Windowed Multitaper Correlation Analysis of Multimodal Brain Monitoring Parameters

Although multimodal monitoring sets the standard in daily practice of neurocritical care, problem-oriented analysis tools to interpret the huge amount of data are lacking. Recently a mathematical model was presented that simulates the cerebral perfusion and oxygen supply in case of a severe head trauma, predicting the appearance of distinct correlations between arterial blood pressure and intracranial pressure. In this study we present a set of mathematical tools that reliably detect the predicted correlations in data recorded at a neurocritical care unit. The time resolved correlations will be identified by a windowing technique combined with Fourier-based coherence calculations. The phasing of the data is detected by means of Hilbert phase difference within the above mentioned windows. A statistical testing method is introduced that allows tuning the parameters of the windowing method in such a way that a predefined accuracy is reached. With this method the data of fifteen patients were examined in which we found the predicted correlation in each patient. Additionally it could be shown that the occurrence of a distinct correlation parameter, called scp, represents a predictive value of high quality for the patients outcome.

[1]  M. Czosnyka,et al.  Merits and Pitfalls of Multimodality Brain Monitoring , 2010, Neurocritical care.

[2]  S. Mayer,et al.  Continuous electroencephalography in the medical intensive care unit* , 2009, Critical care medicine.

[3]  Rupert Faltermeier,et al.  Comparison of Near-Infrared Spectroscopy and Tissue Po2 Time Series in Patients after Severe Head Injury and Aneurysmal Subarachnoid Hemorrhage , 2002, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[4]  A. Vandervoort,et al.  Clinical applicability and test-retest reliability of an external perturbation test of balance in stroke subjects. , 1995, Archives of physical medicine and rehabilitation.

[5]  J. Claude Hemphill,et al.  Multimodal monitoring and neurocritical care bioinformatics , 2011, Nature Reviews Neurology.

[6]  P. Andrews Cerebral perfusion pressure and brain ischaemia: can one size fit all? , 2005, Critical care.

[7]  Jürgen Kurths,et al.  Analysing Synchronization Phenomena from Bivariate Data by Means of the Hilbert Transform , 1998 .

[8]  R. Chesnut,et al.  Talk and die revisited: bifrontal contusions and late deterioration. , 2011, The Journal of trauma.

[9]  D. Dragosavac,et al.  Glasgow outcome scale at hospital discharge as a prognostic index in patients with severe traumatic brain injury. , 2012, Arquivos de neuro-psiquiatria.

[10]  Rupert Faltermeier,et al.  Computerized data analysis of neuromonitoring parameters identifies patients with reduced cerebral compliance as seen on CT. , 2012, Acta neurochirurgica. Supplement.

[11]  P. Vespa,et al.  Multimodality monitoring and telemonitoring in neurocritical care: from microdialysis to robotic telepresence , 2005, Current opinion in critical care.

[12]  Emery N. Brown,et al.  A Review of Multitaper Spectral Analysis , 2014, IEEE Transactions on Biomedical Engineering.

[13]  Giuseppe Citerio,et al.  Brain multimodality monitoring: an update , 2012, Current opinion in critical care.

[14]  P. Reilly,et al.  Brain injury: the pathophysiology of the first hours.'Talk and Die revisited' , 2001, Journal of Clinical Neuroscience.

[15]  Geoffrey T Manley,et al.  New Approaches to Physiological Informatics in Neurocritical Care , 2007, Neurocritical care.

[16]  S. Mayer,et al.  Randomized Trial of Clazosentan in Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Endovascular Coiling , 2012, Stroke.

[17]  A. Bhatia,et al.  Neuromonitoring in the intensive care unit. , 2012 .

[18]  J. Stover Actual evidence for neuromonitoring-guided intensive care following severe traumatic brain injury. , 2011, Swiss medical weekly.

[19]  M Smith,et al.  Multimodal monitoring in traumatic brain injury: current status and future directions. , 2007, British journal of anaesthesia.

[20]  J. Pickard,et al.  Monitoring and interpretation of intracranial pressure , 2004, Journal of Neurology, Neurosurgery & Psychiatry.

[21]  P. Bjerre,et al.  Cerebral microdialysis monitoring: determination of normal and ischemic cerebral metabolisms in patients with aneurysmal subarachnoid hemorrhage. , 2000, Journal of neurosurgery.

[22]  G. Friedman,et al.  Mechanical ventilation with high tidal volume induces inflammation in patients without lung disease , 2010, Critical care.

[23]  A. Bhatia,et al.  Neuromonitoring in the intensive care unit. I. Intracranial pressure and cerebral blood flow monitoring , 2007, Intensive Care Medicine.

[24]  Michael Ghil,et al.  ADVANCED SPECTRAL METHODS FOR CLIMATIC TIME SERIES , 2002 .

[25]  M. D. De Georgia,et al.  Multimodal Monitoring in the Neurological Intensive Care Unit , 2005, The neurologist.

[26]  P. Narotam,et al.  Brain tissue oxygen monitoring in traumatic brain injury and major trauma: outcome analysis of a brain tissue oxygen-directed therapy. , 2009, Journal of neurosurgery.

[27]  Sean M. Grady,et al.  Clinical trials in head injury. , 2002, Neurological research.

[28]  Rupert Faltermeier,et al.  A mathematical model of cerebral circulation and oxygen supply , 2005, Journal of mathematical biology.

[29]  S. Mayer,et al.  Multimodality monitoring in neurocritical care. , 2007, Critical care clinics.

[30]  M Uzura,et al.  Prevention of secondary ischemic insults after severe head injury. , 1999, Critical care medicine.