Detection of Delayed Cerebral Ischemia (DCI) in Subarachnoid Haemorrhage Applying Near-Infrared Spectroscopy: Elimination of the Extracerebral Signal by Transcutaneous and Intraparenchymatous Measurements in Parallel

Keller, Emanuela; Froehlich, Juerg; Baumann, D.; Böcklin, Christoph; Sikorski, Christopher; Oberle, Martin; Muser, Markus H.

doi:10.1007/978-3-319-04981-6_41

Cited by 11 publications

(7 citation statements)

References 15 publications

(19 reference statements)

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“…cardiac and vascular surgeries) [Maldonado et al ; Kato et al ], the neurosurgical critical care unit (ex. monitoring of seizures or vasospasm) [Yokose et al, ; Keller et al, ; Seule et al, ; Tanaka et al, ] and rehabilitation centers (ex. study of brain plasticity after injury) [Strangman et al, ; Arenth et al, ; Mihara et al, ; Yoshino et al, ; Khan et al, ].…”

Section: Discussionmentioning

confidence: 99%

Multichannel wearable fNIRS‐EEGsystem for long‐term clinical monitoring

Kassab

Lan

Tremblay

et al. 2017

Human Brain Mapping

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Continuous brain imaging techniques can be beneficial for the monitoring of neurological pathologies (such as epilepsy or stroke) and neuroimaging protocols involving movement. Among existing ones, functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) have the advantage of being noninvasive, nonobstructive, inexpensive, yield portable solutions, and offer complementary monitoring of electrical and local hemodynamic activities. This article presents a novel system with 128 fNIRS channels and 32 EEG channels with the potential to cover a larger fraction of the adult superficial cortex than earlier works, is integrated with 32 EEG channels, is light and batterypowered to improve portability, and can transmit data wirelessly to an interface for real-time display of electrical and hemodynamic activities. A novel fNIRS-EEG stretchable cap, two analog channels for auxiliary data (e.g., electrocardiogram), eight digital triggers for event-related protocols and an internal accelerometer for movement artifacts removal contribute to improve data acquisition quality. The system can run continuously for 24 h. Following instrumentation validation and reliability on a solid phantom, performance was evaluated on (1) 12 healthy participants during either a visual (checkerboard) task at rest or while pedalling on a stationary bicycle or a cognitive (language) task and (2) 4 patients admitted either to the epilepsy (n 5 3) or stroke (n 5 1) units. Data analysis confirmed expected hemodynamic variations during validation recordings and useful clinical information during inhospital testing. To the best of our knowledge, this is the first demonstration of a wearable wireless Additional Supporting Information may be found in the online version of this article.

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Section: Discussionmentioning

confidence: 99%

Multichannel wearable fNIRS‐EEGsystem for long‐term clinical monitoring

Kassab

Lan

Tremblay

et al. 2017

Human Brain Mapping

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“…Ecological and long-term recordings of electrical and hemodynamic brain activity together with the evaluation of neurovascular coupling could allow diagnosis and monitoring of acute and chronic diseases that influence brain status and cerebrovascular health (e.g., epilepsy, stroke, vascular dementia, Alzheimer's Disease) [8,[64][65][66]. Such a neuroimaging tool can also be employed during intensive care and surgery [67][68][69][70][71][72]. Furthermore, the technology may be essential in rehabilitation protocols for studying brain plasticity and for implementing neurofeedback protocols based on brain computer interface approaches [73,74].…”

Section: Discussionmentioning

confidence: 99%

Fiberless, Multi-Channel fNIRS-EEG System Based on Silicon Photomultipliers: Towards Sensitive and Ecological Mapping of Brain Activity and Neurovascular Coupling

Chiarelli

Perpetuini

Croce

et al. 2020

Sensors

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Portable neuroimaging technologies can be employed for long-term monitoring of neurophysiological and neuropathological states. Functional Near-Infrared Spectroscopy (fNIRS) and Electroencephalography (EEG) are highly suited for such a purpose. Their multimodal integration allows the evaluation of hemodynamic and electrical brain activity together with neurovascular coupling. An innovative fNIRS-EEG system is here presented. The system integrated a novel continuous-wave fNIRS component and a modified commercial EEG device. fNIRS probing relied on fiberless technology based on light emitting diodes and silicon photomultipliers (SiPMs). SiPMs are sensitive semiconductor detectors, whose large detection area maximizes photon harvesting from the scalp and overcomes limitations of fiberless technology. To optimize the signal-to-noise ratio and avoid fNIRS-EEG interference, a digital lock-in was implemented for fNIRS signal acquisition. A benchtop characterization of the fNIRS component showed its high performances with a noise equivalent power below 1 pW. Moreover, the fNIRS-EEG device was tested in vivo during tasks stimulating visual, motor and pre-frontal cortices. Finally, the capabilities to perform ecological recordings were assessed in clinical settings on one Alzheimer’s Disease patient during long-lasting cognitive tests. The system can pave the way to portable technologies for accurate evaluation of multimodal brain activity, allowing their extensive employment in ecological environments and clinical practice.

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“…However, one study showed that an early exposure to hyperoxia in the first few hours of medical care was more harmful than delayed exposure [20]. Furthermore, we were not able to analyze hyperoxia by other techniques such as interstitial brain tissue oxygenation by PbtO 2 probe or by Near Infrared Spectroscopy (NIRS), instead of PaO 2 levels [21][22][23].…”

Section: Limitationsmentioning

confidence: 93%

Association between Early Hyperoxia and Neurologic Outcome in Patient with High Grade Aneurysmal Subarachnoid Hemorrhage

Beaudeux¹,

Kanagaratnam²,

Bard³

et al. 2019

J Neurol Neurosci

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Background: Oxygenation support is a common practice in patients with aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to analyze the association between early hyperoxia and the neurological outcome in patients presenting a High Grade SAH, using the modified Rankin Scale (mRS) at 6 months. Methods: We retrospectively analyzed data of SAH in a single center, retrospective, observational study. The inclusion criteria were patients' ≥ 18 years-old, under mechanical ventilation upon admission to the intensive care unit (ICU) and presenting an aneurysmal SAH with a WFNS score ≥3. Hyperoxia was defined as PaO 2 > 120 mmHg and classified into 3 subgroups: mild (121-200 mmHg), moderate (201-300 mmHg) and severe (> 300 mmHg). Patients with a 6 months-mRS >3 were considered as having a poor outcome. Results: One hundred and thirty-nine patients with aneurysmal SAH were included. 82% of patients were exposed to hyperoxia with predominance of mild hyperoxia (42.8%). A higher yet non-statistical, poor neurologic outcome was identified in the hyperoxic compared to normoxic group (72% vs. 87.7% OR 2.8 [1.02-7.71], p 0.12). Following a multivariate analysis, a statistical trend was identified between the hyperoxic group and a 6-month poor neurological outcome (OR 2.84, 95% CI, 0.99-8.19; p=0.052), but no statistical association was found with delayed cerebral ischemia (OR 1.68, 95% CI, 0.5-5.71, p=0.39) nor with 28-day mortality (OR 2.17, 95% CI, 0.82-5.75, p=0.11). Conclusions: Our findings suggest a statistical trend between early hyperoxia and a poor neurological outcome at 6 months, in patients with a high grade aneurysmal SAH admitted to the ICU. Further, large-scale studies are required to fully evaluate the effects of hyperoxia.

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Detection of Delayed Cerebral Ischemia (DCI) in Subarachnoid Haemorrhage Applying Near-Infrared Spectroscopy: Elimination of the Extracerebral Signal by Transcutaneous and Intraparenchymatous Measurements in Parallel

Cited by 11 publications

References 15 publications

Multichannel wearable fNIRS‐EEGsystem for long‐term clinical monitoring

Multichannel wearable fNIRS‐EEGsystem for long‐term clinical monitoring

Fiberless, Multi-Channel fNIRS-EEG System Based on Silicon Photomultipliers: Towards Sensitive and Ecological Mapping of Brain Activity and Neurovascular Coupling

Association between Early Hyperoxia and Neurologic Outcome in Patient with High Grade Aneurysmal Subarachnoid Hemorrhage

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