Development of a combined broadband near-infrared and diffusion correlation system for monitoring cerebral blood flow and oxidative metabolism in preterm infants

Diop, Mamadou; Kishimoto, Jessica; Toronov, Vladislav; Lee, David S. C.; Lawrence, Keith St.

doi:10.1364/boe.6.003907

Cited by 44 publications

(56 citation statements)

References 42 publications

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“…Considering that the DCS data in the current study were collected directly on the brain, this agreement is evidence that DCS is relatively insensitive to extracerebral signal contamination in applications in which the scalp and skull are thin. These would include animal models, such as piglets and rats [4,13], but more importantly, also applies to newborns [34,35].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the best flow model to characterize diffuse correlation spectroscopy data acquired directly on the brain

Verdecchia¹,

Diop²,

Morrison³

et al. 2015

Biomed. Opt. Express

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Diffuse correlation spectroscopy (DCS) is a non-invasive optical technique capable of monitoring tissue perfusion. The normalized temporal intensity autocorrelation function generated by DCS is typically characterized by assuming that the movement of erythrocytes can be modeled as a Brownian diffusion-like process instead of by the expected random flow model. Recently, a hybrid model, referred to as the hydrodynamic diffusion model, was proposed, which combines the random and Brownian flow models. The purpose of this study was to investigate the best model to describe autocorrelation functions acquired directly on the brain in order to avoid confounding effects of extracerebral tissues. Data were acquired from 11 pigs during normocapnia and hypocapnia, and flow changes were verified by computed tomography perfusion (CTP). The hydrodynamic diffusion model was found to provide the best fit to the autocorrelation functions; however, no significant difference for relative flow changes measured by the Brownian and hydrodynamic diffusion models was observed.

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Section: Discussionmentioning

confidence: 99%

Assessment of the best flow model to characterize diffuse correlation spectroscopy data acquired directly on the brain

Verdecchia¹,

Diop²,

Morrison³

et al. 2015

Biomed. Opt. Express

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“…In particular, near-infrared spectroscopy (NIRS) – a safe, quantitative, and portable technology – is widely used to obtain estimates of cerebral oxygen saturation (S t O 2 ), which has been used as a surrogate marker of CBF in the clinic [ 8 ]. NIRS can also directly measure CBF, either by dynamic contrast-enhanced (DCE) methods [ 9 , 10 ], or by diffuse correlation spectroscopy (DCS). DCS has been extensively validated against other perfusion techniques and it has the advantage of providing continuous monitoring [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous monitoring of cerebral perfusion and cytochrome c oxidase by combining broadband near-infrared spectroscopy and diffuse correlation spectroscopy

Rajaram

Bale

Kewin

et al. 2018

Biomed. Opt. Express

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Preterm infants born with very low birth weights are at a high risk of brain injury, in part because the premature brain is believed to be prone to periods of low cerebral blood flow (CBF). Tissue damage is likely to occur if reduction in CBF is sufficient to impair cerebral energy metabolism for extended periods. Therefore, a neuromonitoring method that can detect reductions in CBF, large enough to affect metabolism, could alert the neonatal intensive care team before injury occurs. In this report, we present the development of an optical system that combines diffuse correlation spectroscopy (DCS) for monitoring CBF and broadband near-infrared spectroscopy (B-NIRS) for monitoring the oxidation state of cytochrome c oxidase (oxCCO) – a key biomarker of oxidative metabolism. The hybrid instrument includes a multiplexing system to enable concomitant DCS and B-NIRS measurements while avoiding crosstalk between the two subsystems. The ability of the instrument to monitor dynamic changes in CBF and oxCCO was demonstrated in a piglet model of neonatal hypoxia-ischemia (HI). Experiments conducted in eight animals, including two controls, showed that oxCCO exhibited a delayed response to ischemia while CBF and tissue oxygenation (StO2) responses were instantaneous. These findings suggest that simultaneous neuromonitoring of perfusion and metabolism could provide critical information regarding clinically significant hemodynamic events prior to the onset of brain injury.

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“…DCS is complementary to TCD as it measures cerebral blood flow in the microvasculature by measuring light intensity fluctuations caused by the movement of red blood cells3031. While absolute CBF i does not have units of cerebral blood flow, it has shown a strong correlation with cerebral blood flow measured by bolus tracking techniques using time-domain NIRS in a neonatal pig model32 as well as in preterm neonates33, and with cerebral blood flow measured by phase-encoded velocity mapping using magnetic resonance imaging in neonates34. Since both DCS and FD-NIRS are sensitive to microvasculature underneath the optical sensor, they offer better estimates of CMRO 2 than by combining SO 2 NIRS with other modalities like TCD which measure blood velocity in large vessels and may not accurately reflect cortical perfusion at the site of the probe.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive Assessment of Cerebral Blood Flow and Oxygen Metabolism in Neonates during Hypothermic Cardiopulmonary Bypass: Feasibility and Clinical Implications

Ferradal

Yuki

Vyas

et al. 2017

Sci Rep

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The neonatal brain is extremely vulnerable to injury during periods of hypoxia and/or ischemia. Risk of brain injury is increased during neonatal cardiac surgery, where pre-existing hemodynamic instability and metabolic abnormalities are combined with long periods of low cerebral blood flow and/or circulatory arrest. Our understanding of events associated with cerebral hypoxia-ischemia during cardiopulmonary bypass (CPB) remains limited, largely due to inadequate tools to quantify cerebral oxygen delivery and consumption non-invasively and in real-time. This pilot study aims to evaluate cerebral blood flow (CBF) and oxygen metabolism (CMRO2) intraoperatively in neonates by combining two novel non-invasive optical techniques: frequency-domain near-infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS). CBF and CMRO2 were quantified before, during and after deep hypothermic cardiopulmonary bypass (CPB) in nine neonates. Our results show significantly decreased CBF and CMRO2 during hypothermic CPB. More interestingly, a change of coupling between both variables is observed during deep hypothermic CPB in all subjects. Our results are consistent with previous studies using invasive techniques, supporting the concept of FD-NIRS/DCS as a promising technology to monitor cerebral physiology in neonates providing the potential for individual optimization of surgical management.

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Development of a combined broadband near-infrared and diffusion correlation system for monitoring cerebral blood flow and oxidative metabolism in preterm infants

Cited by 44 publications

References 42 publications

Assessment of the best flow model to characterize diffuse correlation spectroscopy data acquired directly on the brain

Assessment of the best flow model to characterize diffuse correlation spectroscopy data acquired directly on the brain

Simultaneous monitoring of cerebral perfusion and cytochrome c oxidase by combining broadband near-infrared spectroscopy and diffuse correlation spectroscopy

Non-invasive Assessment of Cerebral Blood Flow and Oxygen Metabolism in Neonates during Hypothermic Cardiopulmonary Bypass: Feasibility and Clinical Implications

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