence and Intelligent System, Beijing University of Technology, Beijing 100124, China
| | - Kebin Jia
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing Laboratory of Advanced Information Networks, Beijing 100124, China
- Beijing Key Laboratory of Computational Intelligence and Intelligent System, Beijing University of Technology, Beijing 100124, China
| | - Jing Zhao
- College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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11
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Cortese L, Lo Presti G, Zanoletti M, Aranda G, Buttafava M, Contini D, Dalla Mora A, Dehghani H, Di Sieno L, de Fraguier S, Hanzu FA, Mora Porta M, Nguyen-Dinh A, Renna M, Rosinski B, Squarcia M, Tosi A, Weigel UM, Wojtkiewicz S, Durduran T. The LUCA device: a multi-modal platform combining diffuse optics and ultrasound imaging for thyroid cancer screening. BIOMEDICAL OPTICS EXPRESS 2021; 12:3392-3409. [PMID: 34221667 PMCID: PMC8221941 DOI: 10.1364/boe.416561] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 05/07/2023]
Abstract
We present the LUCA device, a multi-modal platform combining eight-wavelength near infrared time resolved spectroscopy, sixteen-channel diffuse correlation spectroscopy and a clinical ultrasound in a single device. By simultaneously measuring the tissue hemodynamics and performing ultrasound imaging, this platform aims to tackle the low specificity and sensitivity of the current thyroid cancer diagnosis techniques, improving the screening of thyroid nodules. Here, we show a detailed description of the device, components and modules. Furthermore, we show the device tests performed through well established protocols for phantom validation, and the performance assessment for in vivo. The characterization tests demonstrate that LUCA device is capable of performing high quality measurements, with a precision in determining in vivo tissue optical and dynamic properties of better than 3%, and a reproducibility of better than 10% after ultrasound-guided probe repositioning, even with low photon count-rates, making it suitable for a wide variety of clinical applications.
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Affiliation(s)
- Lorenzo Cortese
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- These authors equally contributed to this work. Authors are listed in alphabetical order except for the first three and the last
| | - Giuseppe Lo Presti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- These authors equally contributed to this work. Authors are listed in alphabetical order except for the first three and the last
| | - Marta Zanoletti
- Politecnico di Milano, Dipartimento di Fisica, 20133 Milano, Italy
| | - Gloria Aranda
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, Barcelona, Spain
| | - Mauro Buttafava
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, 20133 Milano, Italy
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, 20133 Milano, Italy
| | | | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, UK
| | - Laura Di Sieno
- Politecnico di Milano, Dipartimento di Fisica, 20133 Milano, Italy
| | | | - Felicia A. Hanzu
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomèdica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Mireia Mora Porta
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomèdica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | | | - Marco Renna
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, 20133 Milano, Italy
- Athinoula A. Martinos Center for Biomedical Imaging, MGH, Harvard Medical School, Charlestown, MA 02129, USA
| | | | - Mattia Squarcia
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, Barcelona, Spain
- Neuroradiology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Alberto Tosi
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, 20133 Milano, Italy
| | - Udo M. Weigel
- HemoPhotonics S.L., 08860 Castelldefels (Barcelona), Spain
| | - Stanislaw Wojtkiewicz
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, UK
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08015 Barcelona, Spain
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12
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The Use of Supercontinuum Laser Sources in Biomedical Diffuse Optics: Unlocking the Power of Multispectral Imaging. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11104616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Optical techniques based on diffuse optics have been around for decades now and are making their way into the day-to-day medical applications. Even though the physics foundations of these techniques have been known for many years, practical implementation of these technique were hindered by technological limitations, mainly from the light sources and/or detection electronics. In the past 20 years, the developments of supercontinuum laser (SCL) enabled to unlock some of these limitations, enabling the development of system and methodologies relevant for medical use, notably in terms of spectral monitoring. In this review, we focus on the use of SCL in biomedical diffuse optics, from instrumentation and methods developments to their use for medical applications. A total of 95 publications were identified, from 1993 to 2021. We discuss the advantages of the SCL to cover a large spectral bandwidth with a high spectral power and fast switching against the disadvantages of cost, bulkiness, and long warm up times. Finally, we summarize the utility of using such light sources in the development and application of diffuse optics in biomedical sciences and clinical applications.
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13
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Pham T, Blaney G, Sassaroli A, Fernandez C, Fantini S. Sensitivity of frequency-domain optical measurements to brain hemodynamics: simulations and human study of cerebral blood flow during hypercapnia. BIOMEDICAL OPTICS EXPRESS 2021; 12:766-789. [PMID: 33680541 PMCID: PMC7901322 DOI: 10.1364/boe.412766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 05/20/2023]
Abstract
This study characterizes the sensitivity of noninvasive measurements of cerebral blood flow (CBF) by using frequency-domain near-infrared spectroscopy (FD-NIRS) and coherent hemodynamics spectroscopy (CHS). We considered six FD-NIRS methods: single-distance intensity and phase (SDI and SDϕ), single-slope intensity and phase (SSI and SSϕ), and dual-slope intensity and phase (DSI and DSϕ). Cerebrovascular reactivity (CVR) was obtained from the relative change in measured CBF during a step hypercapnic challenge. Greater measured values of CVR are assigned to a greater sensitivity to cerebral hemodynamics. In a first experiment with eight subjects, CVRSDϕ was greater than CVRSDI (p < 0.01), whereas CVRDSI and CVRDSϕ showed no significant difference (p > 0.5). In a second experiment with four subjects, a 5 mm scattering layer was added between the optical probe and the scalp tissue to increase the extracerebral layer thickness (L ec ), which caused CVRDSϕ to become significantly greater than CVRDSI (p < 0.05). CVRSS measurements yielded similar results as CVRDS measurements but with a greater variability, possibly resulting from instrumental artifacts in SS measurements. Theoretical simulations with two-layered media confirmed that, if the top (extracerebral) layer is more scattering than the bottom (brain) layer, the relative values of CVRDSI and CVRDSϕ depend on L ec . Specifically, the sensitivity to the brain is greater for DSI than DSϕ for a thin extracerebral layer (L ec < 13 mm), whereas it is greater for DSϕ than DSI for a thicker extracerebral layer.
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Affiliation(s)
- Thao Pham
- Tufts University, Department of Biomedical Engineering, 4 Colby Street, Medford, MA 02155, USA
| | - Giles Blaney
- Tufts University, Department of Biomedical Engineering, 4 Colby Street, Medford, MA 02155, USA
| | - Angelo Sassaroli
- Tufts University, Department of Biomedical Engineering, 4 Colby Street, Medford, MA 02155, USA
| | - Cristianne Fernandez
- Tufts University, Department of Biomedical Engineering, 4 Colby Street, Medford, MA 02155, USA
| | - Sergio Fantini
- Tufts University, Department of Biomedical Engineering, 4 Colby Street, Medford, MA 02155, USA
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14
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Amendola C, Lacerenza M, Buttafava M, Tosi A, Spinelli L, Contini D, Torricelli A. A Compact Multi-Distance DCS and Time Domain NIRS Hybrid System for Hemodynamic and Metabolic Measurements. SENSORS 2021; 21:s21030870. [PMID: 33525488 PMCID: PMC7866011 DOI: 10.3390/s21030870] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 01/17/2023]
Abstract
In this work, we present a new multi-distance diffuse correlation spectroscopy (DCS) device integrated with a compact state-of-the-art time domain near infrared spectroscopy (TD-NIRS) device. The hybrid DCS and TD-NIRS system allows to retrieve information on blood flow, tissue oxygenation, and oxygen metabolic rate. The DCS device performances were estimated in terms of stability, repeatability, ability in retrieving variations of diffusion coefficient, influence of the tissue optical properties, effect of varying count rates and depth sensitivity. Crosstalk between DCS and TD-NIRS optical signals was also evaluated. Finally, in vivo experiments (venous and arterial cuff occlusions on the arm) were conducted to test the ability of the hybrid system in measuring blood flow variations.
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Affiliation(s)
- Caterina Amendola
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
- Correspondence: (C.A.); (A.T.)
| | - Michele Lacerenza
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
| | - Mauro Buttafava
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, via Ponzio 34/5, 20133 Milan, Italy; (M.B.); (A.T.)
| | - Alberto Tosi
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, via Ponzio 34/5, 20133 Milan, Italy; (M.B.); (A.T.)
| | - Lorenzo Spinelli
- Consiglio Nazionale delle Ricerche, Istituto di Fotonica e Nanotecnologie, piazza Leonardo da Vinci 32, 20133 Milan, Italy;
| | - Davide Contini
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
| | - Alessandro Torricelli
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
- Consiglio Nazionale delle Ricerche, Istituto di Fotonica e Nanotecnologie, piazza Leonardo da Vinci 32, 20133 Milan, Italy;
- Correspondence: (C.A.); (A.T.)
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15
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Kirschen MP, Morgan RW, Majmudar T, Landis WP, Ko T, Balu R, Balasubramanian S, Topjian A, Sutton RM, Berg RA, Kilbaugh TJ. The association between early impairment in cerebral autoregulation and outcome in a pediatric swine model of cardiac arrest. Resusc Plus 2020; 4:100051. [PMID: 34223325 PMCID: PMC8244245 DOI: 10.1016/j.resplu.2020.100051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 12/26/2022] Open
Abstract
AIMS Evaluate cerebral autoregulation (CAR) by intracranial pressure reactivity index (PRx) and cerebral blood flow reactivity index (CBFx) during the first four hours following return of spontaneous circulation (ROSC) in a porcine model of pediatric cardiac arrest. Determine whether impaired CAR is associated with neurologic outcome. METHODS Four-week-old swine underwent seven minutes of asphyxia followed by ventricular fibrillation induction and hemodynamic-directed CPR. Those achieving ROSC had arterial blood pressure, intracranial pressure (ICP), and microvascular cerebral blood flow (CBF) monitored for 4 h. Animals were assigned an 8 -h post-ROSC swine cerebral performance category score (1 = normal; 2-4=abnormal neurologic function). In this secondary analytic study, we calculated PRx and CBFx using a continuous, moving correlation coefficient between mean arterial pressure (MAP) and ICP, and between MAP and CBF, respectively. Burden of impaired CAR was the area under the PRx or CBFx curve using a threshold of 0.3 and normalized as percentage of monitoring duration. RESULTS Among 23 animals, median PRx was 0.14 [0.06,0.25] and CBFx was 0.36 [0.05,0.44]. Median burden of impaired CAR was 21% [18,27] with PRx and 30% [17,40] with CBFx. Neurologically abnormal animals (n = 10) did not differ from normal animals (n = 13) in post-ROSC MAP (63 vs. 61 mmHg, p = 0.74), ICP (15 vs. 14 mmHg, p = 0.78) or CBF (274 vs. 397 Perfusion Units, p = 0.12). CBFx burden was greater among abnormal than normal animals (45% vs. 24%, p = 0.001), but PRx burden was not (25% vs. 20%, p = 0.38). CONCLUSION CAR is impaired early after ROSC. A greater burden of CAR impairment measured by CBFx was associated with abnormal neurologic outcome.CHOP Institutional Animal Care and Use Committee protocol 19-001327.
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Affiliation(s)
- Matthew P Kirschen
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, USA
| | - Ryan W. Morgan
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, USA
| | - Tanmay Majmudar
- School of Biomedical Engineering, Science and Health Systems, Drexel University, USA
| | - William P. Landis
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
| | - Tiffany Ko
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
| | - Ramani Balu
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, USA
| | | | - Alexis Topjian
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, USA
| | - Robert M. Sutton
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, USA
| | - Robert A. Berg
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, USA
| | - Todd J. Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, USA
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16
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Rajaram A, Milej D, Suwalski M, Yip LCM, Guo LR, Chu MWA, Chui J, Diop M, Murkin JM, St. Lawrence K. Optical monitoring of cerebral perfusion and metabolism in adults during cardiac surgery with cardiopulmonary bypass. BIOMEDICAL OPTICS EXPRESS 2020; 11:5967-5981. [PMID: 33149999 PMCID: PMC7587277 DOI: 10.1364/boe.404101] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 05/23/2023]
Abstract
During cardiac surgery with cardiopulmonary bypass (CPB), adequate maintenance of cerebral blood flow (CBF) is vital in preventing postoperative neurological injury - i.e. stroke, delirium, cognitive impairment. Reductions in CBF large enough to impact cerebral energy metabolism can lead to tissue damage and subsequent brain injury. Current methods for neuromonitoring during surgery are limited. This study presents the clinical translation of a hybrid optical neuromonitor for continuous intraoperative monitoring of cerebral perfusion and metabolism in ten patients undergoing non-emergent cardiac surgery with non-pulsatile CPB. The optical system combines broadband near-infrared spectroscopy (B-NIRS) to measure changes in the oxidation state of cytochrome c oxidase (oxCCO) - a direct marker of cellular energy metabolism - and diffuse correlation spectroscopy (DCS) to provide an index of cerebral blood flow (CBFi). As the heart was arrested and the CPB-pump started, increases in CBFi (88.5 ± 125.7%) and significant decreases in oxCCO (-0.5 ± 0.2 µM) were observed; no changes were noted during transitions off CPB. Fifteen hypoperfusion events, defined as large and sustained reductions in CPB-pump flow rate, were identified across all patients and resulted in significant decreases in perfusion and metabolism when mean arterial pressure dropped to 30 mmHg or below. The maximum reduction in cerebral blood flow preceded the corresponding metabolic reduction by 18.2 ± 15.0 s. Optical neuromonitoring provides a safe and non-invasive approach for assessing intraoperative perfusion and metabolism and has potential in guiding patient management to prevent adverse clinical outcomes.
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Affiliation(s)
- Ajay Rajaram
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London, ON, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada
| | - Daniel Milej
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London, ON, N6A 4V2, Canada
| | - Marianne Suwalski
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London, ON, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada
| | - Lawrence C. M. Yip
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London, ON, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada
| | - Linrui R. Guo
- Division of Cardiac Surgery, London Health Science Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - Michael W. A. Chu
- Division of Cardiac Surgery, London Health Science Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - Jason Chui
- Department of Anesthesiology and Perioperative Medicine, London Health Science Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - Mamadou Diop
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London, ON, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada
| | - John M. Murkin
- Department of Anesthesiology and Perioperative Medicine, London Health Science Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - Keith St. Lawrence
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London, ON, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada
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17
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Milej D, Abdalmalak A, Rajaram A, St. Lawrence K. Direct assessment of extracerebral signal contamination on optical measurements of cerebral blood flow, oxygenation, and metabolism. NEUROPHOTONICS 2020; 7:045002. [PMID: 33062801 PMCID: PMC7540337 DOI: 10.1117/1.nph.7.4.045002] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/04/2020] [Indexed: 05/08/2023]
Abstract
Significance: Near-infrared spectroscopy (NIRS) combined with diffuse correlation spectroscopy (DCS) provides a noninvasive approach for monitoring cerebral blood flow (CBF), oxygenation, and oxygen metabolism. However, these methods are vulnerable to signal contamination from the scalp. Our work evaluated methods of reducing the impact of this contamination using time-resolved (TR) NIRS and multidistance (MD) DCS. Aim: The magnitude of scalp contamination was evaluated by measuring the flow, oxygenation, and metabolic responses to a global hemodynamic challenge. Contamination was assessed by collecting data with and without impeding scalp blood flow. Approach: Experiments involved healthy participants. A pneumatic tourniquet was used to cause scalp ischemia, as confirmed by contrast-enhanced NIRS, and a computerized gas system to generate a hypercapnic challenge. Results: Comparing responses acquired with and without the tourniquet demonstrated that the TR-NIRS technique could reduce scalp contributions in hemodynamic signals up to 4 times (r SD = 3 cm ) and 6 times (r SD = 4 cm ). Similarly, blood flow responses from the scalp and brain could be separated by analyzing MD DCS data with a multilayer model. Using these techniques, there was no change in metabolism during hypercapnia, as expected, despite large increases in CBF and oxygenation. Conclusion: NIRS/DCS can accurately monitor CBF and metabolism with the appropriate enhancement to depth sensitivity, highlighting the potential of these techniques for neuromonitoring.
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Affiliation(s)
- Daniel Milej
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Androu Abdalmalak
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Ajay Rajaram
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Keith St. Lawrence
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Department of Medical Biophysics, London, Ontario, Canada
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18
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Giovannella M, Andresen B, Andersen JB, El-Mahdaoui S, Contini D, Spinelli L, Torricelli A, Greisen G, Durduran T, Weigel UM, Law I. Validation of diffuse correlation spectroscopy against 15O-water PET for regional cerebral blood flow measurement in neonatal piglets. J Cereb Blood Flow Metab 2020; 40:2055-2065. [PMID: 31665953 PMCID: PMC7786848 DOI: 10.1177/0271678x19883751] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 09/06/2019] [Accepted: 09/19/2019] [Indexed: 11/15/2022]
Abstract
Diffuse correlation spectroscopy (DCS) can non-invasively and continuously asses regional cerebral blood flow (rCBF) at the cot-side by measuring a blood flow index (BFI) in non-traditional units of cm2/s. We have validated DCS against positron emission tomography using 15O-labeled water (15O-water PET) in a piglet model allowing us to derive a conversion formula for BFI to rCBF in conventional units (ml/100g/min). Neonatal piglets were continuously monitored by the BabyLux device integrating DCS and time resolved near infrared spectroscopy (TRS) while acquiring 15O-water PET scans at baseline, after injection of acetazolamide and during induced hypoxic episodes. BFI by DCS was highly correlated with rCBF (R = 0.94, p < 0.001) by PET. A scaling factor of 0.89 (limits of agreement for individual measurement: 0.56, 1.39)×109× (ml/100g/min)/(cm2/s) was used to derive baseline rCBF from baseline BFI measurements of another group of piglets and of healthy newborn infants showing an agreement with expected values. These results pave the way towards non-invasive, cot-side absolute CBF measurements by DCS on neonates.
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Affiliation(s)
- Martina Giovannella
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Bjørn Andresen
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Julie B Andersen
- Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Sahla El-Mahdaoui
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Davide Contini
- Politecnico di Milano-Dipartimento di Fisica, Milan, Italy
| | - Lorenzo Spinelli
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Alessandro Torricelli
- Politecnico di Milano-Dipartimento di Fisica, Milan, Italy
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Udo M Weigel
- HemoPhotonics S.L., Castelldefels (Barcelona), Spain
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
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19
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Carp SA, Tamborini D, Mazumder D, Wu KC(T, Robinson MR, Stephens KA, Shatrovoy O, Lue N, Ozana N, Blackwell MH, Franceschini MA. Diffuse correlation spectroscopy measurements of blood flow using 1064 nm light. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200140RR. [PMID: 32996299 PMCID: PMC7522668 DOI: 10.1117/1.jbo.25.9.097003] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/11/2020] [Indexed: 05/18/2023]
Abstract
SIGNIFICANCE Diffuse correlation spectroscopy (DCS) is an established optical modality that enables noninvasive measurements of blood flow in deep tissue by quantifying the temporal light intensity fluctuations generated by dynamic scattering of moving red blood cells. Compared with near-infrared spectroscopy, DCS is hampered by a limited signal-to-noise ratio (SNR) due to the need to use small detection apertures to preserve speckle contrast. However, DCS is a dynamic light scattering technique and does not rely on hemoglobin contrast; thus, there are significant SNR advantages to using longer wavelengths (>1000 nm) for the DCS measurement due to a variety of biophysical and regulatory factors. AIM We offer a quantitative assessment of the benefits and challenges of operating DCS at 1064 nm versus the typical 765 to 850 nm wavelength through simulations and experimental demonstrations. APPROACH We evaluate the photon budget, depth sensitivity, and SNR for detecting blood flow changes using numerical simulations. We discuss continuous wave (CW) and time-domain (TD) DCS hardware considerations for 1064 nm operation. We report proof-of-concept measurements in tissue-like phantoms and healthy adult volunteers. RESULTS DCS at 1064 nm offers higher intrinsic sensitivity to deep tissue compared with DCS measurements at the typically used wavelength range (765 to 850 nm) due to increased photon counts and a slower autocorrelation decay. These advantages are explored using simulations and are demonstrated using phantom and in vivo measurements. We show the first high-speed (cardiac pulsation-resolved), high-SNR measurements at large source-detector separation (3 cm) for CW-DCS and late temporal gates (1 ns) for TD-DCS. CONCLUSIONS DCS at 1064 nm offers a leap forward in the ability to monitor deep tissue blood flow and could be especially useful in increasing the reliability of cerebral blood flow monitoring in adults.
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Affiliation(s)
- Stefan A. Carp
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Address all correspondence to Stefan A. Carp, E-mail:
| | - Davide Tamborini
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Dibbyan Mazumder
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Kuan-Cheng (Tony) Wu
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Mitchell R. Robinson
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- MIT, Health Sciences and Technology Program, Cambridge, Massachusetts, United States
| | - Kimberly A. Stephens
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Oleg Shatrovoy
- MIT Lincoln Laboratory, Lexington, Massachusetts, United States
| | - Niyom Lue
- MIT Lincoln Laboratory, Lexington, Massachusetts, United States
| | - Nisan Ozana
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | | | - Maria A. Franceschini
- Massachusetts General Hospital, Harvard Medical School, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
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20
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Nitzan M, Nitzan I, Arieli Y. The Various Oximetric Techniques Used for the Evaluation of Blood Oxygenation. SENSORS 2020; 20:s20174844. [PMID: 32867184 PMCID: PMC7506757 DOI: 10.3390/s20174844] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022]
Abstract
Adequate oxygen delivery to a tissue depends on sufficient oxygen content in arterial blood and blood flow to the tissue. Oximetry is a technique for the assessment of blood oxygenation by measurements of light transmission through the blood, which is based on the different absorption spectra of oxygenated and deoxygenated hemoglobin. Oxygen saturation in arterial blood provides information on the adequacy of respiration and is routinely measured in clinical settings, utilizing pulse oximetry. Oxygen saturation, in venous blood (SvO2) and in the entire blood in a tissue (StO2), is related to the blood supply to the tissue, and several oximetric techniques have been developed for their assessment. SvO2 can be measured non-invasively in the fingers, making use of modified pulse oximetry, and in the retina, using the modified Beer–Lambert Law. StO2 is measured in peripheral muscle and cerebral tissue by means of various modes of near infrared spectroscopy (NIRS), utilizing the relative transparency of infrared light in muscle and cerebral tissue. The primary problem of oximetry is the discrimination between absorption by hemoglobin and scattering by tissue elements in the attenuation measurement, and the various techniques developed for isolating the absorption effect are presented in the current review, with their limitations.
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Affiliation(s)
- Meir Nitzan
- Department of Physics/Electro-Optics Engineering, Jerusalem College of Technology, 21 Havaad Haleumi St., Jerusalem 91160, Israel;
- Correspondence:
| | - Itamar Nitzan
- Monash Newborn, Monash Children’s Hospital, Melbourne 3168, Australia;
- Department of Neonatology, Shaare Zedek Medical Center, Shmuel Bait St 12, Jerusalem 9103102, Israel
| | - Yoel Arieli
- Department of Physics/Electro-Optics Engineering, Jerusalem College of Technology, 21 Havaad Haleumi St., Jerusalem 91160, Israel;
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21
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Milej D, Shahid M, Abdalmalak A, Rajaram A, Diop M, St. Lawrence K. Characterizing dynamic cerebral vascular reactivity using a hybrid system combining time-resolved near-infrared and diffuse correlation spectroscopy. BIOMEDICAL OPTICS EXPRESS 2020; 11:4571-4585. [PMID: 32923065 PMCID: PMC7449704 DOI: 10.1364/boe.392113] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 05/09/2023]
Abstract
This study presents the characterization of dynamic cerebrovascular reactivity (CVR) in healthy adults by a hybrid optical system combining time-resolved (TR) near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS). Blood flow and oxygenation (oxy- and deoxy-hemoglobin) responses to a step hypercapnic challenge were recorded to characterize dynamic and static components of CVR. Data were acquired at short and long source-detector separations (r SD) to assess the impact of scalp hemodynamics, and moment analysis applied to the TR-NIRS to further enhance the sensitivity to the brain. Comparing blood flow and oxygenation responses acquired at short and long r SD demonstrated that scalp contamination distorted the CVR time courses, particularly for oxyhemoglobin. This effect was significantly diminished by the greater depth sensitivity of TR NIRS and less evident in the DCS data due to the higher blood flow in the brain compared to the scalp. The reactivity speed was similar for blood flow and oxygenation in the healthy brain. Given the ease-of-use, portability, and non-invasiveness of this hybrid approach, it is well suited to investigate if the temporal relationship between CBF and oxygenation is altered by factors such as age and cerebrovascular disease.
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Affiliation(s)
- Daniel Milej
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Marwan Shahid
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Androu Abdalmalak
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Ajay Rajaram
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Mamadou Diop
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Keith St. Lawrence
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
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22
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Milej D, He L, Abdalmalak A, Baker WB, Anazodo UC, Diop M, Dolui S, Kavuri VC, Pavlosky W, Wang L, Balu R, Detre JA, Amendolia O, Quattrone F, Kofke WA, Yodh AG, St Lawrence K. Quantification of cerebral blood flow in adults by contrast-enhanced near-infrared spectroscopy: Validation against MRI. J Cereb Blood Flow Metab 2020; 40:1672-1684. [PMID: 31500522 PMCID: PMC7370369 DOI: 10.1177/0271678x19872564] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 07/29/2019] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to assess the accuracy of absolute cerebral blood flow (CBF) measurements obtained by dynamic contrast-enhanced (DCE) near-infrared spectroscopy (NIRS) using indocyanine green as a perfusion contrast agent. For validation, CBF was measured independently using the MRI perfusion method arterial spin labeling (ASL). Data were acquired at two sites and under two flow conditions (normocapnia and hypercapnia). Depth sensitivity was enhanced using time-resolved detection, which was demonstrated in a separate set of experiments using a tourniquet to temporally impede scalp blood flow. A strong correlation between CBF measurements from ASL and DCE-NIRS was observed (slope = 0.99 ± 0.08, y-intercept = -1.7 ± 7.4 mL/100 g/min, and R2 = 0.88). Mean difference between the two techniques was 1.9 mL/100 g/min (95% confidence interval ranged from -15 to 19 mL/100g/min and the mean ASL CBF was 75.4 mL/100 g/min). Error analysis showed that structural information and baseline absorption coefficient were needed for optimal CBF reconstruction with DCE-NIRS. This study demonstrated that DCE-NIRS is sensitive to blood flow in the adult brain and can provide accurate CBF measurements with the appropriate modeling techniques.
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Affiliation(s)
- Daniel Milej
- Department of Medical Biophysics, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Lian He
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | - Androu Abdalmalak
- Department of Medical Biophysics, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Wesley B Baker
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA
| | - Udunna C Anazodo
- Department of Medical Biophysics, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Mamadou Diop
- Department of Medical Biophysics, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Sudipto Dolui
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Venkaiah C Kavuri
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | - William Pavlosky
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Lin Wang
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | - Ramani Balu
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Olivia Amendolia
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Francis Quattrone
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
| | - W Andrew Kofke
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | - Keith St Lawrence
- Department of Medical Biophysics, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
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23
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Novi SL, Forero EJ, Rubianes Silva JAI, de Souza NGSR, Martins GG, Quiroga A, Wu ST, Mesquita RC. Integration of Spatial Information Increases Reproducibility in Functional Near-Infrared Spectroscopy. Front Neurosci 2020; 14:746. [PMID: 32848543 PMCID: PMC7399018 DOI: 10.3389/fnins.2020.00746] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
As functional near-infrared spectroscopy (fNIRS) is developed as a neuroimaging technique and becomes an option to study a variety of populations and tasks, the reproducibility of the fNIRS signal is still subject of debate. By performing test-retest protocols over different functional tasks, several studies agree that the fNIRS signal is reproducible over group analysis, but the inter-subject and within-subject reproducibility is poor. The high variability at the first statistical level is often attributed to global systemic physiology. In the present work, we revisited the reproducibility of the fNIRS signal during a finger-tapping task across multiple sessions on the same and different days. We expanded on previous studies by hypothesizing that the lack of spatial information of the optodes contributes to the low reproducibility in fNIRS, and we incorporated a real-time neuronavigation protocol to provide accurate cortical localization of the optodes. Our proposed approach was validated in 10 healthy volunteers, and our results suggest that the addition of neuronavigation can increase the within-subject reproducibility of the fNIRS data, particularly in the region of interest. Unlike traditional approaches to positioning the optodes, in which low intra-subject reproducibility has been found, we were able to obtain consistent and robust activation of the contralateral primary motor cortex at the intra-subject level using a neuronavigation protocol. Overall, our findings support the hypothesis that at least part of the variability in fNIRS cannot be only attributed to global systemic physiology. The use of neuronavigation to guide probe positioning, as proposed in this work, has impacts to longitudinal protocols performed with fNIRS.
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Affiliation(s)
- Sergio Luiz Novi
- “Gleb Wataghin” Institute of Physics, University of Campinas, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Edwin Johan Forero
- “Gleb Wataghin” Institute of Physics, University of Campinas, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Jose Angel Ivan Rubianes Silva
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
- School of Electrical and Computer Engineering, University of Campinas, Campinas, Brazil
| | - Nicolas Gabriel S. R. de Souza
- “Gleb Wataghin” Institute of Physics, University of Campinas, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Giovani Grisotti Martins
- “Gleb Wataghin” Institute of Physics, University of Campinas, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Andres Quiroga
- “Gleb Wataghin” Institute of Physics, University of Campinas, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Shin-Ting Wu
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
- School of Electrical and Computer Engineering, University of Campinas, Campinas, Brazil
| | - Rickson C. Mesquita
- “Gleb Wataghin” Institute of Physics, University of Campinas, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
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24
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Rajaram A, Yip LCM, Milej D, Suwalski M, Kewin M, Lo M, Carson JJL, Han V, Bhattacharya S, Diop M, de Ribaupierre S, St. Lawrence K. Perfusion and Metabolic Neuromonitoring during Ventricular Taps in Infants with Post-Hemorrhagic Ventricular Dilatation. Brain Sci 2020; 10:E452. [PMID: 32679665 PMCID: PMC7407524 DOI: 10.3390/brainsci10070452] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/03/2020] [Accepted: 07/13/2020] [Indexed: 01/08/2023] Open
Abstract
Post-hemorrhagic ventricular dilatation (PHVD) is characterized by a build-up of cerebral spinal fluid (CSF) in the ventricles, which increases intracranial pressure and compresses brain tissue. Clinical interventions (i.e., ventricular taps, VT) work to mitigate these complications through CSF drainage; however, the timing of these procedures remains imprecise. This study presents Neonatal NeuroMonitor (NNeMo), a portable optical device that combines broadband near-infrared spectroscopy (B-NIRS) and diffuse correlation spectroscopy (DCS) to provide simultaneous assessments of cerebral blood flow (CBF), tissue saturation (StO2), and the oxidation state of cytochrome c oxidase (oxCCO). In this study, NNeMo was used to monitor cerebral hemodynamics and metabolism in PHVD patients selected for a VT. Across multiple VTs in four patients, no significant changes were found in any of the three parameters: CBF increased by 14.6 ± 37.6% (p = 0.09), StO2 by 1.9 ± 4.9% (p = 0.2), and oxCCO by 0.4 ± 0.6 µM (p = 0.09). However, removing outliers resulted in significant, but small, increases in CBF (6.0 ± 7.7%) and oxCCO (0.1 ± 0.1 µM). The results of this study demonstrate NNeMo's ability to provide safe, non-invasive measurements of cerebral perfusion and metabolism for neuromonitoring applications in the neonatal intensive care unit.
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Affiliation(s)
- Ajay Rajaram
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
| | - Lawrence C. M. Yip
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
| | - Daniel Milej
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
| | - Marianne Suwalski
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
| | - Matthew Kewin
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
| | - Marcus Lo
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
| | - Jeffrey J. L. Carson
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
| | - Victor Han
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, London Health Sciences Centre, London, ON N6A 3K7, Canada; (V.H.); (S.B.)
| | - Soume Bhattacharya
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, London Health Sciences Centre, London, ON N6A 3K7, Canada; (V.H.); (S.B.)
| | - Mamadou Diop
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
| | - Sandrine de Ribaupierre
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
- Department of Clinical Neurological Sciences, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Keith St. Lawrence
- Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada; (L.C.M.Y.); (D.M.); (M.S.); (M.K.); (M.L.); (J.J.L.C.); (M.D.); (K.S.L.)
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada;
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25
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Elliott JT, Addante RR, Slobogean GP, Jiang S, Henderson ER, Pogue BW, Gitajn IL. Intraoperative fluorescence perfusion assessment should be corrected by a measured subject-specific arterial input function. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-14. [PMID: 32519522 PMCID: PMC7282620 DOI: 10.1117/1.jbo.25.6.066002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/27/2020] [Indexed: 05/05/2023]
Abstract
SIGNIFICANCE The effects of varying the indocyanine green injection dose, injection rate, physiologic dispersion of dye, and intravenous tubing volume propagate into the shape and magnitude of the arterial input function (AIF) during intraoperative fluorescence perfusion assessment, thereby altering the observed kinetics of the fluorescence images in vivo. AIM Numerical simulations are used to demonstrate the effect of AIF on metrics derived from tissue concentration curves such as peak fluorescence, time-to-peak (TTP), and egress slope. APPROACH Forward models of tissue concentration were produced by convolving simulated AIFs with the adiabatic approximation to the tissue homogeneity model using input parameters representing six different tissue examples (normal brain, glioma, normal skin, ischemic skin, normal bone, and osteonecrosis). RESULTS The results show that AIF perturbations result in variations in estimates of total intensity of up to 80% and TTP error of up to 200%, with the errors more dominant in brain, less in skin, and less in bone. Interestingly, error in ingress slope was as high as 60% across all tissue types. These are key observable parameters used in fluorescence imaging either implicitly by viewing the image or explicitly through intensity fitting algorithms. Correcting by deconvolving the image with a measured subject-specific AIF provides an intuitive means of visualizing the data while also removing the source of variance and allowing intra- and intersubject comparisons. CONCLUSIONS These results suggest that intraoperative fluorescence perfusion assessment should be corrected by patient-specific AIFs measured by pulse dye densitometry.
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Affiliation(s)
- Jonathan T. Elliott
- Dartmouth-Hitchcock Medical Center, Department of Surgery, Lebanon, New Hampshire, United States
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, United States
- Address all correspondence to Jonathan T. Elliott, E-mail:
| | - Rocco R. Addante
- Dartmouth-Hitchcock Medical Center, Department of Surgery, Lebanon, New Hampshire, United States
| | - Gerard P. Slobogean
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Department of Orthopaedics, Baltimore, Maryland, United States
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, United States
| | - Eric R. Henderson
- Dartmouth-Hitchcock Medical Center, Department of Orthopaedics, Lebanon, New Hampshire, United States
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, United States
| | - Ida Leah Gitajn
- Dartmouth-Hitchcock Medical Center, Department of Orthopaedics, Lebanon, New Hampshire, United States
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26
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Forti RM, Katsurayama M, Menko J, Valler L, Quiroga A, Falcão ALE, Li LM, Mesquita RC. Real-Time Non-invasive Assessment of Cerebral Hemodynamics With Diffuse Optical Spectroscopies in a Neuro Intensive Care Unit: An Observational Case Study. Front Med (Lausanne) 2020; 7:147. [PMID: 32411712 PMCID: PMC7198738 DOI: 10.3389/fmed.2020.00147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 04/06/2020] [Indexed: 12/30/2022] Open
Abstract
Prevention of secondary damage is an important goal in the treatment of severe neurological conditions, such as major head trauma or stroke. However, there is currently a lack of non-invasive methods for monitoring cerebral physiology. Diffuse optical methods have been proposed as an inexpensive, non-invasive bedside monitor capable of providing neurophysiology information in neurocritical patients. However, the reliability of the technique to provide accurate longitudinal measurement during the clinical evolution of a patient remains largely unaddressed. Here, we report on the translation of a hybrid diffuse optical system combining frequency domain diffuse optical spectroscopy (FD-DOS) and diffuse correlation spectroscopy (DCS) for real-time monitoring of cerebral physiology in a neuro intensive care unit (neuro-ICU). More specifically, we present a case study of a patient admitted with a high-grade aneurysmal subarachnoid hemorrhage, who was monitored throughout hospitalization. We show that the neurophysiological parameters measured by diffuse optics at the bedside are consistent with the clinical evolution of the patient at all the different stages following its brain lesion. These data provide support for clinical translation of DOS/DCS as a useful biomarker of neurophysiology in the neuro-ICU, particularly in locations where other clinical resources are limited.
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Affiliation(s)
- Rodrigo M Forti
- Institute of Physics, University of Campinas, Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Marilise Katsurayama
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil.,Clinical Hospital, University of Campinas, Campinas, Brazil
| | - Julien Menko
- Department of Emergency Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Lenise Valler
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil.,Clinical Hospital, University of Campinas, Campinas, Brazil
| | - Andres Quiroga
- Institute of Physics, University of Campinas, Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | | | - Li M Li
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil.,School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Rickson C Mesquita
- Institute of Physics, University of Campinas, Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
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Davies DJ, Yakoub KM, Su Z, Clancy M, Forcione M, Lucas SJE, Dehghani H, Belli A. The Valsalva maneuver: an indispensable physiological tool to differentiate intra versus extracranial near-infrared signal. BIOMEDICAL OPTICS EXPRESS 2020; 11:1712-1724. [PMID: 32341842 PMCID: PMC7173884 DOI: 10.1364/boe.11.001712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 05/03/2023]
Abstract
Developing near-infrared spectroscopy (NIRS) parameter recovery techniques to more specifically resolve brain physiology from that of the overlying tissue is an important part of improving the clinical utility of the technology. The Valsalva maneuver (VM) involves forced expiration against a closed glottis causing widespread venous congestion within the context of a fall in cardiac output. Due to the specific anatomical confines and metabolic demands of the brain we believe a properly executed VM has the ability to separate haemodynamic activity of brain tissue from that of the overlying scalp as observed by NIRS, and confirmed by functional magnetic resonance imaging (fMRI). Healthy individuals performed a series of standing maximum effort VMs under separate observation by frequency domain near-infrared spectroscopy (FD-NIRS) and fMRI. Nine individuals completed the clinical protocol (6 males, age 21-40). During the VMs, brain and extracranial tissue targeted signal were significantly different (opposite direction of change) in both fMRI and NIRS (p=0.00025 and 0.00115 respectively), with robust cross correlation of parameters between modalities. Four of these individuals performed further VMs after infiltrating 2% xylocaine/1:100,000 epinephrine (vasoconstrictor) into scalp tissue beneath the probes. No significant difference in the cerebrally derived parameters was observed. The maximum effort VM has the ability to separate NIRS observable physiology of the brain from the overlying extracranial tissue. Observations made by this FD cerebral NIRS device are comparable with fMRI in this context.
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Affiliation(s)
- David James Davies
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, UK
- Co-first authors with equal contribution
| | - Kamal Makram Yakoub
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, UK
- Co-first authors with equal contribution
| | - Zhangjie Su
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, UK
| | - Michael Clancy
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - Mario Forcione
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, UK
| | - Samuel John Edwin Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Hamid Dehghani
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - Antonio Belli
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, UK
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28
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Novi SL, Roberts E, Spagnuolo D, Spilsbury BM, Price DC, Imbalzano CA, Forero E, Yodh AG, Tellis GM, Tellis CM, Mesquita RC. Functional near-infrared spectroscopy for speech protocols: characterization of motion artifacts and guidelines for improving data analysis. NEUROPHOTONICS 2020; 7:015001. [PMID: 31956662 PMCID: PMC6953699 DOI: 10.1117/1.nph.7.1.015001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/19/2019] [Indexed: 05/02/2023]
Abstract
Monitoring speech tasks with functional near-infrared spectroscopy (fNIRS) enables investigation of speech production mechanisms and informs treatment strategies for speech-related disorders such as stuttering. Unfortunately, due to movement of the temporalis muscle, speech production can induce relative movement between probe optodes and skin. These movements generate motion artifacts during speech tasks. In practice, spurious hemodynamic responses in functional activation signals arise from lack of information about the consequences of speech-related motion artifacts, as well as from lack of standardized processing procedures for fNIRS signals during speech tasks. To this end, we characterize the effects of speech production on fNIRS signals, and we introduce a systematic analysis to ameliorate motion artifacts. The study measured 50 healthy subjects performing jaw movement (JM) tasks and found that JM produces two different patterns of motion artifacts in fNIRS. To remove these unwanted contributions, we validate a hybrid motion-correction algorithm based sequentially on spline interpolation and then wavelet filtering. We compared performance of the hybrid algorithm with standard algorithms based on spline interpolation only and wavelet decomposition only. The hybrid algorithm corrected 94% of the artifacts produced by JM, and it did not lead to spurious responses in the data. We also validated the hybrid algorithm during a reading task performed under two different conditions: reading aloud and reading silently. For both conditions, we observed significant cortical activation in brain regions related to reading. Moreover, when comparing the two conditions, good agreement of spatial and temporal activation patterns was found only when data were analyzed using the hybrid approach. Overall, the study demonstrates a standardized processing scheme for fNIRS data during speech protocols. The scheme decreases spurious responses and intersubject variability due to motion artifacts.
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Affiliation(s)
- Sergio L. Novi
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Erin Roberts
- Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States
| | - Danielle Spagnuolo
- Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States
| | - Brianna M. Spilsbury
- Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States
| | - D’manda C. Price
- Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States
| | - Cara A. Imbalzano
- Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States
| | - Edwin Forero
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - Glen M. Tellis
- Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States
| | - Cari M. Tellis
- Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States
| | - Rickson C. Mesquita
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
- Address all correspondence to: Rickson C. Mesquita, E-mail:
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29
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Quaresima V, Farzam P, Anderson P, Farzam PY, Wiese D, Carp SA, Ferrari M, Franceschini MA. Diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy for measuring microvascular blood flow in dynamically exercising human muscles. J Appl Physiol (1985) 2019; 127:1328-1337. [PMID: 31513443 DOI: 10.1152/japplphysiol.00324.2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In the last 20 yr, near-infrared diffuse correlation spectroscopy (DCS) has been developed for providing a noninvasive estimate of microvascular blood flow (BF) as a BF index (BFi) in the human skin, muscle, breast, brain, and other tissue types. In this study, we proposed a new motion correction algorithm for DCS-derived BFi able to remove motion artifacts during cycling exercise. We tested this algorithm on DCS data collected during cycling exercise and demonstrated that DCS can be used to quantify muscle BFi during dynamic high-intensity exercise. In addition, we measured tissue regional oxygen metabolic rate (MRO2i) by combining frequency-domain multidistance near-infrared spectroscopy (FDNIRS) oximetry with DCS flow measures. Recreationally active subjects (n = 12; 31 ± 8 yr, 183 ± 4 cm, 79 ± 10 kg) pedaled at 80-100 revolutions/min until volitional fatigue with a work rate increase of 30 W every 4 min. Exercise intensity was normalized in each subject to the cycling power peak (Wpeak). Both rectus femoris BFi and MRO2i increased from 15% up to 75% Wpeak and then plateaued to the end of the exercise. During the recovery at 30 W cycling power, BFi remained almost constant, whereas MRO2i started to decrease. The BFi/MRO2i plateau was associated with the rising of the lactate concentration, indicating the progressive involvement of the anaerobic metabolism. These findings further highlight the utility of DCS and FDNIRS oximetry as effective, reproducible, and noninvasive techniques to assess muscle BFi and MRO2i in real time during a dynamic exercise such as cycling.NEW & NOTEWORTHY To the best of our knowledge, this study is the first to demonstrate that diffuse correlation spectroscopy in combination with frequency-domain near-infrared spectroscopy can monitor human quadriceps microvascular blood flow and oxygen metabolism with high temporal resolution during a cycling exercise. The optically measured parameters confirm the expected relationship between blood flow, muscle oxidative metabolism, and lactate production during exercise.
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Affiliation(s)
- Valentina Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Parisa Farzam
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | | | - Parya Y Farzam
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | | | - Stefan A Carp
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Marco Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Angela Franceschini
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
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Khalid M, Milej D, Rajaram A, Abdalmalak A, Morrison L, Diop M, St. Lawrence K. Development of a stand-alone DCS system for monitoring absolute cerebral blood flow. BIOMEDICAL OPTICS EXPRESS 2019; 10:4607-4620. [PMID: 31565512 PMCID: PMC6757462 DOI: 10.1364/boe.10.004607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 05/23/2023]
Abstract
Diffuse correlation spectroscopy (DCS) is a noninvasive optical technique for monitoring cerebral blood flow (CBF). This work presents a stand-alone DCS system capable of monitoring absolute CBF by incorporating a quantitative dynamic contrast-enhanced (DCE) technique. Multi-distance data were acquired to measure the tissue optical properties and to perform DCE experiments. Feasibility of the technique was assessed in piglets in which the optical properties were measured independently by time-resolved near-infrared spectroscopy. A strong linear correlation was observed between CBF values derived using the two sets of optical properties, demonstrating that this hybrid DCS approach can provide real-time monitoring of absolute CBF.
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Affiliation(s)
- Mahro Khalid
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Daniel Milej
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Ajay Rajaram
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Androu Abdalmalak
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Laura Morrison
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
| | - Mamadou Diop
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Keith St. Lawrence
- Imaging Program, Lawson Health Research Institute, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
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31
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Baker WB, Balu R, He L, Kavuri VC, Busch DR, Amendolia O, Quattrone F, Frangos S, Maloney-Wilensky E, Abramson K, Mahanna Gabrielli E, Yodh AG, Andrew Kofke W. Continuous non-invasive optical monitoring of cerebral blood flow and oxidative metabolism after acute brain injury. J Cereb Blood Flow Metab 2019; 39:1469-1485. [PMID: 31088234 PMCID: PMC6681541 DOI: 10.1177/0271678x19846657] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Rapid detection of ischemic conditions at the bedside can improve treatment of acute brain injury. In this observational study of 11 critically ill brain-injured adults, we employed a monitoring approach that interleaves time-resolved near-infrared spectroscopy (TR-NIRS) measurements of cerebral oxygen saturation and oxygen extraction fraction (OEF) with diffuse correlation spectroscopy (DCS) measurement of cerebral blood flow (CBF). Using this approach, we demonstrate the clinical promise of non-invasive, continuous optical monitoring of changes in CBF and cerebral metabolic rate of oxygen (CMRO2). In addition, the optical CBF and CMRO2 measures were compared to invasive brain tissue oxygen tension (PbtO2), thermal diffusion flowmetry CBF, and cerebral microdialysis measures obtained concurrently. The optical CBF and CMRO2 information successfully distinguished between ischemic, hypermetabolic, and hyperemic conditions that arose spontaneously during patient care. Moreover, CBF monitoring during pressor-induced changes of mean arterial blood pressure enabled assessment of cerebral autoregulation. In total, the findings suggest that this hybrid non-invasive neurometabolic optical monitor (NNOM) can facilitate clinical detection of adverse physiological changes in brain injured patients that are otherwise difficult to measure with conventional bedside monitoring techniques.
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Affiliation(s)
- Wesley B Baker
- 1 Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA.,2 Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ramani Balu
- 3 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lian He
- 4 Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | - Venkaiah C Kavuri
- 4 Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | - David R Busch
- 4 Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA.,5 Department of Anesthesiology & Pain Management and Neurology & Neurotherapeutics, University of Texas Southwestern, Dallas, TX, USA
| | - Olivia Amendolia
- 6 Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Francis Quattrone
- 6 Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Suzanne Frangos
- 6 Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kenneth Abramson
- 4 Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Arjun G Yodh
- 4 Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA
| | - W Andrew Kofke
- 1 Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA
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32
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Wang D, Baker WB, He H, Gao P, Zhu L, Peng Q, Li Z, Li F, Chen T, Feng H. Influence of probe pressure on the pulsatile diffuse correlation spectroscopy blood flow signal on the forearm and forehead regions. NEUROPHOTONICS 2019; 6:035013. [PMID: 31548976 PMCID: PMC6755374 DOI: 10.1117/1.nph.6.3.035013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/04/2019] [Indexed: 05/24/2023]
Abstract
In a pilot study of 11 healthy adults (24 to 39 years, all male), we characterize the influence of external probe pressure on optical diffuse correlation spectroscopy (DCS) measurements of pulsatile blood flow obtained on the forearm and forehead. For external probe pressure control, a hand inflatable air balloon is inserted between the tissue and an elastic strap. The air balloon is sequentially inflated to achieve a wide range of external probe pressures between 20 and 250 mmHg on the forearm and forehead, which are measured with a flexible pressure sensor underneath the probe. At each probe pressure, the pulsatility index (PI) of arteriole blood flow on the forehead and forearm is measured with DCS (2.1-cm source-detector separation). We observe a strong correlation between probe pressure and PI on the forearm ( R = 0.66 , p < 0.001 ), but not on the forehead ( R = - 0.11 , p = 0.4 ). The forearm measurements demonstrate the sensitivity of the DCS PI to skeletal muscle tissue pressure, whereas the forehead measurements indicate that DCS PI measurements are not sensitive to scalp tissue pressure. Note, in contrast to pulsatility, the time-averaged DCS blood flow index on the forehead was significantly correlated with probe pressure ( R = - 0.55 , p < 0.001 ). This pilot data appears to support the initiation of more comprehensive clinical studies on DCS to detect trends in internal pressure in brain and skeletal muscle.
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Affiliation(s)
- Detian Wang
- Army Medical University, Southwest Hospital, Department of Neurosurgery, Chong Qing, China
- China Academy of Engineering Physics, Institute of Fluid Physics, Mianyang, China
| | - Wesley B. Baker
- Children’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Philadelphia, United States
| | - Hui He
- China Academy of Engineering Physics, Institute of Fluid Physics, Mianyang, China
| | - Peng Gao
- China Academy of Engineering Physics, Institute of Fluid Physics, Mianyang, China
| | - Liguo Zhu
- China Academy of Engineering Physics, Institute of Fluid Physics, Mianyang, China
| | - Qixian Peng
- China Academy of Engineering Physics, Institute of Fluid Physics, Mianyang, China
| | - Zeren Li
- China Academy of Engineering Physics, Institute of Fluid Physics, Mianyang, China
| | - Fei Li
- Army Medical University, Southwest Hospital, Department of Neurosurgery, Chong Qing, China
| | - Tunan Chen
- Army Medical University, Southwest Hospital, Department of Neurosurgery, Chong Qing, China
| | - Hua Feng
- Army Medical University, Southwest Hospital, Department of Neurosurgery, Chong Qing, China
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33
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Clinical Brain Monitoring with Time Domain NIRS: A Review and Future Perspectives. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9081612] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Near-infrared spectroscopy (NIRS) is an optical technique that can measure brain tissue oxygenation and haemodynamics in real-time and at the patient bedside allowing medical doctors to access important physiological information. However, despite this, the use of NIRS in a clinical environment is hindered due to limitations, such as poor reproducibility, lack of depth sensitivity and poor brain-specificity. Time domain NIRS (or TD-NIRS) can resolve these issues and offer detailed information of the optical properties of the tissue, allowing better physiological information to be retrieved. This is achieved at the cost of increased instrument complexity, operation complexity and price. In this review, we focus on brain monitoring clinical applications of TD-NIRS. A total of 52 publications were identified, spanning the fields of neonatal imaging, stroke assessment, traumatic brain injury (TBI) assessment, brain death assessment, psychiatry, peroperative care, neuronal disorders assessment and communication with patient with locked-in syndrome. In all the publications, the advantages of the TD-NIRS measurement to (1) extract absolute values of haemoglobin concentration and tissue oxygen saturation, (2) assess the reduced scattering coefficient, and (3) separate between extra-cerebral and cerebral tissues, are highlighted; and emphasize the utility of TD-NIRS in a clinical context. In the last sections of this review, we explore the recent developments of TD-NIRS, in terms of instrumentation and methodologies that might impact and broaden its use in the hospital.
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