Transcranial optical monitoring of cerebrovascular hemodynamics in acute stroke patients

Durdurán, Turgut; Zhou, Chao; Edlow, Brian L.; Yu, Guoqiang; Choe, Regine; Kim, Meeri N.; Cucchiara, Brett; Putt, Mary; Shah, Qaisar; Kasner, Scott E.; Greenberg, Joel; Yodh, Arjun G.; Detre, John A.

doi:10.1364/oe.17.003884

Cited by 145 publications

(157 citation statements)

References 74 publications

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“…TCD studies during obstructive apneas showed repetitive, transient increases of MCA blood flow velocity. 8 Moreover, cerebral vasoregulation assessed by TCD, 9 or by NIRS, 10 is impaired in acute stroke with consequent dependence of brain perfusion of the affected hemisphere from arterial blood pressure. Therefore, blood pressure increases at each obstructive apnea termination probably induce transient cerebral blood flow velocity increases in the affected hemisphere of patients with stroke.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Hemodynamic Changes in Stroke During Sleep-Disordered Breathing

Pizza

Biallas

Kallweit

et al. 2012

Stroke

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Background and Purpose-Sleep-disordered breathing (SDB) negatively impacts stroke outcome. Near-infrared spectroscopy showed the acute cerebral hemodynamic effects of SDB. Methods-Eleven patients (7 men, age 61Ϯ13 years) with acute/subacute middle cerebral artery stroke (National Institutes of Health Stroke Scale score 10Ϯ7) and SDB (apnea-hypopnea index 32Ϯ28/hour) were assessed with nocturnal polysomnography and bilateral near-infrared spectroscopy recording. Cerebral oxygenation and hemoglobin concentration changes during obstructive and central apneas were analyzed. Results-During SDB, near-infrared spectroscopy showed asymmetrical patterns of cerebral oxygenation and hemoglobin concentrations with changes significantly larger on the unaffected compared with the affected hemisphere. Brain tissue hypoxia was more severe during obstructive compared with central apneas. Conclusions-Profound cerebral deoxygenation effects of SDB occurred in acute/subacute stroke. These changes may contribute to poor outcome, arising in the possibility of a potential benefit of SDB treatment in stroke management. (Stroke.

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Section: Discussionmentioning

confidence: 99%

Cerebral Hemodynamic Changes in Stroke During Sleep-Disordered Breathing

Pizza

Biallas

Kallweit

et al. 2012

Stroke

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“…In a recent study, we monitored cerebral haemodynamics at the bedside when changes were induced in HOB positioning [47,58]. In healthy populations, CBF responses to posture change were shown to be small owing to autoregulation [47].…”

Section: Clinical and Pre-clinical Applications Of Diffuse Correlatiomentioning

confidence: 99%

Direct measurement of tissue blood flow and metabolism with diffuse optics

Mesquita

Durdurán

et al. 2011

Phil. Trans. R. Soc. A.

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Diffuse optics has proven useful for quantitative assessment of tissue oxy-and deoxyhaemoglobin concentrations and, more recently, for measurement of microvascular blood flow. In this paper, we focus on the flow monitoring technique: diffuse correlation spectroscopy (DCS). Representative clinical and pre-clinical studies from our laboratory illustrate the potential of DCS. Validation of DCS blood flow indices in human brain and muscle is presented. Comparison of DCS with arterial spin-labelled MRI, xenon-CT and Doppler ultrasound shows good agreement (0.50 < r < 0.95) over a wide range of tissue types and source detector distances, corroborating the potential of the method to measure perfusion non-invasively and in vivo at the microvasculature level. Alloptical measurements of cerebral oxygen metabolism in both rat brain, following middle cerebral artery occlusion, and human brain, during functional activation, are also described. In both situations, the use of combined DCS and diffuse optical spectroscopy/near-infrared spectroscopy to monitor changes in oxygen consumption by the tissue is demonstrated. Finally, recent results spanning from gene expression-induced angiogenic response to stroke care and cancer treatment monitoring are discussed.

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“…This exciting new technique has also been applied in stroke patients [69]. Using a standardized protocol applying a −5…”

Section: (A) Monitoring Cerebral Autoregulationmentioning

confidence: 99%

Non-invasive optical imaging of stroke

Obrig

Steinbrink

2011

Phil. Trans. R. Soc. A.

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The acute onset of a neurological deficit is the key clinical feature of stroke. In most cases, however, pathophysiological changes in the cerebral vasculature precede the event, often by many years. Persisting neurological deficits may also require long-term rehabilitation. Hence, stroke may be considered a chronic disease, and diagnostic and therapeutic efforts must include identification of specific risk factors, and the monitoring of and interventions in the acute and subacute stages, and should aim at a pathophysiologically based approach to optimize the rehabilitative effort. Non-invasive optical techniques have been experimentally used in all three stages of the disease and may complement the established diagnostic and monitoring tools. Here, we provide an overview of studies using the methodology in the context of stroke, and we sketch perspectives of how they may be integrated into the assessment of the highly dynamic pathophysiological processes during the acute and subacute stages of the disease and also during rehabilitation and (secondary) prevention of stroke.

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Transcranial optical monitoring of cerebrovascular hemodynamics in acute stroke patients

Cited by 145 publications

References 74 publications

Cerebral Hemodynamic Changes in Stroke During Sleep-Disordered Breathing

Cerebral Hemodynamic Changes in Stroke During Sleep-Disordered Breathing

Direct measurement of tissue blood flow and metabolism with diffuse optics

Non-invasive optical imaging of stroke

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