Near-infrared measurements of brain oxygenation in stroke

Abstract. We investigated the feasibility of using frequency-domain near-infrared spectroscopy (fdNIRS) to study brain oxygenation in the first few hours of stroke onset. The OxiplexTS® fdNIRS system was used in this study. Using a standard probing protocol based on surface landmarks, we measured brain tHb and StO2 in healthy volunteers, cadavers, and acute stroke patients within 9 h of stroke onset and 3 days later. We obtained measurements from 11 controls, 5 cadavers, and 5 acute stroke patients. StO2 values were significantly lower in cadavers compared to the controls and stroke patients. Each stroke patient had at least one area with reduced StO2 on the stroke side compared to the contralateral side. The evolution of tHb and StO2 at 3 days differed depending on whether a large infarct occurred. This study shows the proof of principle that quantified measurements of brain oxygenation using NIRS could be used in the hectic environment of acute stroke management. It also highlights the current technical limitations and future challenges in the development of this unique bedside monitoring tool for stroke.

[1]  M. Damian,et al.  Bilateral near infrared spectroscopy in space-occupying middle cerebral artery stroke , 2007, Neurocritical care.

[2]  Reto Meuli,et al.  Perfusion-CT Assessment of Infarct Core and Penumbra: Receiver Operating Characteristic Curve Analysis in 130 Patients Suspected of Acute Hemispheric Stroke , 2006, Stroke.

[3]  Yukio Kobayashi,et al.  Tissue oxygenation monitor using NIR spatially resolved spectroscopy , 1999, Photonics West - Biomedical Optics.

[4]  David A Boas,et al.  Spontaneous low-frequency oscillations in cerebral vessels: applications in carotid artery disease and ischemic stroke. , 2010, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[5]  M. Aries,et al.  Near Infrared Spectroscopy for the Detection of Desaturations in Vulnerable Ischemic Brain Tissue: A Pilot Study at the Stroke Unit Bedside , 2012, Stroke.

[6]  Otto W. Witte,et al.  Noninvasive Assessment of Cerebral Perfusion and Oxygenation in Acute Ischemic Stroke by Near-Infrared Spectroscopy , 2009, European Neurology.

[7]  M. Raichle,et al.  Cerebral Blood Flow and Cerebral Metabolic Rate of Oxygen Requirements for Cerebral Function and Viability in Humans , 1985, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[8]  C. W. Yoxall,et al.  Determinants of Cerebral Fractional Oxygen Extraction Using Near Infrared Spectroscopy in Preterm Neonates , 2000, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[9]  P. Rossini,et al.  Near Infrared Spectroscopy and Transcranial Doppler in Monohemispheric Stroke , 1999, European Neurology.

[10]  David A Boas,et al.  Assessment of Infant Brain Development With Frequency-Domain Near-Infrared Spectroscopy , 2007, Pediatric Research.

[11]  Martin Wolf,et al.  Absolute frequency-domain pulse oximetry of the brain: methodology and measurements. , 2003, Advances in experimental medicine and biology.

[12]  Appendix I – Methodology and Measurement , 1977 .

[13]  J. Baron,et al.  Relationships between High Oxygen Extraction Fraction in the Acute Stage and Final Infarction in Reversible Middle Cerebral Artery Occlusion: An Investigation in Anesthetized Baboons with Positron Emission Tomography , 1996, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[14]  Fahmeed Hyder,et al.  Dynamics of Changes in Blood Flow, Volume, and Oxygenation: Implications for Dynamic Functional Magnetic Resonance Imaging Calibration , 2007, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[15]  C. Weiller,et al.  Reduced vasomotor reactivity in cerebral microangiopathy : a study with near-infrared spectroscopy and transcranial Doppler sonography. , 2000, Stroke.

[16]  Ying Wu,et al.  Monitoring angiogenesis using a human compatible calibration for broadband near-infrared spectroscopy , 2013, Journal of biomedical optics.

[17]  Jean-Claude Baron,et al.  Outcome of Acutely Ischemic Brain Tissue in Prolonged Middle Cerebral Artery Occlusion: A Serial Positron Emission Tomography Investigation in the Baboon , 2004, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[18]  M. Wolf,et al.  Effect of different assumptions for brain water content on absolute measures of cerebral oxygenation determined by frequency-domain near-infrared spectroscopy in preterm infants: an observational study , 2014, BMC Pediatrics.

[19]  W. Heiss,et al.  Dynamic Penumbra Demonstrated by Sequential Multitracer PET after Middle Cerebral Artery Occlusion in Cats , 1994, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[20]  Fady T. Charbel,et al.  Frequency domain near-infrared spectroscopy technique in the assessment of brain oxygenation: A validation study in live subjects and cadavers , 2006, Journal of Neuroscience Methods.

[21]  Takashi Inoue,et al.  Transcranial Regional Cerebral Oxygen Saturation Monitoring during Carotid Endarterectomy as a Predictor of Postoperative Hyperperfusion , 2003, Neurosurgery.

[22]  M. Raichle,et al.  Physiological responses to focal cerebral ischemia in humans , 1984, Annals of neurology.

[23]  A. Yodh,et al.  Diffuse optics for tissue monitoring and tomography , 2010, Reports on progress in physics. Physical Society.

[24]  A. Alexandrov,et al.  Specific transcranial Doppler flow findings related to the presence and site of arterial occlusion. , 2000, Stroke.

[25]  Richard S. J. Frackowiak,et al.  Cerebral blood flow, blood volume and oxygen utilization. Normal values and effect of age. , 1990, Brain : a journal of neurology.

[26]  Ilias Tachtsidis,et al.  Estimating a modified Grubb's exponent in healthy human brains with near infrared spectroscopy and transcranial Doppler , 2009, Physiological measurement.

[27]  M. Mintun,et al.  Brain oxygen utilization measured with O-15 radiotracers and positron emission tomography. , 1984, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[28]  A. Yodh,et al.  Direct measurement of tissue blood flow and metabolism with diffuse optics , 2011, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[29]  D. Boas,et al.  Haemoglobin oxygen saturation as a biomarker: the problem and a solution , 2011, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[30]  Paolo Maria Rossini,et al.  Transcranial Doppler and Near-Infrared Spectroscopy Can Evaluate the Hemodynamic Effect of Carotid Artery Occlusion , 2003, Stroke.

[31]  B. M. Fulk MATH , 1992 .

[32]  V. Pomeroy,et al.  The influence of positioning upon cerebral oxygenation after acute stroke: a pilot study. , 2008, Age and ageing.