1
|
Wårdell K, Richter J, Zsigmond P. Cerebral Microcirculation: Progress and Outlook of Laser Doppler Flowmetry in Neurosurgery and Neurointensive Care. Microcirculation 2024:e12884. [PMID: 39340816 DOI: 10.1111/micc.12884] [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: 01/30/2024] [Revised: 07/29/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024]
Abstract
Laser Doppler flowmetry (LDF) is a well-established technique for the investigation of tissue microcirculation. Compared to skin, the use in the human brain is sparse. The measurement of cerebral microcirculation in neurointensive care and during neurosurgery is challenging and requires adaptation to the respective clinical setting. The aim of the review is to present state of the art and progress in neurosurgery and neurointensive care where LDF has proven useful and can find clinical importance in the investigation of cerebral microcirculation. The literature in the field is summarized and recent technical improvements regarding LDF systems and fiber optical probe designs for neurosurgical and neurocritical care described. By combining two signals from the LDF unit, the measurement of the microcirculation (Perfusion) and gray whiteness (TLI) of the brain tissue, the full potential of the device is achieved. For example, a forward-looking LDF-probe detects high-risk hemorrhage areas and gray-white matter boundaries along intraoperative trajectories during stereotactic neurosurgery. Proof of principles are given for LDF as a guidance tool in deep brain stimulation implantation, brain tumor needle biopsies, and as long-term monitoring device in neurocritical care. With well-designed fiber optical probes, surgical fixation, and signal processing for movement reduction, LDF monitoring of the cerebral microcirculation is successful up to 10 days. The use of LDF can be combined with other physiological measurement techniques, for example, fluorescence spectroscopy for identification of glioblastoma during tumor surgery. Fiber optics can also be used during magnetic resonance imaging (MRI). Despite the many advantages, fiber optical LDF has not yet reached its full potential in clinical neuro-applications. Multicenter studies are required to further evaluate LDF in neurosurgery and neurointensive care. In conclusion, the present status of LDF in neurosurgery and neurointensive care has been reviewed. By combining Perfusion and TLI with tailored probe designs the full potential of LDF can be achived in measuring cerebral microcirculation. This includes guidance during DBS implantation and needle biopsies, and long-term monitoring in neurocritical care.
Collapse
Affiliation(s)
- Karin Wårdell
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Johan Richter
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- Department of Neurosurgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Peter Zsigmond
- Department of Neurosurgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
2
|
Liu Q, Contreras A, Afaq MS, Yang W, Hsu DK, Russell M, Lyeth B, Zanto TP, Zhao M. Intensity-dependent gamma electrical stimulation regulates microglial activation, reduces beta-amyloid load, and facilitates memory in a mouse model of Alzheimer's disease. Cell Biosci 2023; 13:138. [PMID: 37507776 PMCID: PMC10386209 DOI: 10.1186/s13578-023-01085-5] [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: 02/21/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Gamma sensory stimulation may reduce AD-specific pathology. Yet, the efficacy of alternating electrical current stimulation in animal models of AD is unknown, and prior research has not addressed intensity-dependent effects. METHODS The intensity-dependent effect of gamma electrical stimulation (GES) with a sinusoidal alternating current at 40 Hz on Aβ clearance and microglia modulation were assessed in 5xFAD mouse hippocampus and cortex, as well as the behavioral performance of the animals with the Morris Water Maze. RESULTS One hour of epidural GES delivered over a month significantly (1) reduced Aβ load in the AD brain, (2) increased microglia cell counts, decreased cell body size, increased length of cellular processes of the Iba1 + cells, and (3) improved behavioral performance (learning & memory). All these effects were most pronounced when a higher stimulation current was applied. CONCLUSION The efficacy of GES on the reduction of AD pathology and the intensity-dependent feature provide guidance for the development of this promising therapeutic approach.
Collapse
Affiliation(s)
- Qian Liu
- Institute for Regenerative Cures, Department of Ophthalmology & Vision Science, Department of Dermatology, University of California Davis, Sacramento, CA, 95817, USA
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China
| | - Adam Contreras
- Institute for Regenerative Cures, Department of Ophthalmology & Vision Science, Department of Dermatology, University of California Davis, Sacramento, CA, 95817, USA
| | - Muhammad Shan Afaq
- Institute for Regenerative Cures, Department of Ophthalmology & Vision Science, Department of Dermatology, University of California Davis, Sacramento, CA, 95817, USA
| | - Weijian Yang
- Department of Electrical and Computer Engineering, University of California, Davis, CA, 95616, USA
| | - Daniel K Hsu
- Institute for Regenerative Cures, Department of Ophthalmology & Vision Science, Department of Dermatology, University of California Davis, Sacramento, CA, 95817, USA
| | - Michael Russell
- Institute for Regenerative Cures, Department of Ophthalmology & Vision Science, Department of Dermatology, University of California Davis, Sacramento, CA, 95817, USA
| | - Bruce Lyeth
- Department of Neurological Surgery, University of California, Davis, CA, 95616, USA
| | - Theodore P Zanto
- Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, USA.
| | - Min Zhao
- Institute for Regenerative Cures, Department of Ophthalmology & Vision Science, Department of Dermatology, University of California Davis, Sacramento, CA, 95817, USA.
| |
Collapse
|
3
|
DePaoli D, Côté DC, Bouma BE, Villiger M. Endoscopic imaging of white matter fiber tracts using polarization-sensitive optical coherence tomography. Neuroimage 2022; 264:119755. [PMID: 36400379 PMCID: PMC9802682 DOI: 10.1016/j.neuroimage.2022.119755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/29/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
Polarization sensitive optical coherence tomography (PSOCT) has been shown to image and delineate white matter fibers in a label-free manner by revealing optical birefringence within the myelin sheath using a microscope setup. In this proof-of-concept study, we adapt recent advancements in endoscopic PSOCT to perform depth-resolved imaging of white matter structures deep inside intact porcine brain tissue ex-vivo, through a small, rotational fiber probe. The probe geometry is comparable to microelectrodes currently used in neurosurgical interventions. The presented imaging system is mobile, robust, and uses biologically safe levels of optical radiation making it well suited for clinical translation. In neurosurgery, where accuracy is imperative, endoscopic PSOCT through a narrow-gauge fiber probe could provide intra-operative feedback on the location of critical white matter structures.
Collapse
Affiliation(s)
- Damon DePaoli
- Harvard Medical School, Boston, MA 02115, USA,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Daniel C. Côté
- CERVO Brain Research Center, Université Laval, Quebec City, Quebec G1E 1T2, Canada
| | - Brett E. Bouma
- Harvard Medical School, Boston, MA 02115, USA,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Martin Villiger
- Harvard Medical School, Boston, MA 02115, USA,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA,Corresponding author. (M. Villiger)
| |
Collapse
|
4
|
Ruiz MCM, Guimarães RP, Mortari MR. Parkinson’s Disease Rodent Models: are they suitable for DBS research? J Neurosci Methods 2022; 380:109687. [DOI: 10.1016/j.jneumeth.2022.109687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/20/2022] [Accepted: 08/02/2022] [Indexed: 11/20/2022]
|
5
|
Fosca M, Basoli V, Della Bella E, Russo F, Vadala G, Alini M, Rau JV, Verrier S. Raman spectroscopy in skeletal tissue disorders and tissue engineering: present and prospective. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:949-965. [PMID: 34579558 DOI: 10.1089/ten.teb.2021.0139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Musculoskeletal disorders are the most common reason of chronic pain and disability representing worldwide an enormous socio-economic burden. In this review, new biomedical application fields for Raman spectroscopy (RS) technique related to skeletal tissues are discussed showing that it can provide a comprehensive profile of tissue composition in situ, in a rapid, label-free, and non-destructive manner. RS can be used as a tool to study tissue alterations associated to aging, pathologies, and disease treatments. The main advantage with respect to currently applied methods in clinics is its ability to provide specific information on molecular composition, which goes beyond other diagnostic tools. Being compatible with water, RS can be performed without pre-treatment on unfixed, hydrated tissue samples, without any labelling and chemical fixation used in histochemical methods. This review provides first the description of basic principles of RS as a biotechnology tool and introduces into the field of currently available RS based techniques, developed to enhance Raman signal. The main spectral processing statistical tools, fingerprint identification and available databases are mentioned. The recent literature has been analysed for such applications of RS as tendon and ligaments, cartilage, bone, and tissue engineered constructs for regenerative medicine. Several cases of proof-of-concept preclinical studies have been described. Finally, advantages, limitations, future perspectives, and challenges for translation of RS into clinical practice have been also discussed.
Collapse
Affiliation(s)
- Marco Fosca
- Istituto di Struttura della Materia Consiglio Nazionale delle Ricerche, 204549, Roma, Lazio, Italy;
| | - Valentina Basoli
- AO Research Institute Davos, 161930, Regenerative Orthopaedics, Davos, Graubünden, Switzerland;
| | - Elena Della Bella
- AO Research Institute Davos, 161930, Regenerative Orthopaedics, Davos, Graubünden, Switzerland;
| | - Fabrizio Russo
- Campus Bio-Medico University Hospital, 220431, Roma, Lazio, Italy;
| | - Gianluca Vadala
- Campus Bio-Medico University Hospital, 220431, Roma, Lazio, Italy;
| | - Mauro Alini
- AO Research Institute Davos, 161930, Regenerative Orthopaedics, Davos, Graubünden, Switzerland;
| | - Julietta V Rau
- Istituto di Struttura della Materia Consiglio Nazionale delle Ricerche, 204549, Roma, Lazio, Italy.,I M Sechenov First Moscow State Medical University, 68477, Moskva, Moskva, Russian Federation;
| | - Sophie Verrier
- AO Research Institute Davos, 161930, Regenerative Orthopaedics, Davos, Graubünden, Switzerland;
| |
Collapse
|
6
|
DePaoli D, Lemoine É, Ember K, Parent M, Prud’homme M, Cantin L, Petrecca K, Leblond F, Côté DC. Rise of Raman spectroscopy in neurosurgery: a review. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-36. [PMID: 32358930 PMCID: PMC7195442 DOI: 10.1117/1.jbo.25.5.050901] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/10/2020] [Indexed: 05/21/2023]
Abstract
SIGNIFICANCE Although the clinical potential for Raman spectroscopy (RS) has been anticipated for decades, it has only recently been used in neurosurgery. Still, few devices have succeeded in making their way into the operating room. With recent technological advancements, however, vibrational sensing is poised to be a revolutionary tool for neurosurgeons. AIM We give a summary of neurosurgical workflows and key translational milestones of RS in clinical use and provide the optics and data science background required to implement such devices. APPROACH We performed an extensive review of the literature, with a specific emphasis on research that aims to build Raman systems suited for a neurosurgical setting. RESULTS The main translatable interest in Raman sensing rests in its capacity to yield label-free molecular information from tissue intraoperatively. Systems that have proven usable in the clinical setting are ergonomic, have a short integration time, and can acquire high-quality signal even in suboptimal conditions. Moreover, because of the complex microenvironment of brain tissue, data analysis is now recognized as a critical step in achieving high performance Raman-based sensing. CONCLUSIONS The next generation of Raman-based devices are making their way into operating rooms and their clinical translation requires close collaboration between physicians, engineers, and data scientists.
Collapse
Affiliation(s)
- Damon DePaoli
- Université Laval, CERVO Brain Research Center, Québec, Canada
- Université Laval, Centre d’optique, Photonique et Lasers, Québec, Canada
| | - Émile Lemoine
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Katherine Ember
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Martin Parent
- Université Laval, CERVO Brain Research Center, Québec, Canada
| | - Michel Prud’homme
- Hôpital de l’Enfant-Jésus, Department of Neurosurgery, Québec, Canada
| | - Léo Cantin
- Hôpital de l’Enfant-Jésus, Department of Neurosurgery, Québec, Canada
| | - Kevin Petrecca
- McGill University, Montreal Neurological Institute-Hospital, Department of Neurology and Neurosurgery, Montreal, Canada
| | - Frédéric Leblond
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Daniel C. Côté
- Université Laval, CERVO Brain Research Center, Québec, Canada
- Université Laval, Centre d’optique, Photonique et Lasers, Québec, Canada
| |
Collapse
|