Cerebral Blood Flow Response to Hypercapnia in Children with Obstructive Sleep Apnea Syndrome

Busch, David R.; Lynch, Jennifer M.; Winters, Madeline; McCarthy, Ann L.; Newland, John J.; Ko, Tiffany; Cornaglia, Mary Anne; Radcliffe, Jerilynn; McDonough, Joseph M.; Samuel, John; Matthews, Edward; Xiao, Rui; Yodh, Arjun G.; Marcus, Carole L.; Licht, Daniel J.; Tapia, Ignacio E.

doi:10.5665/sleep.5350

Cited by 28 publications

(29 citation statements)

References 48 publications

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“…Nonetheless, it can be considered a limitation because the characteristics of OSA and brain injuries might differ between the sexes (Macey et al ., ). Secondly, the control subjects enrolled in our study, while not diagnosed with OSA, all had the complaint of snoring, and even such milder forms of sleep‐disordered breathing might be associated with diminished CBF (Busch et al ., ). Thirdly, the flow cytometry results demonstrated the presence of leucocyte apoptosis, but revealed different subtypes compared to previous results (Chen et al ., ).…”

Section: Discussionmentioning

confidence: 97%

Systemic inflammation and alterations to cerebral blood flow in obstructive sleep apnea

Chen

Lin

et al. 2017

Journal of Sleep Research

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Systemic inflammation and alterations to regional cerebral blood flow (CBF) have been reported previously in obstructive sleep apnea (OSA). This study utilized arterial spin labelling (ASL) perfusion magnetic resonance imaging (MRI) to evaluate CBF in OSA patients and determine its relationship with systemic inflammation. Twenty male patients with moderate and severe OSA [apnea-hypopnea index (AHI) >15] and 16 healthy male volunteers (AHI <5) were recruited. Early- or late-phase changes in leucocyte apoptosis and its subsets were determined by flow cytometry. Perfusion MRI data were acquired with a pulsed continuous ASL technique. The CBF maps were compared using voxel-based statistics to determine differences between the OSA and control groups. The differences in CBF, clinical severity and leucocyte apoptosis were correlated. Exploratory groupwise comparison between the two groups revealed that the OSA patients exhibited low CBF values in the vulnerable regions. The lower regional CBF values were correlated with higher clinical disease severity and leucocyte apoptosis. OSA impairs cerebral perfusion in vulnerable regions, and this deficit is associated with increased disease severity. The apparent correlation between systemic inflammation and cerebral perfusion may be indicative of haemodynamic alterations and their consequences in OSA.

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Section: Discussionmentioning

confidence: 97%

Systemic inflammation and alterations to cerebral blood flow in obstructive sleep apnea

Chen

Lin

et al. 2017

Journal of Sleep Research

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“…DCS/DCT technologies have been extensively explored to be used in animal models and human subjects for the diagnosis and therapeutic monitoring of diseases in various tissues and organs including brains (Cheng et al , 2014; Hou et al , 2014; Busch et al , 2016a; Kim et al , 2014; Kim et al , 2010; Favilla et al , 2014; Lin et al , 2016; Dehaes et al , 2014; Durduran et al , 2010b; Shang et al , 2011b; Buckley et al , 2013; Zirak et al , 2014), skeletal muscles (Henry et al , 2015; Mesquita et al , 2013; Yu et al , 2005a; Shang et al , 2012; Gurley et al , 2012), and tumors (Chung et al , 2015; Choe et al , 2014; Zhou et al , 2007; Durduran et al , 2005; He et al , 2015; Sunar et al , 2006; Dong et al , 2012b; Dong et al , 2016). Since this review focuses on the clinical applications, only typical clinical examples are presented in the following subsections based on different types of tissues/organs.…”

Section: Clinical Application Examplesmentioning

confidence: 99%

“…For example, DCS was utilized to investigate CBF responses in adult patients with cerebral diseases including vasovagal syncope (Cheng et al, 2014), obstructive sleep apnea-hypopnea (Hou et al , 2014; Busch et al , 2016a), traumatic brain injury (Kim et al , 2010; Kim et al , 2014), and ischemic stroke (Durduran et al , 2009; Favilla et al , 2014). …”

Section: Clinical Application Examplesmentioning

confidence: 99%

“…Similarly, DCS was also adopted to measure CBF responses to hypercapnia during wakefulness rather than during sleep in children with obstructive sleep syndrome (OSA) and/or snores (Busch et al , 2016a). Both OSA and snore subjects were found to have significant less changes in CBF during hypercapnia than health controls, indicating the diseased-induced blunted brain responses.…”

Section: Clinical Application Examplesmentioning

confidence: 99%

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Clinical applications of near-infrared diffuse correlation spectroscopy and tomography for tissue blood flow monitoring and imaging

Shang

2017

Physiol. Meas.

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Blood flow is one such available observable promoting a wealth of physiological insight both individually and in combination with other metrics. Near-infrared diffuse correlation spectroscopy (DCS) and, to a lesser extent, diffuse correlation tomography (DCT), have increasingly received interest over the past decade as noninvasive methods for tissue blood flow measurements and imaging. DCS/DCT offers several attractive features for tissue blood flow measurements/imaging such as noninvasiveness, portability, high temporal resolution, and relatively large penetration depth (up to several centimeters). This review first introduces the basic principle and instrumentation of DCS/DCT, followed by presenting clinical application examples of DCS/DCT for the diagnosis and therapeutic monitoring of diseases in a variety of organs/tissues including brain, skeletal muscle, and tumor. Clinical study results demonstrate technical versatility of DCS/DCT in providing important information for disease diagnosis and intervention monitoring.

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“…[20][21][22][23][24][25][26] DCS and DOS employ NIR light to probe tissues up to a few centimeters below the surface with high temporal resolution (>0.5 Hz). These instruments are minimally invasive, portable, [27][28][29][30] and they have been successfully employed to measure hemodynamics in a variety of tissues, including the brain, 21,[31][32][33][34] bone, 35,36 cancer, 37,38 and muscle, 39,40 both at the bedside and intraoperatively. [41][42][43] However, while optical techniques have been used for continuous long-term monitoring of tissues, 22 such measurements typically employ low optical powers/fluence rates, and often, the input light travels through barrier tissues (e.g., scalp/skull), which effectively protect more sensitive tissues (e.g., cerebral cortex) from injury due to light radiation by reducing light energy deposition.…”

Section: Introductionmentioning

confidence: 99%

Laser safety in fiber-optic monitoring of spinal cord hemodynamics: a preclinical evaluation

et al. 2018

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The prevention and treatment of spinal cord injury are focused upon the maintenance of spinal cord blood flow, yet no technology exists to monitor spinal cord ischemia. We recently demonstrated continuous monitoring of spinal cord ischemia with diffuse correlation and optical spectroscopies using an optical probe. Prior to clinical translation of this technology, it is critically important to demonstrate the safety profile of spinal cord exposure to the required light. To our knowledge, this is the first report of in situ safety testing of such a monitor. We expose the spinal cord to laser light utilizing a custom fiber-optic epidural probe in a survival surgery model (11 adult Dorset sheep). We compare the tissue illumination from our instrument with the American National Standards Institute maximum permissible exposures. We experimentally evaluate neurological and pathological outcomes of the irradiated sheep associated with prolonged exposure to the laser source and evaluate heating in ex vivo spinal cord samples. Spinal cord tissue was exposed to light levels at ∼18 × the maximum permissible exposure for the eye and ∼ ( 1 / 3 ) × for the skin. Multidisciplinary testing revealed no functional neurological sequelae, histopathologic evidence of laser-related injury to the spinal cord, or significant temperature changes in ex vivo samples. Low tissue irradiance and the lack of neurological, pathological, and temperature changes upon prolonged exposure to the laser source offer evidence that spinal cord tissues can be monitored safely with near-infrared optical probes placed within the epidural space.

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Cerebral Blood Flow Response to Hypercapnia in Children with Obstructive Sleep Apnea Syndrome

Cited by 28 publications

References 48 publications

Systemic inflammation and alterations to cerebral blood flow in obstructive sleep apnea

Systemic inflammation and alterations to cerebral blood flow in obstructive sleep apnea

Clinical applications of near-infrared diffuse correlation spectroscopy and tomography for tissue blood flow monitoring and imaging

Laser safety in fiber-optic monitoring of spinal cord hemodynamics: a preclinical evaluation

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