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Wang Q, Pan M, Kreiss L, Samaei S, Carp SA, Johansson JD, Zhang Y, Wu M, Horstmeyer R, Diop M, Li DDU. A comprehensive overview of diffuse correlation spectroscopy: Theoretical framework, recent advances in hardware, analysis, and applications. Neuroimage 2024; 298:120793. [PMID: 39153520 DOI: 10.1016/j.neuroimage.2024.120793] [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: 05/19/2024] [Revised: 07/23/2024] [Accepted: 08/14/2024] [Indexed: 08/19/2024] Open
Abstract
Diffuse correlation spectroscopy (DCS) is a powerful tool for assessing microvascular hemodynamic in deep tissues. Recent advances in sensors, lasers, and deep learning have further boosted the development of new DCS methods. However, newcomers might feel overwhelmed, not only by the already-complex DCS theoretical framework but also by the broad range of component options and system architectures. To facilitate new entry to this exciting field, we present a comprehensive review of DCS hardware architectures (continuous-wave, frequency-domain, and time-domain) and summarize corresponding theoretical models. Further, we discuss new applications of highly integrated silicon single-photon avalanche diode (SPAD) sensors in DCS, compare SPADs with existing sensors, and review other components (lasers, sensors, and correlators), as well as data analysis tools, including deep learning. Potential applications in medical diagnosis are discussed and an outlook for the future directions is provided, to offer effective guidance to embark on DCS research.
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Affiliation(s)
- Quan Wang
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Mingliang Pan
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Lucas Kreiss
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Saeed Samaei
- Department of Medical and Biophysics, Schulich School of Medical & Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
| | - Stefan A Carp
- Massachusetts General Hospital, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA, United States
| | | | - Yuanzhe Zhang
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Melissa Wu
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Roarke Horstmeyer
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Mamadou Diop
- Department of Medical and Biophysics, Schulich School of Medical & Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
| | - David Day-Uei Li
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom.
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2
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Baker WB, Forti RM, Heye P, Heye K, Lynch JM, Yodh AG, Licht DJ, White BR, Hwang M, Ko TS, Kilbaugh TJ. Modified Beer-Lambert algorithm to measure pulsatile blood flow, critical closing pressure, and intracranial hypertension. BIOMEDICAL OPTICS EXPRESS 2024; 15:5511-5532. [PMID: 39296411 PMCID: PMC11407241 DOI: 10.1364/boe.529150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 08/12/2024] [Accepted: 08/12/2024] [Indexed: 09/21/2024]
Abstract
We introduce a frequency-domain modified Beer-Lambert algorithm for diffuse correlation spectroscopy to non-invasively measure flow pulsatility and thus critical closing pressure (CrCP). Using the same optical measurements, CrCP was obtained with the new algorithm and with traditional nonlinear diffusion fitting. Results were compared to invasive determination of intracranial pressure (ICP) in piglets (n = 18). The new algorithm better predicted ICP elevations; the area under curve (AUC) from logistic regression analysis was 0.85 for ICP ≥ 20 mmHg. The corresponding AUC for traditional analysis was 0.60. Improved diagnostic performance likely results from better filtering of extra-cerebral tissue contamination and measurement noise.
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Affiliation(s)
- Wesley B Baker
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rodrigo M Forti
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Pascal Heye
- Division of General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kristina Heye
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer M Lynch
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel J Licht
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Prenatal Pediatrics, Children's National, Washington DC, USA
| | - Brian R White
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tiffany S Ko
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Todd J Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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3
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Moore CH, Sunar U, Lin W. A Device-on-Chip Solution for Real-Time Diffuse Correlation Spectroscopy Using FPGA. BIOSENSORS 2024; 14:384. [PMID: 39194613 DOI: 10.3390/bios14080384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 08/03/2024] [Accepted: 08/05/2024] [Indexed: 08/29/2024]
Abstract
Diffuse correlation spectroscopy (DCS) is a non-invasive technology for the evaluation of blood perfusion in deep tissue. However, it requires high computational resources for data analysis, which poses challenges in its implementation for real-time applications. To address the unmet need, we developed a novel device-on-chip solution that fully integrates all the necessary computational components needed for DCS. It takes the output of a photon detector and determines the blood flow index (BFI). It is implemented on a field-programmable gate array (FPGA) chip including a multi-tau correlator for the calculation of the temporal light intensity autocorrelation function and a DCS analyzer to perform the curve fitting operation that derives the BFI at a rate of 6000 BFIs/s. The FPGA DCS system was evaluated against a lab-standard DCS system for both phantom and cuff ischemia studies. The results indicate that the autocorrelation of the light correlation and BFI from both the FPGA DCS and the reference DCS matched well. Furthermore, the FPGA DCS system was able to achieve a measurement rate of 50 Hz and resolve pulsatile blood flow. This can significantly lower the cost and footprint of the computational components of DCS and pave the way for portable, real-time DCS systems.
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Affiliation(s)
- Christopher H Moore
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Ulas Sunar
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Wei Lin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
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4
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Mokin M, Thanki S, Mohammad PPS, Sheehy S, Jade KM, Peto I, Guerrero WR, Vakharia K, Burgin WS, Parthasarathy AB. Preliminary experience with diffuse correlation spectroscopy in acute ischemic stroke neurointerventional procedures. J Neurointerv Surg 2024; 16:624-630. [PMID: 37197931 PMCID: PMC10654255 DOI: 10.1136/jnis-2023-020407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/03/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Diffuse correlation spectroscopy (DCS) is a non-invasive optical technique that enables continuous blood flow measurements in various organs, including the brain. DCS quantitatively measures blood flow from temporal fluctuations in the intensity of diffusely reflected light caused by the dynamic scattering of light from moving red blood cells within the tissue. METHODS We performed bilateral cerebral blood flow (CBF) measurements using a custom DCS device in patients undergoing neuroendovascular interventions for acute ischemic stroke. Experimental, clinical, and imaging data were collected in a prospective manner. RESULTS The device was successfully applied in nine subjects. There were no safety concerns or interference with the standard angiography suite or intensive care unit workflow. Six cases were selected for final analysis and interpretation. DCS measurements with photon count rates greater than 30 KHz had sufficient signal-to-noise to resolve blood flow pulsatility. We found an association between angiographic changes in cerebral reperfusion (partial or complete reperfusion established in stroke thrombectomy cases; temporary flow arrest during carotid artery stenting) and those observed intraprocedurally with CBF measurements via DCS. Limitations of the current technology included sensitivity to the interrogated tissue volume under the probe and the effect of local changes in tissue optical properties on the accuracy of CBF estimates. CONCLUSION Our initial experience with DCS in neurointerventional procedures showed the feasibility of this non-invasive approach in providing continuous measurement of regional CBF brain tissue properties.
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Affiliation(s)
- Maxim Mokin
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Shail Thanki
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | | | - Steve Sheehy
- Department of Electrical Engineering, University of South Florida, Tampa, Florida, USA
| | - Kassandra M Jade
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Ivo Peto
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Waldo R Guerrero
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Kunal Vakharia
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | - W Scott Burgin
- Department of Neurology, University of South Florida College of Medicine, Tampa, Florida, USA
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Mazumder D, Kholiqov O, Srinivasan VJ. Interferometric near-infrared spectroscopy (iNIRS) reveals that blood flow index depends on wavelength. BIOMEDICAL OPTICS EXPRESS 2024; 15:2152-2174. [PMID: 38633063 PMCID: PMC11019706 DOI: 10.1364/boe.507373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 04/19/2024]
Abstract
Blood flow index (BFI) is an optically accessible parameter, with unit distance-squared-over-time, that is widely used as a proxy for tissue perfusion. BFI is defined as the dynamic scattering probability (i.e. the ratio of dynamic to overall reduced scattering coefficients) times an effective Brownian diffusion coefficient that describes red blood cell (RBC) motion. Here, using a wavelength division multiplexed, time-of-flight- (TOF) - resolved iNIRS system, we obtain TOF-resolved field autocorrelations at 773 nm and 855 nm via the same source and collector. We measure the human forearm, comprising biological tissues with mixed static and dynamic scattering, as well as a purely dynamic scattering phantom. Our primary finding is that forearm BFI increases from 773 nm to 855 nm, though the magnitude of this increase varies across subjects (23% ± 19% for N = 3). However, BFI is wavelength-independent in the purely dynamic scattering phantom. From these data, we infer that the wavelength-dependence of BFI arises from the wavelength-dependence of the dynamic scattering probability. This inference is further supported by RBC scattering literature. Our secondary finding is that the higher-order cumulant terms of the mean squared displacement (MSD) of RBCs are significant, but decrease with wavelength. Thus, laser speckle and related modalities should exercise caution when interpreting field autocorrelations.
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Affiliation(s)
- Dibbyan Mazumder
- Department of Radiology, New York University Langone Health, New York, NY 10016, USA
- Department of Ophthalmology, New York University Langone Health, New York, NY 10016, USA
| | - Oybek Kholiqov
- Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, USA
| | - Vivek J. Srinivasan
- Department of Radiology, New York University Langone Health, New York, NY 10016, USA
- Department of Ophthalmology, New York University Langone Health, New York, NY 10016, USA
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Bi R, Zhang R, Meng L, Du Y, Low J, Qi Y, Rajarahm P, Lai AYF, Tan VSY, Ho P, Olivo M. A portable optical pulsatile flowmetry demonstrates strong clinical relevance for diabetic foot perfusion assessment. APL Bioeng 2024; 8:016109. [PMID: 38390315 PMCID: PMC10883714 DOI: 10.1063/5.0182670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
We present a robust, cost-effective (<2000 USD), and portable optical diffuse speckle pulsatile flowmetry (DSPF) device with a flexible handheld probe for deep tissue blood flow measurement in the human foot as well as a first-in-man observational clinical study using the proposed optical device for tissue ischemia assessment and peripheral artery disease (PAD) diagnosis. Blood flow in tissue is inherently pulsatile in nature. However, most conventional methods cannot measure deep tissue-level pulsatile blood flow noninvasively. The proposed optical device can measure tissue-level pulsatile blood flow ∼6 mm underneath the skin surface. A new quantitative tissue perfusion index (TPIDSPF) based on frequency domain analysis of the pulsatile blood flow waveform is defined to assess tissue ischemia status. Through a clinical study involving 66 subjects, including healthy individuals and diabetes patients with and without PAD, TPIDSPF demonstrated strong correlations of 0.720 with transcutaneous tissue partial oxygen pressure (TcPO2) and 0.652 with toe-brachial index (TBI). Moreover, among the three methods, TPIDSPF demonstrated the highest area under the curve for PAD diagnosis among diabetes patients, with a notable value of 0.941. The promising clinical results suggest that the proposed optical method has the potential to be an effective clinical tool for identifying PAD among the diabetic cohort.
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Affiliation(s)
- Renzhe Bi
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, Nanos, Singapore 138669, Republic of Singapore
| | - Ruochong Zhang
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, Nanos, Singapore 138669, Republic of Singapore
| | - Lingyan Meng
- National University Health System (NUHS), 1E Kent Ridge Rd., Singapore 119228, Republic of Singapore
| | - Yao Du
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, Nanos, Singapore 138669, Republic of Singapore
| | - Julie Low
- National University Health System (NUHS), 1E Kent Ridge Rd., Singapore 119228, Republic of Singapore
| | - Yi Qi
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, Nanos, Singapore 138669, Republic of Singapore
| | - Poongkulali Rajarahm
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, Nanos, Singapore 138669, Republic of Singapore
| | - Alexis Yuen Fun Lai
- National University Health System (NUHS), 1E Kent Ridge Rd., Singapore 119228, Republic of Singapore
| | - Victoria Shi Ying Tan
- National University Health System (NUHS), 1E Kent Ridge Rd., Singapore 119228, Republic of Singapore
| | | | - Malini Olivo
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, Nanos, Singapore 138669, Republic of Singapore
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7
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Kobayashi Frisk L, Verma M, Bešlija F, Lin CHP, Patil N, Chetia S, Trobaugh JW, Culver JP, Durduran T. Comprehensive workflow and its validation for simulating diffuse speckle statistics for optical blood flow measurements. BIOMEDICAL OPTICS EXPRESS 2024; 15:875-899. [PMID: 38404339 PMCID: PMC10890893 DOI: 10.1364/boe.502421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 02/27/2024]
Abstract
Diffuse optical methods including speckle contrast optical spectroscopy and tomography (SCOS and SCOT), use speckle contrast (κ) to measure deep blood flow. In order to design practical systems, parameters such as signal-to-noise ratio (SNR) and the effects of limited sampling of statistical quantities, should be considered. To that end, we have developed a method for simulating speckle contrast signals including effects of detector noise. The method was validated experimentally, and the simulations were used to study the effects of physical and experimental parameters on the accuracy and precision of κ. These results revealed that systematic detector effects resulted in decreased accuracy and precision of κ in the regime of low detected signals. The method can provide guidelines for the design and usage of SCOS and/or SCOT instruments.
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Affiliation(s)
- Lisa Kobayashi Frisk
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Manish Verma
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Faruk Bešlija
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Chen-Hao P. Lin
- Department of Physics, Washington University in St. Louis, St. Louis, Missouri 63110, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Nishighanda Patil
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Sumana Chetia
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Jason W. Trobaugh
- Department of Electrical and Systems Engineering, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Joseph P. Culver
- Department of Physics, Washington University in St. Louis, St. Louis, Missouri 63110, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - 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
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Biswas A, Mohammad PPS, Moka S, Takshi A, Parthasarathy AB. Non-invasive low-cost deep tissue blood flow measurement with integrated Diffuse Speckle Contrast Spectroscopy. FRONTIERS IN NEUROERGONOMICS 2024; 4:1288922. [PMID: 38234484 PMCID: PMC10790947 DOI: 10.3389/fnrgo.2023.1288922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024]
Abstract
Diffuse Correlation Spectroscopy (DCS) is a widely used non-invasive measurement technique to quantitatively measure deep tissue blood flow. Conventional implementations of DCS use expensive single photon counters as detecting elements and optical probes with bulky fiber optic cables. In recent years, newer approaches to blood flow measurement such as Diffuse Speckle Contrast Analysis (DSCA) and Speckle Contrast Optical Spectroscopy (SCOS), have adapted speckle contrast analysis methods to simplify deep tissue blood flow measurements using cameras and single photon counting avalanche detector arrays as detectors. Here, we introduce and demonstrate integrated Diffuse Speckle Contrast Spectroscopy (iDSCS), a novel optical sensor setup which leverages diffuse speckle contrast analysis for probe-level quantitative measurement of tissue blood flow. iDSCS uses a standard photodiode configured in photovoltaic mode to integrate photon intensity fluctuations over multiple integration durations using a custom electronic circuit, as opposed to the high frequency sampling of photon counts with DCS. We show that the iDSCS device is sensitive to deep-tissue blood flow measurements with experiments on a human forearm and compare the sensitivity and dynamic range of the device to a conventional DCS instrument. The iDSCS device features a low-cost, low-power, small form factor instrument design that will enable wireless probe-level measurements of deep tissue blood flow.
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Cowdrick KR, Akbar M, Boodooram T, Harris LH, Bai S, Brothers RO, Arrington M, Lee SY, Khemani K, Gee B, Buckley EM. Impaired cerebrovascular reactivity in pediatric sickle cell disease using diffuse correlation spectroscopy. BIOMEDICAL OPTICS EXPRESS 2023; 14:5696-5708. [PMID: 38021121 PMCID: PMC10659811 DOI: 10.1364/boe.499274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023]
Abstract
Cerebrovascular reactivity (CVR), defined as the ability of cerebral vasculature to dilate in response to a vasodilatory stimulus, is an integral mechanism in brain homeostasis that is thought to be impaired in sickle cell disease (SCD). This study used diffuse correlation spectroscopy and a simple breath-hold stimulus to quantify CVR non-invasively in a cohort of 12 children with SCD and 14 controls. Median [interquartile range] CVR was significantly decreased in SCD compared to controls (2.03 [1.31, 2.44] versus 3.49 [3.00, 4.11] %/mmHg, p = 0.028). These results suggest DCS may provide a feasible means to routinely monitor CVR impairments in pediatric SCD.
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Affiliation(s)
- Kyle R. Cowdrick
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 1760 Haygood Drive NE, Atlanta, GA 30322, USA
| | - Mariam Akbar
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 1760 Haygood Drive NE, Atlanta, GA 30322, USA
| | - Tisha Boodooram
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 1760 Haygood Drive NE, Atlanta, GA 30322, USA
| | - LaBeausha H. Harris
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 1760 Haygood Drive NE, Atlanta, GA 30322, USA
| | - Shasha Bai
- Pediatric Biostatistics Core, Emory University School of Medicine, 1405 Clifton Road NE, Atlanta, GA 30322, USA
| | - Rowan O. Brothers
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 1760 Haygood Drive NE, Atlanta, GA 30322, USA
| | - Michael Arrington
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 1760 Haygood Drive NE, Atlanta, GA 30322, USA
| | - Seung Yup Lee
- Department of Electrical and Computer Engineering, Kennesaw State University, 840 Polytechnic Lane, Marietta, GA 30060, USA
| | - Kirsma Khemani
- Aflac Cancer and Blood Disorders Center, Division of Pediatric Hematology/Oncology, Children's Healthcare of Atlanta, 2015 Uppergate Drive, Atlanta, GA 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Beatrice Gee
- Aflac Cancer and Blood Disorders Center, Division of Pediatric Hematology/Oncology, Children's Healthcare of Atlanta, 2015 Uppergate Drive, Atlanta, GA 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Erin M. Buckley
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 1760 Haygood Drive NE, Atlanta, GA 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Children's Research Scholar, Children's Healthcare of Atlanta, 2015 Uppergate Drive, Atlanta, GA 30322, USA
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10
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Favilla CG, Forti RM, Carter S, Kofke WA, Kasner SE, Baker WB, Yodh AG, Messé SR, Cummings S, Kung DK, Burkhardt JK, Choudhri OA, Pukenas B, Srinivasan VM, Hurst RW, Detre JA. Microvascular reperfusion during endovascular therapy: the balance of supply and demand. J Neurointerv Surg 2023:jnis-2023-020834. [PMID: 37898551 PMCID: PMC11055937 DOI: 10.1136/jnis-2023-020834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/03/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Endovascular therapy (EVT) has revolutionized the treatment of acute stroke, but large vessel recanalization does not always result in tissue-level reperfusion. Cerebral blood flow (CBF) is not routinely monitored during EVT. We aimed to leverage diffuse correlation spectroscopy (DCS), a novel transcranial optical imaging technique, to assess the relationship between microvascular CBF and post-EVT outcomes. METHODS Frontal lobe CBF was monitored by DCS in 40 patients undergoing EVT. Baseline CBF deficit was calculated as the percentage of CBF impairment on pre-EVT CT perfusion. Microvascular reperfusion was calculated as the percentage increase in DCS-derived CBF that occurred with recanalization. The adequacy of reperfusion was defined by persistent CBF deficit, calculated as: baseline CBF deficit - microvascular reperfusion. A good functional outcome was defined as 90-day modified Rankin Scale score ≤2. RESULTS Thirty-six of 40 patients achieved successful recanalization, in whom microvascular reperfusion in itself was not associated with infarct volume or functional outcome. However, patients with good functional outcomes had a smaller persistent CBF deficit (median 1% (IQR -11%-16%)) than patients with poor outcomes (median 28% (IQR 2-50%)) (p=0.02). Smaller persistent CBF deficit was also associated with smaller infarct volume (p=0.004). Multivariate models confirmed that persistent CBF deficit was independently associated with infarct volume and functional outcome. CONCLUSIONS CBF augmentation alone does not predict post-EVT outcomes, but when microvascular reperfusion closely matches the baseline CBF deficit, patients experience favorable clinical and radiographic outcomes. By recognizing inadequate reperfusion, bedside CBF monitoring may provide opportunities to personalize post-EVT care aimed at CBF optimization.
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Affiliation(s)
- Christopher G Favilla
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rodrigo M Forti
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sarah Carter
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - W Andrew Kofke
- Department of Anesthesia & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Wesley B Baker
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Arjun G Yodh
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven R Messé
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stephanie Cummings
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David K Kung
- Department of Neurosurgery, Robert Wood Johnson Health System, Livingston, New Jersey, USA
| | - Jan Karl Burkhardt
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Omar A Choudhri
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bryan Pukenas
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Visish M Srinivasan
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert W Hurst
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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11
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Mohtasebi M, Singh D, Liu X, Fathi F, Haratbar SR, Saatman KE, Chen L, Yu G. Depth-sensitive diffuse speckle contrast topography for high-density mapping of cerebral blood flow in rodents. NEUROPHOTONICS 2023; 10:045007. [PMID: 38076725 PMCID: PMC10704187 DOI: 10.1117/1.nph.10.4.045007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 02/12/2024]
Abstract
Significance Frequent assessment of cerebral blood flow (CBF) is crucial for the diagnosis and management of cerebral vascular diseases. In contrast to large and expensive imaging modalities, such as nuclear medicine and magnetic resonance imaging, optical imaging techniques are portable and inexpensive tools for continuous measurements of cerebral hemodynamics. The recent development of an innovative noncontact speckle contrast diffuse correlation tomography (scDCT) enables three-dimensional (3D) imaging of CBF distributions. However, scDCT requires complex and time-consuming 3D reconstruction, which limits its ability to achieve high spatial resolution without sacrificing temporal resolution and computational efficiency. Aim We investigate a new diffuse speckle contrast topography (DSCT) method with parallel computation for analyzing scDCT data to achieve fast and high-density two-dimensional (2D) mapping of CBF distributions at different depths without the need for 3D reconstruction. Approach A new moving window method was adapted to improve the sampling rate of DSCT. A fast computation method utilizing MATLAB functions in the Image Processing Toolbox™ and Parallel Computing Toolbox™ was developed to rapidly generate high-density CBF maps. The new DSCT method was tested for spatial resolution and depth sensitivity in head-simulating layered phantoms and in-vivo rodent models. Results DSCT enables 2D mapping of the particle flow in the phantom at different depths through the top layer with varied thicknesses. Both DSCT and scDCT enable the detection of global and regional CBF changes in deep brains of adult rats. However, DSCT achieves fast and high-density 2D mapping of CBF distributions at different depths without the need for complex and time-consuming 3D reconstruction. Conclusions The depth-sensitive DSCT method has the potential to be used as a noninvasive, noncontact, fast, high resolution, portable, and inexpensive brain imager for basic neuroscience research in small animal models and for translational studies in human neonates.
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Affiliation(s)
- Mehrana Mohtasebi
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Dara Singh
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Xuhui Liu
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Faraneh Fathi
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | | | - Kathryn E. Saatman
- University of Kentucky, Spinal Cord and Brain Injury Research Center, Department of Physiology, Lexington, Kentucky, United States
| | - Lei Chen
- University of Kentucky, Spinal Cord and Brain Injury Research Center, Department of Physiology, Lexington, Kentucky, United States
| | - Guoqiang Yu
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
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12
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Urner TM, Cowdrick KR, Brothers RO, Boodooram T, Zhao H, Goyal V, Sathialingam E, Quadri A, Turrentine K, Akbar MM, Triplett SE, Bai S, Buckley EM. Normative cerebral microvascular blood flow waveform morphology assessed with diffuse correlation spectroscopy. BIOMEDICAL OPTICS EXPRESS 2023; 14:3635-3653. [PMID: 37497521 PMCID: PMC10368026 DOI: 10.1364/boe.489760] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/05/2023] [Accepted: 05/20/2023] [Indexed: 07/28/2023]
Abstract
Microvascular cerebral blood flow exhibits pulsatility at the cardiac frequency that carries valuable information about cerebrovascular health. This study used diffuse correlation spectroscopy to quantify normative features of these waveforms in a cohort of thirty healthy adults. We demonstrate they are sensitive to changes in vascular tone, as indicated by pronounced morphological changes with hypercapnia. Further, we observe significant sex-based differences in waveform morphology, with females exhibiting higher flow, greater area-under-the-curve, and lower pulsatility. Finally, we quantify normative values for cerebral critical closing pressure, i.e., the minimum pressure required to maintain flow in a given vascular region.
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Affiliation(s)
- Tara M Urner
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Kyle R Cowdrick
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Rowan O Brothers
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Tisha Boodooram
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Hongting Zhao
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Vidisha Goyal
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Eashani Sathialingam
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Ayesha Quadri
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Katherine Turrentine
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Mariam M Akbar
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Sydney E Triplett
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
| | - Shasha Bai
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
| | - Erin M Buckley
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
- Children's Research Scholar, Children's Healthcare of Atlanta, 2015 Uppergate Dr., Atlanta, GA 30322, USA
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13
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Tabassum S, Ruesch A, Acharya D, Yang J, Relander FAJ, Scammon B, Wolf MS, Rakkar J, Clark RSB, McDowell MM, Kainerstorfer JM. Clinical translation of noninvasive intracranial pressure sensing with diffuse correlation spectroscopy. J Neurosurg 2023; 139:184-193. [PMID: 36683191 PMCID: PMC11423936 DOI: 10.3171/2022.9.jns221203] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Intracranial pressure (ICP) is an important therapeutic target in many critical neuropathologies. The current tools for ICP measurements are invasive; hence, these are only selectively applied in critical cases where the benefits surpass the risks. To address the need for low-risk ICP monitoring, the authors developed a noninvasive alternative. METHODS The authors recently demonstrated noninvasive quantification of ICP in an animal model by using morphological analysis of microvascular cerebral blood flow (CBF) measured with diffuse correlation spectroscopy (DCS). The current prospective observational study expanded on this preclinical study by translating the method to pediatric patients. Here, the CBF features, along with mean arterial pressure (MAP) and heart rate (HR) data, were used to build a random decision forest, machine learning model for estimation of ICP; the results of this model were compared with those of invasive monitoring. RESULTS Fifteen patients (mean age ± SD [range] 9.8 ± 5.1 [0.3-17.5] years; median age [interquartile range] 11 [7.4] years; 10 males and 5 females) who underwent invasive neuromonitoring for any purpose were enrolled. Estimated ICP (ICPest) very closely matched invasive ICP (ICPinv), with a root mean square error (RMSE) of 1.01 mm Hg and 95% limit of agreement of ≤ 1.99 mm Hg for ICPinv 0.01-41.25 mm Hg. When the ICP range (ICPinv 0.01-29.05 mm Hg) was narrowed on the basis of the sample population, both RMSE and limit of agreement improved to 0.81 mm Hg and ≤ 1.6 mm Hg, respectively. In addition, 0.3% of the test samples for ICPinv ≤ 20 mm Hg and 5.4% of the test samples for ICPinv > 20 mm Hg had a limit of agreement > 5 mm Hg, which may be considered the acceptable limit of agreement for clinical validity of ICP sensing. For the narrower case, 0.1% of test samples for ICPinv ≤ 20 mm Hg and 1.1% of the test samples for ICPinv > 20 mm Hg had a limit of agreement > 5 mm Hg. Although the CBF features were crucial, the best prediction accuracy was achieved when these features were combined with MAP and HR data. Lastly, preliminary leave-one-out analysis showed model accuracy with an RMSE of 6 mm Hg and limit of agreement of ≤ 7 mm Hg. CONCLUSIONS The authors have shown that DCS may enable ICP monitoring with additional clinical validation. The lower risk of such monitoring would allow ICP to be estimated for a wide spectrum of indications, thereby both reducing the use of invasive monitors and increasing the types of patients who may benefit from ICP-directed therapies.
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Affiliation(s)
- Syeda Tabassum
- 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh
| | - Alexander Ruesch
- 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh
- 4Neuroscience Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Deepshikha Acharya
- 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh
| | - Jason Yang
- 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh
| | - Filip A J Relander
- 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh
| | - Bradley Scammon
- 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh
| | - Michael S Wolf
- 2Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh
| | - Jaskaran Rakkar
- 2Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh
| | - Robert S B Clark
- 2Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh
| | - Michael M McDowell
- 3Division of Neurological Surgery, UPMC Children's Hospital of Pittsburgh, Pittsburgh; and
| | - Jana M Kainerstorfer
- 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh
- 4Neuroscience Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania
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14
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Ko TS, Catennacio E, Shin SS, Stern J, Massey SL, Kilbaugh TJ, Hwang M. Advanced Neuromonitoring Modalities on the Horizon: Detection and Management of Acute Brain Injury in Children. Neurocrit Care 2023; 38:791-811. [PMID: 36949362 PMCID: PMC10241718 DOI: 10.1007/s12028-023-01690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/31/2023] [Indexed: 03/24/2023]
Abstract
Timely detection and monitoring of acute brain injury in children is essential to mitigate causes of injury and prevent secondary insults. Increasing survival in critically ill children has emphasized the importance of neuroprotective management strategies for long-term quality of life. In emergent and critical care settings, traditional neuroimaging modalities, such as computed tomography and magnetic resonance imaging (MRI), remain frontline diagnostic techniques to detect acute brain injury. Although detection of structural and anatomical abnormalities remains crucial, advanced MRI sequences assessing functional alterations in cerebral physiology provide unique diagnostic utility. Head ultrasound has emerged as a portable neuroimaging modality for point-of-care diagnosis via assessments of anatomical and perfusion abnormalities. Application of electroencephalography and near-infrared spectroscopy provides the opportunity for real-time detection and goal-directed management of neurological abnormalities at the bedside. In this review, we describe recent technological advancements in these neurodiagnostic modalities and elaborate on their current and potential utility in the detection and management of acute brain injury.
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Affiliation(s)
- Tiffany S Ko
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, USA.
| | - Eva Catennacio
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Samuel S Shin
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - Joseph Stern
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
| | - Shavonne L Massey
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Todd J Kilbaugh
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
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15
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Cowdrick KR, Urner T, Sathialingam E, Fang Z, Quadri A, Turrentine K, Yup Lee S, Buckley EM. Agreement in cerebrovascular reactivity assessed with diffuse correlation spectroscopy across experimental paradigms improves with short separation regression. NEUROPHOTONICS 2023; 10:025002. [PMID: 37034012 PMCID: PMC10079775 DOI: 10.1117/1.nph.10.2.025002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Significance Cerebrovascular reactivity (CVR), i.e., the ability of cerebral vasculature to dilate or constrict in response to vasoactive stimuli, is a biomarker of vascular health. Exogenous administration of inhaled carbon dioxide, i.e., hypercapnia (HC), remains the "gold-standard" intervention to assess CVR. More tolerable paradigms that enable CVR quantification when HC is difficult/contraindicated have been proposed. However, because these paradigms feature mechanistic differences in action, an assessment of agreement of these more tolerable paradigms to HC is needed. Aim We aim to determine the agreement of CVR assessed during HC, breath-hold (BH), and resting state (RS) paradigms. Approach Healthy adults were subject to HC, BH, and RS paradigms. End tidal carbon dioxide (EtCO2) and cerebral blood flow (CBF, assessed with diffuse correlation spectroscopy) were monitored continuously. CVR (%/mmHg) was quantified via linear regression of CBF versus EtCO2 or via a general linear model (GLM) that was used to minimize the influence of systemic and extracerebral signal contributions. Results Strong agreement ( CCC ≥ 0.69 ; R ≥ 0.76 ) among CVR paradigms was demonstrated when utilizing a GLM to regress out systemic/extracerebral signal contributions. Linear regression alone showed poor agreement across paradigms ( CCC ≤ 0.35 ; R ≤ 0.45 ). Conclusions More tolerable experimental paradigms coupled with regression of systemic/extracerebral signal contributions may offer a viable alternative to HC for assessing CVR.
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Affiliation(s)
- Kyle R. Cowdrick
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Tara Urner
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Eashani Sathialingam
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Zhou Fang
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Ayesha Quadri
- Children’s Healthcare of Atlanta and Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
- Morehouse School of Medicine, Atlanta, Georgia, United States
| | - Katherine Turrentine
- Children’s Healthcare of Atlanta and Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
| | - Seung Yup Lee
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Kennesaw State University, Department of Electrical and Computer Engineering, Marietta, Georgia, United States
| | - Erin M. Buckley
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Children’s Healthcare of Atlanta and Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
- Children’s Healthcare of Atlanta, Children’s Research Scholar, Atlanta, Georgia, United States
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16
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Sathialingam E, Cowdrick KR, Liew AY, Fang Z, Lee SY, McCracken CE, Akbik F, Samuels OB, Kandiah P, Sadan O, Buckley EM. Microvascular cerebral blood flow response to intrathecal nicardipine is associated with delayed cerebral ischemia. Front Neurol 2023; 14:1052232. [PMID: 37006474 PMCID: PMC10064128 DOI: 10.3389/fneur.2023.1052232] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/06/2023] [Indexed: 03/19/2023] Open
Abstract
One of the common complications of non-traumatic subarachnoid hemorrhage (SAH) is delayed cerebral ischemia (DCI). Intrathecal (IT) administration of nicardipine, a calcium channel blocker (CCB), upon detection of large-artery cerebral vasospasm holds promise as a treatment that reduces the incidence of DCI. In this observational study, we prospectively employed a non-invasive optical modality called diffuse correlation spectroscopy (DCS) to quantify the acute microvascular cerebral blood flow (CBF) response to IT nicardipine (up to 90 min) in 20 patients with medium-high grade non-traumatic SAH. On average, CBF increased significantly with time post-administration. However, the CBF response was heterogeneous across subjects. A latent class mixture model was able to classify 19 out of 20 patients into two distinct classes of CBF response: patients in Class 1 (n = 6) showed no significant change in CBF, while patients in Class 2 (n = 13) showed a pronounced increase in CBF in response to nicardipine. The incidence of DCI was 5 out of 6 in Class 1 and 1 out of 13 in Class 2 (p < 0.001). These results suggest that the acute (<90 min) DCS-measured CBF response to IT nicardipine is associated with intermediate-term (up to 3 weeks) development of DCI.
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Affiliation(s)
- Eashani Sathialingam
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Kyle R. Cowdrick
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Amanda Y. Liew
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Zhou Fang
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Seung Yup Lee
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
- Department of Electrical and Computer Engineering, Kennesaw State University, Marietta, GA, United States
| | - Courtney E. McCracken
- Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, United States
| | - Feras Akbik
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Owen B. Samuels
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Prem Kandiah
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Ofer Sadan
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Erin M. Buckley
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, United States
- Children's Research Scholar, Children's Healthcare of Atlanta, Atlanta, GA, United States
- *Correspondence: Erin M. Buckley
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17
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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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18
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Yang J, Acharya D, Scammon WB, Schmitt S, Crane EC, Smith MA, Kainerstorfer JM. Cerebrovascular Impedance as a Function of Cerebral Perfusion Pressure. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 4:96-101. [PMID: 37234191 PMCID: PMC10208597 DOI: 10.1109/ojemb.2023.3236267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 09/30/2023] Open
Abstract
Goal: Cerebrovascular impedance is modulated by a vasoactive autoregulative mechanism in response to changes in cerebral perfusion pressure. Characterization of impedance and the limits of autoregulation are important biomarkers of cerebral health. We developed a method to quantify impedance based on the spectral content of cerebral blood flow and volume at the cardiac frequency, measured with diffuse optical methods. Methods: In three non-human primates, we modulated cerebral perfusion pressure beyond the limits of autoregulation. Cerebral blood flow and volume were measured with diffuse correlation spectroscopy and near-infrared spectroscopy, respectively. Results: We show that impedance can be used to identify the lower and upper limits of autoregulation. Conclusions: This impedance method may be an alternative method to measure autoregulation and a way of assessing cerebral health non-invasively at the clinical bedside.
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Affiliation(s)
- Jason Yang
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
| | - Deepshikha Acharya
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
| | - William B. Scammon
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
| | - Samantha Schmitt
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
- Neuroscience InstituteCarnegie Mellon UniversityPittsburghPA15213USA
| | - Emily C. Crane
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
| | - Matthew A. Smith
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
- Neuroscience InstituteCarnegie Mellon UniversityPittsburghPA15213USA
| | - Jana M. Kainerstorfer
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
- Neuroscience InstituteCarnegie Mellon UniversityPittsburghPA15213USA
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19
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Yang J, Ruesch A, Kainerstorfer JM. Cerebrovascular impedance estimation with near-infrared and diffuse correlation spectroscopy. NEUROPHOTONICS 2023; 10:015002. [PMID: 36699625 PMCID: PMC9868286 DOI: 10.1117/1.nph.10.1.015002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
SIGNIFICANCE Cerebrovascular impedance (CVI) is related to cerebral autoregulation (CA), which is the mechanism of the brain to maintain near-constant cerebral blood flow (CBF) despite changes in cerebral perfusion pressure (CPP). Changes in blood vessel impedance enable the stabilization of blood flow. Due to the interplay between CVI and CA, assessment of CVI may enable quantification of CA and may serve as a biomarker for cerebral health. AIM We developed a method to quantify CVI based on a combination of diffuse correlation spectroscopy (DCS) and continuous wave (CW) near-infrared spectroscopy (NIRS). Data on healthy human volunteers were used to validate the method. APPROACH A combined high-speed DCS-NIRS system was developed, allowing for simultaneous, noninvasive blood flow, and volume measurements in the same tissue compartment. Blood volume was used as a surrogate measurement for blood pressure and CVI was calculated as the spectral ratio of blood volume and blood flow changes. This technique was validated on six healthy human volunteers undergoing postural changes to elicit CVI changes. RESULTS Averaged across the six subjects, a decrease in CVI was found for a head of bed (HOB) tilting of - 40 deg . These impedance changes were reversed when returning to the horizontal (0 deg) HOB baseline. CONCLUSIONS We developed a combined DCS-NIRS system, which measures CBF and volume changes, which we demonstrate can be used to measure CVI. Using CVI as a metric of CA may be beneficial for assessing cerebral health, especially in patients where CPP is altered.
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Affiliation(s)
- Jason Yang
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
| | - Alexander Ruesch
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
- Carnegie Mellon University, Neuroscience Institute, Pittsburgh, Pennsylvania, United States
| | - Jana M. Kainerstorfer
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
- Carnegie Mellon University, Neuroscience Institute, Pittsburgh, Pennsylvania, United States
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20
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Biswas A, Parthasarathy AB. Lossless Compressed Sensing of Photon Counts for Fast Diffuse Correlation Spectroscopy. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2022; 10:129754-129762. [PMID: 36644002 PMCID: PMC9835098 DOI: 10.1109/access.2022.3228439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Diffuse Correlation Spectroscopy (DCS), a noninvasive optical technique, measures deep tissue blood flow using avalanche photon counting modules and data acquisition devices such as FPGAs or correlator boards. Conventional DCS instruments use in-processor counter modules that consume 32 bits/channel which is inefficient for low-photon budget situations prevalent in diffuse optics. Scaling these photon counters for large-scale imaging applications is difficult due to bandwidth and processing time considerations. Here, we introduce a new, lossless compressed sensing approach for fast and efficient detection of photon counts. The compressed DCS method uses an array of binary-coded-decimal counters to record photon counts from 8 channels simultaneously as a single 32-bit number. We validate the compressed DCS approach by comparisons with conventional DCS in experiments on tissue simulating phantoms and in-vivo arm cuff occlusion. Lossless compressed DCS was implemented with 87.5% compression efficiency. In tissue simulating phantoms, it was able to accurately estimate a tissue blood flow index, with no statistically significant difference compared to conventional DCS. Compressed DCS also recorded blood flow in vivo, in human forearm, with signal-to-noise ratio and dynamic range comparable to conventional DCS. Lossless 87.5% efficient compressed sensing counting of photon counts meets and exceeds benchmarks set by conventional DCS systems, offering a low-cost alternative for fast (~100 Hz) deep tissue blood flow measurement with optics.
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Affiliation(s)
- Arindam Biswas
- Department of Electrical Engineering, University of South Florida, Tampa, FL 33620, USA
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21
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Seong M, Oh Y, Lee K, Kim JG. Blood flow estimation via numerical integration of temporal autocorrelation function in diffuse correlation spectroscopy. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 222:106933. [PMID: 35728393 DOI: 10.1016/j.cmpb.2022.106933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Diffuse correlation spectroscopy (DCS) is an optical technique widely used to monitor blood flow. Recently, efforts have been made to derive new signal processing methods to minimize the systems used and shorten the signal processing time. Herein, we propose alternative approaches to obtain blood flow information via DCS by numerically integrating the temporal autocorrelation curves. METHODS We use the following methods: the inverse of K2 (IK2)-based on the framework of diffuse speckle contrast analysis-and the inverse of the numerical integration of squared g1 (INISg1) which, based on the normalized electric field autocorrelation curve, is more simplified than IK2. In addition, g1 thresholding is introduced to further reduce computational time and make the suggested methods comparable to the conventional nonlinear fitting approach. To validate the feasibility of the suggested methods, studies using simulation, liquid phantom, and in vivo settings were performed. In the meantime, the suggested methods were implemented and tested on three types of Arduino (Arduino Due, Arduino Nano 33 BLE Sense, and Portenta H7) to demonstrate the possibility of miniaturizing the DCS systems using microcotrollers for signal processing. RESULTS The simulation and experimental results confirm that both IK2 and INISg1 are sufficiently relevant to capture the changes in blood flow information. More interestingly, when g1 thresholding was applied, our results showed that INISg1 outperformed IK2. It was further confirmed that INISg1 with g1 thresholding implemented on a PC and Portenta H7, an advanced Arduino board, performed faster than did the deep learning-based, state-of-the-art processing method. CONCLUSION Our findings strongly indicate that INISg1 with g1 thresholding could be an alternative approach to derive relative blood flow information via DCS, which may contribute to the simplification of DCS methodologies.
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Affiliation(s)
- Myeongsu Seong
- School of Information Science and Technology, Nantong University, Nantong, Jiangsu, China; Research Center for Intelligent Information Technology, Nantong University, Nantong, Jiangsu, China; Nantong Research Institute for Advanced Communication Technologies, Nantong, Jiangsu, China
| | - Yoonho Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Kijoon Lee
- Department of Electrical Engineering and Computer Science, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea.
| | - Jae G Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea.
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22
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Lafontant A, Mahanna Gabrielli E, Bergonzi K, Forti RM, Ko TS, Shah RM, Arkles JS, Licht DJ, Yodh AG, Kofke WA, White BR, Baker WB. Comparison of optical measurements of critical closing pressure acquired before and during induced ventricular arrhythmia in adults. NEUROPHOTONICS 2022; 9:035004. [PMID: 36039170 PMCID: PMC9407009 DOI: 10.1117/1.nph.9.3.035004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Significance: The critical closing pressure (CrCP) of cerebral circulation, as measured by diffuse correlation spectroscopy (DCS), is a promising biomarker of intracranial hypertension. However, CrCP techniques using DCS have not been assessed in gold standard experiments. Aim: CrCP is typically calculated by examining the variation of cerebral blood flow (CBF) during the cardiac cycle (with normal sinus rhythm). We compare this typical CrCP measurement with a gold standard obtained during the drops in arterial blood pressure (ABP) caused by rapid ventricular pacing (RVP) in patients undergoing invasive electrophysiologic procedures. Approach: Adults receiving electrophysiology procedures with planned ablation were enrolled for DCS CBF monitoring. CrCP was calculated from CBF and ABP data by three methods: (1) linear extrapolation of data during RVP ( CrCP RVP ; the gold standard); (2) linear extrapolation of data during regular heartbeats ( CrCP Linear ); and (3) fundamental harmonic Fourier filtering of data during regular heartbeats ( CrCP Fourier ). Results: CBF monitoring was performed prior to and during 55 episodes of RVP in five adults. CrCP RVP and CrCP Fourier demonstrated agreement ( R = 0.66 , slope = 1.05 (95%CI, 0.72 to 1.38). Agreement between CrCP RVP and CrCP Linear was worse; CrCP Linear was 8.2 ± 5.9 mmHg higher than CrCP RVP (mean ± SD; p < 0.001 ). Conclusions: Our results suggest that DCS-measured CrCP can be accurately acquired during normal sinus rhythm.
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Affiliation(s)
- Alec Lafontant
- Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, Division of Neurology, Philadelphia, Pennsylvania, United States
| | - Elizabeth Mahanna Gabrielli
- University of Miami Miller School of Medicine, Department of Anesthesiology, Perioperative Medicine and Pain Management, Miami, Florida, United States
| | - Karla Bergonzi
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - Rodrigo M. Forti
- Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, Division of Neurology, Philadelphia, Pennsylvania, United States
| | - Tiffany S. Ko
- Children’s Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Philadelphia, Pennsylvania, United States
| | - Ronak M. Shah
- Perelman School of Medicine at the University of Pennsylvania, Department of Anesthesiology and Critical Care, Philadelphia, Pennsylvania, United States
| | - Jeffrey S. Arkles
- Perelman School of Medicine at the University of Pennsylvania, Department of Medicine, Division of Cardiovascular Medicine, Philadelphia, Pennsylvania, United States
| | - Daniel J. Licht
- Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, Division of Neurology, Philadelphia, Pennsylvania, United States
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - W. Andrew Kofke
- Perelman School of Medicine at the University of Pennsylvania, Department of Anesthesiology and Critical Care, Philadelphia, Pennsylvania, United States
| | - Brian R. White
- Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, Division of Pediatric Cardiology, Philadelphia, Pennsylvania, United States
| | - Wesley B. Baker
- Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, Division of Neurology, Philadelphia, Pennsylvania, United States
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23
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Lee SY, Brothers RO, Turrentine KB, Quadri A, Sathialingam E, Cowdrick KR, Gillespie S, Bai S, Goldman-Yassen AE, Joiner CH, Brown RC, Buckley EM. Quantifying the Cerebral Hemometabolic Response to Blood Transfusion in Pediatric Sickle Cell Disease With Diffuse Optical Spectroscopies. Front Neurol 2022; 13:869117. [PMID: 35847200 PMCID: PMC9283827 DOI: 10.3389/fneur.2022.869117] [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: 02/03/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Red blood cell transfusions are common in patients with sickle cell disease who are at increased risk of stroke. Unfortunately, transfusion thresholds needed to sufficiently dilute sickle red blood cells and adequately restore oxygen delivery to the brain are not well defined. Previous work has shown that transfusion is associated with a reduction in oxygen extraction fraction and cerebral blood flow, both of which are abnormally increased in sickle patients. These reductions are thought to alleviate hemometabolic stress by improving the brain's ability to respond to increased metabolic demand, thereby reducing susceptibility to ischemic injury. Monitoring the cerebral hemometabolic response to transfusion may enable individualized management of transfusion thresholds. Diffuse optical spectroscopies may present a low-cost, non-invasive means to monitor this response. In this study, children with SCD undergoing chronic transfusion therapy were recruited. Diffuse optical spectroscopies (namely, diffuse correlation spectroscopy combined with frequency domain near-infrared spectroscopy) were used to quantify oxygen extraction fraction (OEF), cerebral blood volume (CBV), an index of cerebral blood flow (CBFi), and an index of cerebral oxygen metabolism (CMRO2i) in the frontal cortex immediately before and after transfusion. A subset of patients receiving regular monthly transfusions were measured during a subsequent transfusion. Data was captured from 35 transfusions in 23 patients. Transfusion increased median blood hemoglobin levels (Hb) from 9.1 to 11.7 g/dL (p < 0.001) and decreased median sickle hemoglobin (HbS) from 30.9 to 21.7% (p < 0.001). Transfusion decreased OEF by median 5.9% (p < 0.001), CBFi by median 21.2% (p = 0.020), and CBV by median 18.2% (p < 0.001). CMRO2i did not statistically change from pre-transfusion levels (p > 0.05). Multivariable analysis revealed varying degrees of associations between outcomes (i.e., OEF, CBFi, CBV, and CMRO2i), Hb, and demographics. OEF, CBFi, and CBV were all negatively associated with Hb, while CMRO2i was only associated with age. These results demonstrate that diffuse optical spectroscopies are sensitive to the expected decreases of oxygen extraction, blood flow, and blood volume after transfusion. Diffuse optical spectroscopies may be a promising bedside tool for real-time monitoring and goal-directed therapy to reduce stroke risk for sickle cell disease.
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Affiliation(s)
- Seung Yup Lee
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
- Department of Electrical and Computer Engineering, Kennesaw State University, Marietta, GA, United States
| | - Rowan O. Brothers
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Katherine B. Turrentine
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Ayesha Quadri
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Eashani Sathialingam
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Kyle R. Cowdrick
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Scott Gillespie
- Pediatric Biostatistics Core, Emory University School of Medicine, Atlanta, GA, United States
| | - Shasha Bai
- Pediatric Biostatistics Core, Emory University School of Medicine, Atlanta, GA, United States
| | - Adam E. Goldman-Yassen
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Clinton H. Joiner
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - R. Clark Brown
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Erin M. Buckley
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Children's Research Scholar, Children's Healthcare of Atlanta, Atlanta, GA, United States
- *Correspondence: Erin M. Buckley
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24
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James E, Powell S, Munro P. Performance optimisation of a holographic Fourier domain diffuse correlation spectroscopy instrument. BIOMEDICAL OPTICS EXPRESS 2022; 13:3836-3853. [PMID: 35991914 PMCID: PMC9352302 DOI: 10.1364/boe.454346] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/05/2022] [Accepted: 04/22/2022] [Indexed: 06/02/2023]
Abstract
We have previously demonstrated a novel interferometric multispeckle Fourier domain diffuse correlation spectroscopy system that makes use of holographic camera-based detection, and which is capable of making in vivo pulsatile flow measurements. In this work, we report on a systematic characterisation of the signal-to-noise ratio performance of our system. This includes demonstration and elimination of laser mode hopping, and correction for the instrument's modulation transfer function to ensure faithful reconstruction of measured intensity profiles. We also demonstrate a singular value decomposition approach to ensure that spatiotemporally correlated experimental noise sources do not limit optimal signal-to-noise ratio performance. Finally, we present a novel multispeckle denoising algorithm that allows our instrument to achieve a signal-to-noise ratio gain that is equal to the square root of the number of detected speckles, whilst detecting up to ∼1290 speckles in parallel. The signal-to-noise ratio gain of 36 that we report is a significant step toward mitigating the trade-off that exists between signal-to-noise ratio and imaging depth in diffuse correlation spectroscopy.
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Affiliation(s)
- Edward James
- Department of Medical Physics & Biomedical Engineering, University College London, London, WC1E 6BT, UK
| | - Samuel Powell
- Department of Medical Physics & Biomedical Engineering, University College London, London, WC1E 6BT, UK
- Faculty of Engineering, The University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Peter Munro
- Department of Medical Physics & Biomedical Engineering, University College London, London, WC1E 6BT, UK
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25
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Poon CS, Langri DS, Rinehart B, Rambo TM, Miller AJ, Foreman B, Sunar U. First-in-clinical application of a time-gated diffuse correlation spectroscopy system at 1064 nm using superconducting nanowire single photon detectors in a neuro intensive care unit. BIOMEDICAL OPTICS EXPRESS 2022; 13:1344-1356. [PMID: 35414986 PMCID: PMC8973196 DOI: 10.1364/boe.448135] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 06/02/2023]
Abstract
Recently proposed time-gated diffuse correlation spectroscopy (TG-DCS) has significant advantages compared to conventional continuous wave (CW)-DCS, but it is still in an early stage and clinical capability has yet to be established. The main challenge for TG-DCS is the lower signal-to-noise ratio (SNR) when gating for the deeper traveling late photons. Longer wavelengths, such as 1064 nm have a smaller effective attenuation coefficient and a higher power threshold in humans, which significantly increases the SNR. Here, we demonstrate the clinical utility of TG-DCS at 1064 nm in a case study on a patient with severe traumatic brain injury admitted to the neuro-intensive care unit (neuroICU). We showed a significant correlation between TG-DCS early (ρ = 0.67) and late (ρ = 0.76) gated against invasive thermal diffusion flowmetry. We also analyzed TG-DCS at high temporal resolution (50 Hz) to elucidate pulsatile flow data. Overall, this study demonstrates the first clinical translation capability of the TG-DCS system at 1064 nm using a superconducting nanowire single-photon detector.
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Affiliation(s)
- Chien-Sing Poon
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA
| | - Dharminder S. Langri
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA
| | - Benjamin Rinehart
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA
| | | | | | - Brandon Foreman
- Dept of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Ulas Sunar
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA
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26
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Biswas A, Moka S, Muller A, Parthasarathy AB. Fast diffuse correlation spectroscopy with a low-cost, fiber-less embedded diode laser. BIOMEDICAL OPTICS EXPRESS 2021; 12:6686-6700. [PMID: 34858674 PMCID: PMC8606156 DOI: 10.1364/boe.435136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 06/02/2023]
Abstract
Diffuse correlation spectroscopy (DCS), a popular optical technique for fast noninvasive measurement of blood flow, is commonly implemented using expensive fiber-coupled long coherence length laser systems. Here, we report the development of a portable and fiber-less approach that can be used as a low-cost alternative to illuminate tissue in DCS instruments. We validate the accuracy and noise characteristics of the fiber-less DCS laser source, by comparisons against traditional DCS light sources, with experiments on controlled tissue-simulating phantoms and in humans.
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Affiliation(s)
- Arindam Biswas
- Department of Electrical Engineering, University of South Florida, 4202 E. Fowler Avenue, ENG030, Tampa, FL 33620, USA
| | - Sadhu Moka
- Department of Electrical Engineering, University of South Florida, 4202 E. Fowler Avenue, ENG030, Tampa, FL 33620, USA
| | - Andreas Muller
- Department of Physics, University of South Florida, 4202 E. Fowler Avenue, ISA2019, Tampa, FL 33620, USA
| | - Ashwin B. Parthasarathy
- Department of Electrical Engineering, University of South Florida, 4202 E. Fowler Avenue, ENG030, Tampa, FL 33620, USA
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27
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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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28
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Cortese L, Lo Presti G, Pagliazzi M, Contini D, Dalla Mora A, Dehghani H, Ferri F, Fischer JB, Giovannella M, Martelli F, Weigel UM, Wojtkiewicz S, Zanoletti M, Durduran T. Recipes for diffuse correlation spectroscopy instrument design using commonly utilized hardware based on targets for signal-to-noise ratio and precision. BIOMEDICAL OPTICS EXPRESS 2021; 12:3265-3281. [PMID: 34221659 PMCID: PMC8221932 DOI: 10.1364/boe.423071] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/18/2021] [Accepted: 05/04/2021] [Indexed: 05/09/2023]
Abstract
Over the recent years, a typical implementation of diffuse correlation spectroscopy (DCS) instrumentation has been adapted widely. However, there are no detailed and accepted recipes for designing such instrumentation to meet pre-defined signal-to-noise ratio (SNR) and precision targets. These require specific attention due to the subtleties of the DCS signals. Here, DCS experiments have been performed using liquid tissue simulating phantoms to study the effect of the detected photon count-rate, the number of parallel detection channels and the measurement duration on the precision and SNR to suggest scaling relations to be utilized for device design.
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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
| | - Marco Pagliazzi
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - 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
| | - Fabio Ferri
- Università degli Studi dell’Insubria, Dipartimento di Scienza e Alta Tecnologia and To. Sca. Lab., 22100 Como, Italy
| | - Jonas B. Fischer
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- HemoPhotonics S.L., 08860 Castelldefels (Barcelona), Spain
| | - Martina Giovannella
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - Fabrizio Martelli
- Università degli Studi di Firenze, Dipartimento di Fisica, 50100 Firenze, 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
| | - Marta Zanoletti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- Politecnico di Milano, Dipartimento di Fisica, 20133 Milano, Italy
| | - 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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29
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Zhou W, Kholiqov O, Zhu J, Zhao M, Zimmermann LL, Martin RM, Lyeth BG, Srinivasan VJ. Functional interferometric diffusing wave spectroscopy of the human brain. SCIENCE ADVANCES 2021; 7:eabe0150. [PMID: 33980479 PMCID: PMC8115931 DOI: 10.1126/sciadv.abe0150] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 03/23/2021] [Indexed: 05/18/2023]
Abstract
Cerebral blood flow (CBF) is essential for brain function, and CBF-related signals can inform us about brain activity. Yet currently, high-end medical instrumentation is needed to perform a CBF measurement in adult humans. Here, we describe functional interferometric diffusing wave spectroscopy (fiDWS), which introduces and collects near-infrared light via the scalp, using inexpensive detector arrays to rapidly monitor coherent light fluctuations that encode brain blood flow index (BFI), a surrogate for CBF. Compared to other functional optical approaches, fiDWS measures BFI faster and deeper while also providing continuous wave absorption signals. Achieving clear pulsatile BFI waveforms at source-collector separations of 3.5 cm, we confirm that optical BFI, not absorption, shows a graded hypercapnic response consistent with human cerebrovascular physiology, and that BFI has a better contrast-to-noise ratio than absorption during brain activation. By providing high-throughput measurements of optical BFI at low cost, fiDWS will expand access to CBF.
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Affiliation(s)
- Wenjun Zhou
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
| | - Oybek Kholiqov
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
| | - Jun Zhu
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
| | - Mingjun Zhao
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
| | - Lara L Zimmermann
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA
| | - Ryan M Martin
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA
| | - Bruce G Lyeth
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA
| | - Vivek J Srinivasan
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA.
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, CA, USA
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Radiology, NYU Langone Health, New York, NY, USA
- Tech4Health Institute, NYU Langone Health, New York, NY, USA
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30
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Gregori-Pla C, Mesquita RC, Favilla CG, Busch DR, Blanco I, Zirak P, Frisk LK, Avtzi S, Maruccia F, Giacalone G, Cotta G, Camps-Renom P, Mullen MT, Martí-Fàbregas J, Prats-Sánchez L, Martínez-Domeño A, Kasner SE, Greenberg JH, Zhou C, Edlow BL, Putt ME, Detre JA, Yodh AG, Durduran T, Delgado-Mederos R. Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease. BMC Neurol 2021; 21:154. [PMID: 33836684 PMCID: PMC8033703 DOI: 10.1186/s12883-021-02179-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background The cortical microvascular cerebral blood flow response (CBF) to different changes in head-of-bed (HOB) position has been shown to be altered in acute ischemic stroke (AIS) by diffuse correlation spectroscopy (DCS) technique. However, the relationship between these relative ΔCBF changes and associated systemic blood pressure changes has not been studied, even though blood pressure is a major driver of cerebral blood flow. Methods Transcranial DCS data from four studies measuring bilateral frontal microvascular cerebral blood flow in healthy controls (n = 15), patients with asymptomatic severe internal carotid artery stenosis (ICA, n = 27), and patients with acute ischemic stroke (AIS, n = 72) were aggregated. DCS-measured CBF was measured in response to a short head-of-bed (HOB) position manipulation protocol (supine/elevated/supine, 5 min at each position). In a sub-group (AIS, n = 26; ICA, n = 14; control, n = 15), mean arterial pressure (MAP) was measured dynamically during the protocol. Results After elevated positioning, DCS CBF returned to baseline supine values in controls (p = 0.890) but not in patients with AIS (9.6% [6.0,13.3], mean 95% CI, p < 0.001) or ICA stenosis (8.6% [3.1,14.0], p = 0.003)). MAP in AIS patients did not return to baseline values (2.6 mmHg [0.5, 4.7], p = 0.018), but in ICA stenosis patients and controls did. Instead ipsilesional but not contralesional CBF was correlated with MAP (AIS 6.0%/mmHg [− 2.4,14.3], p = 0.038; ICA stenosis 11.0%/mmHg [2.4,19.5], p < 0.001). Conclusions The observed associations between ipsilateral CBF and MAP suggest that short HOB position changes may elicit deficits in cerebral autoregulation in cerebrovascular disorders. Additional research is required to further characterize this phenomenon. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02179-8.
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Affiliation(s)
- Clara Gregori-Pla
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain.
| | | | | | - David R Busch
- Departments of Anesthesiology and Pain Management and Neurology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Igor Blanco
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain
| | - Peyman Zirak
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain
| | - Lisa Kobayashi Frisk
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain
| | - Stella Avtzi
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain
| | - Federica Maruccia
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain.,Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Giacomo Giacalone
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain.,San Raffaele Scientific Institute, Milan, Italy
| | - Gianluca Cotta
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860, Castelldefels, Barcelona, Spain
| | - Pol Camps-Renom
- Department of Neurology (Stroke Unit). Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Michael T Mullen
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Joan Martí-Fàbregas
- Department of Neurology (Stroke Unit). Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Luís Prats-Sánchez
- Department of Neurology (Stroke Unit). Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Alejandro Martínez-Domeño
- Department of Neurology (Stroke Unit). Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Joel H Greenberg
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Chao Zhou
- McKelvey School of Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA
| | - Mary E Putt
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, USA
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, USA
| | - 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
| | - Raquel Delgado-Mederos
- Department of Neurology (Stroke Unit). Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
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31
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Brothers RO, Atlas N, Cowdrick KR, Buckley EM. Cerebrovascular reactivity measured in awake mice using diffuse correlation spectroscopy. NEUROPHOTONICS 2021; 8:015007. [PMID: 33665230 PMCID: PMC7920384 DOI: 10.1117/1.nph.8.1.015007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/15/2021] [Indexed: 05/31/2023]
Abstract
Significance: Cerebrovascular reactivity (CVR), defined as the ability of the cerebral vasculature to dilate or constrict in response to a vasoactive stimulus, is an important indicator of the brain's vascular health. However, mechanisms of cerebrovascular dysregulation are poorly understood, and no effective treatment strategies for impaired CVR exist. Preclinical murine models provide an excellent platform for interrogating mechanisms underlying CVR dysregulation and determining novel therapeutics that restore impaired CVR. However, quantification of CVR in mice is challenging. Aim: We present means of assessing CVR in awake mice using intraperitoneal injection of acetazolamide (ACZ) combined with continuous monitoring of cerebral blood flow. Approach: Measurements of cerebral blood flow were made with a minimally invasive diffuse correlation spectroscopy sensor that was secured to an optical window glued to the intact skull. Two source-detector separations (3 and 4.5 mm) per hemisphere were used to probe different depths. CVR was quantified as the relative increase in blood flow due to ACZ. CVR was assessed once daily for 5 days in 5 mice. Results: We found that CVR and the response half-time were remarkably similar across hemispheres and across 3- versus 4.5-mm separations, suggesting a homogenous, whole brain response to ACZ. Mean(std) intra- and intermouse coefficients of variations were 15(9)% and 19(10)%, respectively, for global CVR and 24(15)% and 27(11)%, respectively, for global response half-time. Conclusion: In sum, we report a repeatable method of measuring CVR in free-behaving mice which can be used to screen for impairments with disease and to track changes in CVR with therapeutic interventions.
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Affiliation(s)
- Rowan O. Brothers
- Emory University and Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Nir Atlas
- Emory University and Children’s Healthcare of Atlanta, Division of Critical Care Medicine, Department of Pediatrics, Atlanta, Georgia, United States
| | - Kyle R. Cowdrick
- Emory University and Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Erin M. Buckley
- Emory University and Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
- Children’s Healthcare of Atlanta, Children’s Research Scholar, Atlanta, Georgia, United States
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32
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James E, Powell S. Fourier domain diffuse correlation spectroscopy with heterodyne holographic detection. BIOMEDICAL OPTICS EXPRESS 2020; 11:6755-6779. [PMID: 33282522 PMCID: PMC7687971 DOI: 10.1364/boe.400525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 05/11/2023]
Abstract
We present a new approach to diffuse correlation spectroscopy which overcomes the limited light throughput of single-mode photon counting techniques. Our system employs heterodyne holographic detection to allow parallel measurement of the power spectrum of a fluctuating electric field across thousands of modes, at the shot noise limit, using a conventional sCMOS camera. This yields an order of magnitude reduction in detector cost compared to conventional techniques, whilst also providing robustness to the effects of ambient light and an improved signal-to-noise ratio during in vitro experiments. We demonstrate a GPU-accelerated holographic demodulation system capable of processing the incoming data (79.4 M pixels per second) in real-time, and a novel Fourier domain model of diffuse correlation spectroscopy which permits the direct recovery of flow parameters from the measured data. Our detection and modelling strategy are rigorously validated by modulating the Brownian component of an optical tissue phantom, demonstrating absolute measurements of the Brownian diffusion coefficient in excellent agreement with conventional methods. We further demonstrate the feasibility of our system through in vivo measurement of pulsatile flow rates measured in the human forearm.
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Affiliation(s)
- Edward James
- Department of Medical Physics & Biomedical Engineering, University College London, London, WC1E 6BT, UK
| | - Samuel Powell
- Department of Medical Physics & Biomedical Engineering, University College London, London, WC1E 6BT, UK
- Faculty of Engineering, The University of Nottingham, University Park, Nottingham, NG7 2RD, UK
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33
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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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34
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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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35
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Bahrani AA, Kong W, Shang Y, Huang C, Smith CD, Powell DK, Jiang Y, Rayapati AO, Jicha GA, Yu G. Diffuse optical assessment of cerebral-autoregulation in older adults stratified by cerebrovascular risk. JOURNAL OF BIOPHOTONICS 2020; 13:e202000073. [PMID: 32533642 PMCID: PMC8824485 DOI: 10.1002/jbio.202000073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/06/2020] [Accepted: 06/09/2020] [Indexed: 05/04/2023]
Abstract
Diagnosis of cerebrovascular disease (CVD) at early stages is essential for preventing sequential complications. CVD is often associated with abnormal cerebral microvasculature, which may impact cerebral-autoregulation (CA). A novel hybrid near-infrared diffuse optical instrument and a finger plethysmograph were used to simultaneously detect low-frequency oscillations (LFOs) of cerebral blood flow (CBF), oxy-hemoglobin concentration ([HbO2 ]), deoxy-hemoglobin concentration ([Hb]) and mean arterial pressure (MAP) in older adults before, during and after 70° head-up-tilting (HUT). The participants with valid data were divided based on Framingham risk score (FRS, 1-30 points) into low-risk (FRS ≤15, n = 13) and high-risk (FRS >15, n = 11) groups for developing CVD. The LFO gains were determined by transfer function analyses with MAP as the input, and CBF, [HbO2 ] and [Hb] as the outputs (CA ∝ 1/Gain). At resting-baseline, LFO gains in the high-risk group were relatively lower compared to the low-risk group. The lower baseline gains in the high-risk group may attribute to compensatory mechanisms to maintain stronger steady-state CAs. However, HUT resulted in smaller gain reductions in the high-risk group compared to the low-risk group, suggesting weaker dynamic CAs. LFO gains are potentially valuable biomarkers for early detection of CVD based on associations with CAs.
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Affiliation(s)
- Ahmed A. Bahrani
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky
- Biomedical Engineering Department, Al-Khwarizmi College of Engineering, University of Baghdad, Baghdad, Iraq
| | - Weikai Kong
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky
| | - Yu Shang
- Shanxi Provincial Key Laboratory for Biomedical Imaging and Big Data, North University of China, Shanxi, China
| | - Chong Huang
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky
| | - Charles D. Smith
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky
- Magnetic Resonance Imaging and Spectroscopy Center (MRISC), University of Kentucky, Lexington, Kentucky
- Department of Neurology, University of Kentucky, Lexington, Kentucky
| | - David K. Powell
- Magnetic Resonance Imaging and Spectroscopy Center (MRISC), University of Kentucky, Lexington, Kentucky
- Neuroscience Department, University of Kentucky, Lexington, Kentucky
| | - Yang Jiang
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky
- Magnetic Resonance Imaging and Spectroscopy Center (MRISC), University of Kentucky, Lexington, Kentucky
- Department of Behavioral Science, University of Kentucky, Lexington, Kentucky
| | - Abner O. Rayapati
- Department of Psychiatry, University of Kentucky, Lexington, Kentucky
| | - Gregory A. Jicha
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky
- Magnetic Resonance Imaging and Spectroscopy Center (MRISC), University of Kentucky, Lexington, Kentucky
- Department of Neurology, University of Kentucky, Lexington, Kentucky
| | - Guoqiang Yu
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky
- Correspondence: Guoqiang Yu, Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506,
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36
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Poon CS, Long F, Sunar U. Deep learning model for ultrafast quantification of blood flow in diffuse correlation spectroscopy. BIOMEDICAL OPTICS EXPRESS 2020; 11:5557-5564. [PMID: 33149970 PMCID: PMC7587273 DOI: 10.1364/boe.402508] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 06/01/2023]
Abstract
Diffuse correlation spectroscopy (DCS) is increasingly used in the optical imaging field to assess blood flow in humans due to its non-invasive, real-time characteristics and its ability to provide label-free, bedside monitoring of blood flow changes. Previous DCS studies have utilized a traditional curve fitting of the analytical or Monte Carlo models to extract the blood flow changes, which are computationally demanding and less accurate when the signal to noise ratio decreases. Here, we present a deep learning model that eliminates this bottleneck by solving the inverse problem more than 2300% faster, with equivalent or improved accuracy compared to the nonlinear fitting with an analytical method. The proposed deep learning inverse model will enable real-time and accurate tissue blood flow quantification with the DCS technique.
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Affiliation(s)
- Chien-Sing Poon
- Department of Biomedical Engineering, Wright State
University, 207 Russ Engineering Center, 3640 Colonel Glenn Hwy.,
Dayton, OH 45435, USA
| | | | - Ulas Sunar
- Department of Biomedical Engineering, Wright State
University, 207 Russ Engineering Center, 3640 Colonel Glenn Hwy.,
Dayton, OH 45435, USA
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37
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Fisher JAN, Gumenchuk I, Rogovin OS, Yodh AG, Busch DR. Asymmetric, dynamic adaptation in prefrontal cortex during dichotic listening tasks. NEUROPHOTONICS 2020; 7:045008. [PMID: 33163546 PMCID: PMC7641958 DOI: 10.1117/1.nph.7.4.045008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/02/2020] [Indexed: 05/25/2023]
Abstract
Significance: Speech processing tasks can be used to assess the integrity and health of many functional and structural aspects of the brain. Despite the potential merits of such behavioral tests as clinical assessment tools, however, the underlying neural substrates remain relatively unclear. Aim: We aimed to obtain a more in-depth portrait of hemispheric asymmetry during dichotic listening tasks at the level of the prefrontal cortex, where prior studies have reported inconsistent results. Approach: To avoid central confounds that limited previous studies, we used diffuse correlation spectroscopy to optically monitor cerebral blood flow (CBF) in the dorsolateral prefrontal cortex during dichotic listening tasks in human subjects. Results: We found that dichotic listening tasks elicited hemispheric asymmetries in both amplitude as well as kinetics. When listening task blocks were repeated, there was an accommodative reduction in the response amplitude of the left, but not the right hemisphere. Conclusions: These heretofore unobserved trends depict a more nuanced portrait of the functional asymmetry that has been observed previously. To our knowledge, these results additionally represent the first direct measurements of CBF during a speech processing task recommended by the American Speech-Language-Hearing Association for diagnosing auditory processing disorders.
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Affiliation(s)
- Jonathan A. N. Fisher
- New York Medical College, Department of Physiology, Valhalla, New York, United States
| | - Iryna Gumenchuk
- New York Medical College, Department of Physiology, Valhalla, New York, United States
| | - Ora S. Rogovin
- New York Medical College, Department of Physiology, Valhalla, New York, United States
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - David R. Busch
- University of Texas Southwestern Medical Center, Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Department of Neurology, Dallas, Texas, United States
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38
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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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Fischer JB, Ghouse A, Tagliabue S, Maruccia F, Rey-Perez A, Báguena M, Cano P, Zucca R, Weigel UM, Sahuquillo J, Poca MA, Durduran T. Non-Invasive Estimation of Intracranial Pressure by Diffuse Optics: A Proof-of-Concept Study. J Neurotrauma 2020; 37:2569-2579. [PMID: 32460617 DOI: 10.1089/neu.2019.6965] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Intracranial pressure (ICP) is an important parameter to monitor in several neuropathologies. However, because current clinically accepted methods are invasive, its monitoring is limited to patients in critical conditions. On the other hand, there are other less critical conditions for which ICP monitoring could still be useful; therefore, there is a need to develop non-invasive methods. We propose a new method to estimate ICP based on the analysis of the non-invasive measurement of pulsatile, microvascular cerebral blood flow with diffuse correlation spectroscopy. This is achieved by training a recurrent neural network using only the cerebral blood flow as the input. The method is validated using a 50% split sample method using the data from a proof-of-concept study. The study involved a population of infants (n = 6) with external hydrocephalus (initially diagnosed as benign enlargement of subarachnoid spaces) as well as a population of adults (n = 6) with traumatic brain injury. The algorithm was applied to each cohort individually to obtain a model and an ICP estimate. In both diverse cohorts, the non-invasive estimation of ICP was achieved with an accuracy of <4 mm Hg and a negligible small bias. Further, we have achieved a good correlation (Pearson's correlation coefficient >0.9) and good concordance (Lin's concordance correlation coefficient >0.9) in comparison with standard clinical, invasive ICP monitoring. This preliminary work paves the way for further investigations of this tool for the non-invasive, bedside assessment of ICP.
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Affiliation(s)
- Jonas B Fischer
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain.,HemoPhotonics S.L., Castelldefels, Barcelona, Spain
| | - Ameer Ghouse
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
| | - Susanna Tagliabue
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
| | - Federica Maruccia
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain.,Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Rey-Perez
- Neurotrauma Intensive Care Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marcelino Báguena
- Neurotrauma Intensive Care Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paola Cano
- Department of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Riccardo Zucca
- Synthetic Perceptive, Emotive and Cognitive Systems (SPECS), Institute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Udo M Weigel
- HemoPhotonics S.L., Castelldefels, Barcelona, Spain
| | - Juan Sahuquillo
- Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria A Poca
- Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - 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
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40
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Sie EJ, Chen H, Saung EF, Catoen R, Tiecke T, Chevillet MA, Marsili F. High-sensitivity multispeckle diffuse correlation spectroscopy. NEUROPHOTONICS 2020; 7:035010. [PMID: 32995362 PMCID: PMC7519351 DOI: 10.1117/1.nph.7.3.035010] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/04/2020] [Indexed: 05/04/2023]
Abstract
Significance: Cerebral blood flow is an important biomarker of brain health and function as it regulates the delivery of oxygen and substrates to tissue and the removal of metabolic waste products. Moreover, blood flow changes in specific areas of the brain are correlated with neuronal activity in those areas. Diffuse correlation spectroscopy (DCS) is a promising noninvasive optical technique for monitoring cerebral blood flow and for measuring cortex functional activation tasks. However, the current state-of-the-art DCS adoption is hindered by a trade-off between sensitivity to the cortex and signal-to-noise ratio (SNR). Aim: We aim to develop a scalable method that increases the sensitivity of DCS instruments. Approach: We report on a multispeckle DCS (mDCS) approach that is based on a 1024-pixel single-photon avalanche diode (SPAD) camera. Our approach is scalable to > 100,000 independent speckle measurements since large-pixel-count SPAD cameras are becoming available, owing to the investments in LiDAR technology for automotive and augmented reality applications. Results: We demonstrated a 32-fold increase in SNR with respect to traditional single-speckle DCS. Conclusion: A mDCS system that is based on a SPAD camera serves as a scalable method toward high-sensitivity DCS measurements, thus enabling both high sensitivity to the cortex and high SNR.
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Affiliation(s)
- Edbert J. Sie
- Facebook Reality Labs Research, Menlo Park, California, United States
- Address all correspondence to Edbert J. Sie, ; Francesco Marsili,
| | - Hui Chen
- Facebook Reality Labs Research, Menlo Park, California, United States
| | - E-Fann Saung
- Facebook Reality Labs Research, Menlo Park, California, United States
| | - Ryan Catoen
- Facebook Reality Labs Research, Menlo Park, California, United States
| | - Tobias Tiecke
- Facebook Reality Labs Research, Menlo Park, California, United States
| | - Mark A. Chevillet
- Facebook Reality Labs Research, Menlo Park, California, United States
| | - Francesco Marsili
- Facebook Reality Labs Research, Menlo Park, California, United States
- Address all correspondence to Edbert J. Sie, ; Francesco Marsili,
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41
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Bi R, Du Y, Singh G, Ho CJH, Zhang S, Attia ABE, Li X, Olivo M. Fast pulsatile blood flow measurement in deep tissue through a multimode detection fiber. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-10. [PMID: 32406214 PMCID: PMC7219964 DOI: 10.1117/1.jbo.25.5.055003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/27/2020] [Indexed: 05/05/2023]
Abstract
SIGNIFICANCE Noninvasive in vivo fast pulsatile blood flow measurement in deep tissue is important because the blood flow waveform is correlated with physiological parameters, such as blood pressure and elasticity of blood vessels. Compromised blood flow may cause diseases, such as stroke, foot ulcer, and myocardial ischemia. There is great clinical demand for a portable and cost-effective device for noninvasive pulsatile blood flow measurement. AIM A diffuse-optics-based method, diffuse speckle pulsatile flowmetry (DSPF), was developed for fast measurement (∼300 Hz) of deep tissue blood flow noninvasively. To validate its performance, both a phantom experiment and in vivo demonstration were conducted. APPROACH Over the past two decades, single-mode fibers have been used as detection fibers in most diffuse-optics-based deep tissue blood flow measurement modalities. We used a multimode (MM) detection fiber with a core size of 200 μm for diffused speckle pattern detection. A background intensity correction algorithm was implemented for speckle contrast calculation. The MM detection fiber helped to achieve a level of deep tissue blood flow measurement similar to that of conventional modalities, such as diffuse correlation spectroscopy and diffuse speckle contrast analysis, but it increases the measurement rate of blood flow to 300 Hz. RESULTS The design and implementation of the DSPF system were introduced. The theory of the background intensity correction for the diffused speckle pattern detected by the MM fiber was explained. A flow phantom was built for validation of the performance of the DSPF system. An in vivo cuff-induced occlusion experiment was performed to demonstrate the capability of the proposed DSPF system. CONCLUSIONS An MM detection fiber can help to achieve fast (∼300 Hz) pulsatile blood flow measurement in the proposed DSPF method. The cost-effective device and the fiber-based flexible probe increase the usability of the DSPF system significantly.
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Affiliation(s)
- Renzhe Bi
- Singapore Bioimaging Consortium, Singapore
| | - Yao Du
- Singapore Bioimaging Consortium, Singapore
| | | | | | | | | | - Xiuting Li
- Singapore Bioimaging Consortium, Singapore
| | - Malini Olivo
- Singapore Bioimaging Consortium, Singapore
- Address all correspondence to Malini Olivo, E-mail:
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42
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Johansson JD, Portaluppi D, Buttafava M, Villa F. A multipixel diffuse correlation spectroscopy system based on a single photon avalanche diode array. JOURNAL OF BIOPHOTONICS 2019; 12:e201900091. [PMID: 31339649 DOI: 10.1002/jbio.201900091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/19/2019] [Accepted: 07/21/2019] [Indexed: 05/21/2023]
Abstract
The autocorrelation of laser speckles from coherent near infrared light is used for noninvasive estimates of relative changes in blood perfusion in techniques such as laser Doppler flowmetry (LDF) and diffuse correlation spectroscopy (DCS). In this study, a 2D array of single photon avalanche diodes (SPADs) was used to combine the strengths of multiple detectors in LDF with high light sensitivity in DCS. The system was tested on milk phantoms with varying detector fiber diameter (200 and 600 μm), source-detector fiber separation (4.6-10.2 mm), fiber-SPAD distance (2.5-36.5 mm), contiguous measurement time per repetition for the autocorrelation (1-33 ms) and temperature (15.6-46.7°C). An in vivo blood occlusion test was also performed. The multipixel approach improved signal-to-noise ratio (SNR) and, in our setup, the use of a multimode detector fiber was beneficial for SNR. In conclusion, the multipixel system works, but improvements and further studies regarding, for example, the data acquisition and optimal settings are still needed.
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Affiliation(s)
| | - Davide Portaluppi
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Mauro Buttafava
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Federica Villa
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
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43
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Favilla CG, Forti RM, Zamzam A, Detre JA, Mullen MT, Yodh AG, Kasner SE, Busch DR, Baker WB, Mesquita RC, Kung D, Messé SR. Perfusion Enhancement with Respiratory Impedance After Stroke (PERI-Stroke). Neurotherapeutics 2019; 16:1296-1303. [PMID: 31140115 PMCID: PMC6985403 DOI: 10.1007/s13311-019-00744-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Intrathoracic pressure influences cardiac output and may affect cerebral blood flow (CBF). We aimed to quantify the cerebral hemodynamic response to intrathoracic pressure reduction in patients with acute ischemic stroke using a noninvasive respiratory impedance (RI) device. We assessed low-level (6 cm H2O) and high-level (12 cm H2O) RI in 17 spontaneously breathing patients within 72 h of anterior circulation acute ischemic stroke. Average age was 65 years, and 35% were female. Frontal lobe tissue perfusion and middle cerebral artery velocity (MCAv) were continuously monitored with optical diffuse correlation spectroscopy (DCS) and transcranial Doppler ultrasound, respectively. High-level RI resulted in a 7% increase in MCAv (p = 0.004). MCAv varied across all studied levels (baseline vs low-level vs high-level, p = 0.006), with a significant test of trend (p = 0.002). Changes were not seen in DCS measured tissue perfusion by nonparametric pairwise comparison. Mixed effects regression analysis identified a small increase in both MCAv (low-level RI: β 2.1, p < 0.001; high-level RI: β 5.0, p < 0.001) and tissue-level flow (low-level RI: β 5.4, p < 0.001; high-level RI: β 5.9, p < 0.001). There was a small increase in mean arterial pressure during low-level and high-level RI, 4% (p = 0.013) and 4% (p = 0.017), respectively. End-tidal CO2 remained stable throughout the protocol. RI was well tolerated. Manipulating intrathoracic pressure via noninvasive RI was safe and produced a small but measurable increase in cerebral perfusion in acute ischemic stroke patients. Future studies are warranted to assess whether RI is feasible and tolerable for prolonged use in hyperacute stroke management.
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Affiliation(s)
- Christopher G Favilla
- Department of Neurology, University of Pennsylvania, Philadelphia, USA.
- Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce St, 3 West Gates, Philadelphia, PA, 19104-4283, USA.
| | - Rodrigo M Forti
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, USA
- Institute of Physics, University of Campinas, Campinas, 13083-859, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, 13083-888, Brazil
| | - Ahmad Zamzam
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Michael T Mullen
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Arjun G Yodh
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, USA
| | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - David R Busch
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, USA
- Department of Anesthesiology & Pain Management, University of Texas Southwestern, Dallas, USA
- Department Neurology & Neurotherapeutics, University of Texas Southwestern, Dallas, USA
| | - Wesley B Baker
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Rickson C Mesquita
- Institute of Physics, University of Campinas, Campinas, 13083-859, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, 13083-888, Brazil
| | - David Kung
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, USA
| | - Steven R Messé
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
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Dragojević T, Vidal Rosas EE, Hollmann JL, Culver JP, Justicia C, Durduran T. High-density speckle contrast optical tomography of cerebral blood flow response to functional stimuli in the rodent brain. NEUROPHOTONICS 2019; 6:045001. [PMID: 31620545 PMCID: PMC6782685 DOI: 10.1117/1.nph.6.4.045001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/12/2019] [Indexed: 05/20/2023]
Abstract
Noninvasive, three-dimensional, and longitudinal imaging of cerebral blood flow (CBF) in small animal models and ultimately in humans has implications for fundamental research and clinical applications. It enables the study of phenomena such as brain development and learning and the effects of pathologies, with a clear vision for translation to humans. Speckle contrast optical tomography (SCOT) is an emerging optical method that aims to achieve this goal by directly measuring three-dimensional blood flow maps in deep tissue with a relatively inexpensive and simple system. High-density SCOT is developed to follow CBF changes in response to somatosensory cortex stimulation. Measurements are carried out through the intact skull on the rat brain. SCOT is able to follow individual trials in each brain hemisphere, where signal averaging resulted in comparable, cortical images to those of functional magnetic resonance images in spatial extent, location, and depth. Sham stimuli are utilized to demonstrate that the observed response is indeed due to local changes in the brain induced by forepaw stimulation. In developing and demonstrating the method, algorithms and analysis methods are developed. The results pave the way for longitudinal, nondestructive imaging in preclinical rodent models that can readily be translated to the human brain.
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Affiliation(s)
- Tanja Dragojević
- Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
- Address all correspondence to Tanja Dragojević, E-mail:
| | - Ernesto E. Vidal Rosas
- Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Joseph L. Hollmann
- Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Joseph P. Culver
- Washington University, School of Medicine, Department of Radiology, St. Louis, Missouri, United States
- Washington University, Department of Physics, St. Louis, Missouri, United States
| | - Carles Justicia
- Institut d’Investigacions Biomèdiques de Barcelona, Consejo Superior de Investigaciones Científicas, Department of Brain Ischemia and Neurodegeneration, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Àrea de Neurociències, Barcelona, Spain
| | - Turgut Durduran
- 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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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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46
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Lin W, Busch DR, Goh CC, Barsi J, Floyd TF. Diffuse Correlation Spectroscopy Analysis Implemented on a Field Programmable Gate Array. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2019; 7:122503-122512. [PMID: 32457822 PMCID: PMC7249994 DOI: 10.1109/access.2019.2938085] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Diffusive correlation spectroscopy (DCS) is an emerging optical technique that measures blood perfusion in deep tissue. In a DCS measurement, temporal changes in the interference pattern of light, which has passed through tissue, are quantified by an autocorrelation function. This autocorrelation function is further parameterized through a non-linear curve fit to a solution to the diffusion equation for coherence transport. The computational load for this non-linear curve fitting is a barrier for deployment of DCS for clinical use, where real-time results, as well as instrument size and simplicity, are important considerations. We have mitigated this computational bottleneck through development of a hardware analyzer for DCS. This analyzer implements the DCS curving fitting algorithm on digital logic circuit using Field Programmable Gate Array (FPGA) technology. The FPGA analyzer is more efficient than a typical software analysis solution. The analyzer module can be easily duplicated for processing multiple channels of DCS data in real-time. We have demonstrated the utility of this analyzer in pre-clinical large animal studies of spinal cord ischemia. In combination with previously described FPGA implementations of auto-correlators, this hardware analyzer can provide a complete device-on-a-chip solution for DCS signal processing. Such a component will enable new DCS applications demanding mobility and real-time processing.
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Affiliation(s)
- Wei Lin
- Stony Brook University, Stony Brook, NY 11794 USA
| | - David R. Busch
- University of Texas Southwestern, Dallas TX 75390 80523 USA
| | | | - James Barsi
- Stony Brook University, Stony Brook, NY 11794 USA
| | - Thomas F. Floyd
- Stony Brook University, Stony Brook, NY 11794 USA
- University of Texas Southwestern, Dallas TX 75390 80523 USA
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47
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Mullen MT, Parthasarathy AB, Zandieh A, Baker WB, Mesquita RC, Loomis C, Torres J, Guo W, Favilla CG, Messé SR, Yodh AG, Detre JA, Kasner SE. Cerebral Blood Flow Response During Bolus Normal Saline Infusion After Ischemic Stroke. J Stroke Cerebrovasc Dis 2019; 28:104294. [PMID: 31416759 DOI: 10.1016/j.jstrokecerebrovasdis.2019.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/11/2019] [Indexed: 01/01/2023] Open
Abstract
GOALS We quantified cerebral blood flow response to a 500 cc bolus of 0.9%% normal saline (NS) within 96 hours of acute ischemic stroke (AIS) using diffuse correlation spectroscopy (DCS). MATERIALS AND METHODS Subjects with AIS in the anterior, middle, or posterior cerebral artery territory were enrolled within 96 hours of symptom onset. DCS measured relative cerebral blood flow (rCBF) in the bilateral frontal lobes for 15 minutes at rest (baseline), during a 30-minute infusion of 500 cc NS (bolus), and for 15 minutes after completion (post-bolus). Mean rCBF for each time period was calculated for individual subjects and median rCBF for the population was compared between time periods. Linear regression was used to evaluate for associations between rCBF and clinical features. RESULTS Among 57 subjects, median rCBF (IQR) increased relative to baseline in the ipsilesional hemisphere by 17% (-2.0%, 43.1%), P< 0.001, and in the contralesional hemisphere by 13.3% (-4.3%, 36.0%), P < .004. No significant associations were found between ipsilesional changes in rCBF and age, race, infarct size, infarct location, presence of large vessel stenosis, NIH stroke scale, or symptom duration. CONCLUSION A 500 cc bolus of .9% NS produced a measurable increase in rCBF in both the affected and nonaffected hemispheres. Clinical features did not predict rCBF response.
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Affiliation(s)
- Michael T Mullen
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Leondard David Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
| | | | - Ali Zandieh
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Wesley B Baker
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Caitlin Loomis
- Department of Neurology, Yale University, New Haven, Connecticut
| | - Jose Torres
- Department of Neurology, New York University, New York City, New York
| | - Wensheng Guo
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Steven R Messé
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
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48
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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: 9] [Impact Index Per Article: 1.8] [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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Forti RM, Favilla CG, Cochran JM, Baker WB, Detre JA, Kasner SE, Mullen MT, Messé SR, Kofke WA, Balu R, Kung D, Pukenas BA, Sedora-Roman NI, Hurst RW, Choudhri OA, Mesquita RC, Yodh AG. Transcranial Optical Monitoring of Cerebral Hemodynamics in Acute Stroke Patients during Mechanical Thrombectomy. J Stroke Cerebrovasc Dis 2019; 28:1483-1494. [PMID: 30975462 PMCID: PMC6686873 DOI: 10.1016/j.jstrokecerebrovasdis.2019.03.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/28/2019] [Accepted: 03/06/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Mechanical thrombectomy is revolutionizing treatment of acute stroke due to large vessel occlusion (LVO). Unfortunately, use of the modified Thrombolysis in Cerebral Infarction score (mTICI) to characterize recanalization of the cerebral vasculature does not address microvascular perfusion of the distal parenchyma, nor provide more than a vascular "snapshot." Thus, little is known about tissue-level hemodynamic consequences of LVO recanalization. Diffuse correlation spectroscopy (DCS) and diffuse optical spectroscopy (DOS) are promising methods for continuous, noninvasive, contrast-free transcranial monitoring of cerebral microvasculature. METHODS Here, we use a combined DCS/DOS system to monitor frontal lobe hemodynamic changes during endovascular treatment of 2 patients with ischemic stroke due to internal carotid artery (ICA) occlusions. RESULTS AND DISCUSSION The monitoring instrument identified a recanalization-induced increase in ipsilateral cerebral blood flow (CBF) with little or no concurrent change in contralateral CBF and extracerebral blood flow. The results suggest that diffuse optical monitoring is sensitive to intracerebral hemodynamics in patients with ICA occlusion and can measure microvascular responses to mechanical thrombectomy.
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Affiliation(s)
- Rodrigo M Forti
- Institute of Physics, University of Campinas, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, SP, Brazil; Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania.
| | | | - Jeffrey M Cochran
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Wesley B Baker
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael T Mullen
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Steven R Messé
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - W Andrew Kofke
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ramani Balu
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David Kung
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bryan A Pukenas
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Neda I Sedora-Roman
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert W Hurst
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Omar A Choudhri
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rickson C Mesquita
- Institute of Physics, University of Campinas, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, SP, Brazil
| | - Arjun G Yodh
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania
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50
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Selb J, Wu KC, Sutin J, Lin PY(I, Farzam P, Bechek S, Shenoy A, Patel AB, Boas DA, Franceschini MA, Rosenthal ES. Prolonged monitoring of cerebral blood flow and autoregulation with diffuse correlation spectroscopy in neurocritical care patients. NEUROPHOTONICS 2018; 5:045005. [PMID: 30450363 PMCID: PMC6233866 DOI: 10.1117/1.nph.5.4.045005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 09/24/2018] [Indexed: 05/13/2023]
Abstract
Monitoring of cerebral blood flow (CBF) and autoregulation are essential components of neurocritical care, but continuous noninvasive methods for CBF monitoring are lacking. Diffuse correlation spectroscopy (DCS) is a noninvasive diffuse optical modality that measures a CBF index ( CBF i ) in the cortex microvasculature by monitoring the rapid fluctuations of near-infrared light diffusing through moving red blood cells. We tested the feasibility of monitoring CBF i with DCS in at-risk patients in the Neurosciences Intensive Care Unit. DCS data were acquired continuously for up to 20 h in six patients with aneurysmal subarachnoid hemorrhage, as permitted by clinical care. Mean arterial blood pressure was recorded synchronously, allowing us to derive autoregulation curves and to compute an autoregulation index. The autoregulation curves suggest disrupted cerebral autoregulation in most patients, with the severity of disruption and the limits of preserved autoregulation varying between subjects. Our findings suggest the potential of the DCS modality for noninvasive, long-term monitoring of cerebral perfusion, and autoregulation.
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Affiliation(s)
- Juliette Selb
- Massachusetts General Hospital, Optics at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Kuan-Cheng Wu
- Massachusetts General Hospital, Optics at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Jason Sutin
- Massachusetts General Hospital, Optics at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Pei-Yi (Ivy) Lin
- Massachusetts General Hospital, Optics at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Parisa Farzam
- Massachusetts General Hospital, Optics at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Sophia Bechek
- Massachusetts General Hospital, Department of Neurology, Boston, Massachusetts, United States
| | - Apeksha Shenoy
- Massachusetts General Hospital, Department of Neurology, Boston, Massachusetts, United States
| | - Aman B. Patel
- Massachusetts General Hospital, Department of Neurology, Boston, Massachusetts, United States
| | - David A. Boas
- Massachusetts General Hospital, Optics at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Maria Angela Franceschini
- Massachusetts General Hospital, Optics at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Address all correspondence to: Maria Angela Franceschini, E-mail:
| | - Eric S. Rosenthal
- Massachusetts General Hospital, Department of Neurology, Boston, Massachusetts, United States
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