Data-Augmented Modeling of Intracranial Pressure

Precise management of patients with cerebral diseases often requires intracranial pressure (ICP) monitoring, which is highly invasive and requires a specialized ICU setting. The ability to noninvasively estimate ICP is highly compelling as an alternative to, or screening for, invasive ICP measurement. Most existing approaches for noninvasive ICP estimation aim to build a regression function that maps noninvasive measurements to an ICP estimate using statistical learning techniques. These data-based approaches have met limited success, likely because the amount of training data needed is onerous for this complex applications. In this work, we discuss an alternative strategy that aims to better utilize noninvasive measurement data by leveraging mechanistic understanding of physiology. Specifically, we developed a Bayesian framework that combines a multiscale model of intracranial physiology with noninvasive measurements of cerebral blood flow using transcranial Doppler. Virtual experiments with synthetic data are conducted to verify and analyze the proposed framework. A preliminary clinical application study on two patients is also performed in which we demonstrate the ability of this method to improve ICP prediction.

[1]  R. Serban,et al.  CVODES: The Sensitivity-Enabled ODE Solver in SUNDIALS , 2005 .

[2]  P. Moireau,et al.  Sequential parameter estimation for fluid–structure problems: Application to hemodynamics , 2012, International journal for numerical methods in biomedical engineering.

[3]  Thomas J. R. Hughes,et al.  On the one-dimensional theory of blood flow in the larger vessels , 1973 .

[4]  Qin Hu,et al.  Analysis of Intense, Subnanosecond Electrical Pulse-Induced Transmembrane Voltage in Spheroidal Cells With Arbitrary Orientation , 2009, IEEE Transactions on Biomedical Engineering.

[5]  C. Giller A bedside test for cerebral autoregulation using transcranial Doppler ultrasound , 1991, Acta Neurochirurgica.

[6]  Miller,et al.  Systems analysis of cerebrovascular pressure transmission: an observational study in head-injured patients. , 1990, Journal of neurosurgery.

[7]  Xiao Hu,et al.  Characterization of the Relationship Between Intracranial Pressure and Electroencephalographic Monitoring in Burst-Suppressed Patients , 2015, Neurocritical Care.

[8]  I. Vignon-Clementel,et al.  Data assimilation and modelling of patient-specific single-ventricle physiology with and without valve regurgitation. , 2016, Journal of biomechanics.

[9]  Michalis Nik Xenos,et al.  Pulsatile cerebrospinal fluid dynamics in the human brain , 2005, IEEE Transactions on Biomedical Engineering.

[10]  J. Webster,et al.  Invasive and noninvasive means of measuring intracranial pressure: a review , 2017, Physiological measurement.

[11]  J-F Gerbeau,et al.  A methodological paradigm for patient‐specific multi‐scale CFD simulations: from clinical measurements to parameter estimates for individual analysis , 2014, International journal for numerical methods in biomedical engineering.

[12]  P Moireau,et al.  Estimation of tissue contractility from cardiac cine-MRI using a biomechanical heart model , 2012, Biomechanics and modeling in mechanobiology.

[13]  J Tiago,et al.  A velocity tracking approach for the data assimilation problem in blood flow simulations , 2016, International journal for numerical methods in biomedical engineering.

[14]  S. Shadden,et al.  Numerical Investigation of Vasospasm Detection by Extracranial Blood Velocity Ratios , 2017, Cerebrovascular Diseases.

[15]  Andreas A. Linninger,et al.  Cerebrospinal Fluid Mechanics and Its Coupling to Cerebrovascular Dynamics , 2016 .

[16]  M. Ursino,et al.  A simple mathematical model of the interaction between intracranial pressure and cerebral hemodynamics. , 1997, Journal of applied physiology.

[17]  D. Comaniciu,et al.  Personalized blood flow computations: A hierarchical parameter estimation framework for tuning boundary conditions , 2017, International journal for numerical methods in biomedical engineering.

[18]  G. Verghese,et al.  Model-Based Noninvasive Estimation of Intracranial Pressure from Cerebral Blood Flow Velocity and Arterial Pressure , 2012, Science Translational Medicine.

[19]  Xiao Hu,et al.  Characterization of Shape Differences Among ICP Pulses Predicts Outcome of External Ventricular Drainage Weaning Trial , 2016, Neurocritical Care.

[20]  B. Cabella,et al.  Non-invasive Monitoring of Intracranial Pressure Using Transcranial Doppler Ultrasonography: Is It Possible? , 2016, Neurocritical Care.

[21]  Andrea Arnold,et al.  Uncertainty Quantification in a Patient-Specific One-Dimensional Arterial Network Model: EnKF-Based Inflow Estimator. , 2017, Journal of verification, validation, and uncertainty quantification.

[22]  P. Avan,et al.  Noninvasive detection of alarming intracranial pressure changes by auditory monitoring in early management of brain injury: a prospective invasive versus noninvasive study , 2017, Critical Care.

[23]  M. Ursino,et al.  Interaction among autoregulation, CO2 reactivity, and intracranial pressure: a mathematical model. , 1998, American journal of physiology. Heart and circulatory physiology.

[24]  Xiao Hu,et al.  Noninvasive Intracranial Pressure Assessment Based on a Data-Mining Approach Using a Nonlinear Mapping Function , 2012, IEEE Transactions on Biomedical Engineering.

[25]  Godfrey A. Mills,et al.  A Review of Non-Invasive Methods of Monitoring Intracranial Pressure , 2014 .

[26]  Xiao Hu,et al.  A Coupled Lumped-Parameter and Distributed Network Model for Cerebral Pulse-Wave Hemodynamics. , 2015, Journal of biomechanical engineering.

[27]  G. Verghese,et al.  Model-based estimation of intracranial pressure and cerebrovascular autoregulation , 2008, 2008 Computers in Cardiology.

[28]  Marco A. Iglesias,et al.  A regularizing iterative ensemble Kalman method for PDE-constrained inverse problems , 2015, 1505.03876.

[29]  Scott A. Stevens,et al.  A whole-body mathematical model for intracranial pressure dynamics , 2003, Journal of mathematical biology.

[30]  A. G. Fieggen,et al.  The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children. , 2016, Child's Nervous System.

[31]  Andrew M. Stuart,et al.  Analysis of the Ensemble Kalman Filter for Inverse Problems , 2016, SIAM J. Numer. Anal..

[32]  Wayne W. Wakeland,et al.  A review of physiological simulation models of intracranial pressure dynamics , 2008, Comput. Biol. Medicine.

[33]  Thomas A Gennarelli,et al.  Quantitative pupillometry, a new technology: normative data and preliminary observations in patients with acute head injury. Technical note. , 2003, Journal of neurosurgery.

[34]  Franck Nicoud,et al.  Data assimilation for identification of cardiovascular network characteristics , 2017, International journal for numerical methods in biomedical engineering.

[35]  S. Lele,et al.  ESTIMATING DENSITY DEPENDENCE, PROCESS NOISE, AND OBSERVATION ERROR , 2006 .

[36]  Max Q.-H. Meng,et al.  Effects of Dielectric Values of Human Body on Specific Absorption Rate Following 430, 800, and 1200 MHz RF Exposure to Ingestible Wireless Device , 2010, IEEE Transactions on Information Technology in Biomedicine.

[37]  Yubing Shi,et al.  Review of Zero-D and 1-D Models of Blood Flow in the Cardiovascular System , 2011, Biomedical engineering online.

[38]  Xiao Hu,et al.  Bayesian tracking of intracranial pressure signal morphology , 2012, Artif. Intell. Medicine.

[39]  Xiao Hu,et al.  Improved Noninvasive Intracranial Pressure Assessment With Nonlinear Kernel Regression , 2010, IEEE Transactions on Information Technology in Biomedicine.

[40]  Ronald L. Iman Latin Hypercube Sampling , 2008 .

[41]  J. J. Moré,et al.  Levenberg--Marquardt algorithm: implementation and theory , 1977 .

[42]  B. Mohammadi,et al.  Non Invasive Blood Flow Features Estimation in Cerebral Arteries from Uncertain Medical Data , 2017, Annals of Biomedical Engineering.

[43]  L. Shuer,et al.  Noninvasive measurement of pulsatile intracranial pressure using ultrasound. , 1998, Acta neurochirurgica. Supplement.

[44]  An experimental study of cerebrovascular resistance, pressure transmission, and craniospinal compliance. , 1994, Neurosurgery.

[45]  M. Muwaswes,et al.  Intracranial pressure monitoring: review of risk factors associated with infection. , 1990, Heart & lung : the journal of critical care.

[46]  S. A. Stevens,et al.  Local Compliance Effects on the Global Pressure-Volume Relationship in Models of Intracranial Pressure Dynamics , 2000 .

[47]  Xiao Hu,et al.  Morphological Clustering and Analysis of Continuous Intracranial Pressure , 2009, IEEE Transactions on Biomedical Engineering.

[48]  A. Marsden Optimization in Cardiovascular Modeling , 2014 .

[49]  Xiao Hu,et al.  A Data mining framework of noninvasive intracranial pressure assessment , 2006, Biomed. Signal Process. Control..

[50]  Jorge J. Moré,et al.  The Levenberg-Marquardt algo-rithm: Implementation and theory , 1977 .

[51]  Xiao Hu,et al.  Reproduction of consistent pulse-waveform changes using a computational model of the cerebral circulatory system. , 2014, Medical engineering & physics.

[52]  Mauro Ursino,et al.  A Model of Cerebrovascular Reactivity Including the Circle of Willis and Cortical Anastomoses , 2010, Annals of Biomedical Engineering.

[53]  Giuseppe Citerio,et al.  NICEM consensus on neurological monitoring in acute neurological disease , 2008, Intensive Care Medicine.

[54]  A. Hale,et al.  Emerging Insights and New Perspectives on the Nature of Hydrocephalus , 2017, Pediatric Neurosurgery.

[55]  C. Haberthür,et al.  Transcranial color-coded duplex sonography allows to assess cerebral perfusion pressure noninvasively following severe traumatic brain injury , 2010, Acta Neurochirurgica.

[56]  Xiao Hu,et al.  Estimation of Hidden State Variables of the Intracranial System Using Constrained Nonlinear Kalman Filters , 2007, IEEE Transactions on Biomedical Engineering.

[57]  R. Penn,et al.  A mathematical model of blood, cerebrospinal fluid and brain dynamics , 2009, Journal of mathematical biology.

[58]  Xiao Hu,et al.  Steady-state indicators of the intracranial pressure dynamic system using geodesic distance of the ICP pulse waveform. , 2012, Physiological measurement.

[59]  Xiao Hu,et al.  Noninvasive Intracranial Hypertension Detection Utilizing Semisupervised Learning , 2013, IEEE Transactions on Biomedical Engineering.

[60]  G. Sutherland,et al.  Diagnostic accuracy of intraocular pressure measurement for the detection of raised intracranial pressure: meta-analysis: a systematic review. , 2014, Journal of neurosurgery.

[61]  Scott A Stevens,et al.  Modeling steady-state intracranial pressures in supine, head-down tilt and microgravity conditions. , 2005, Aviation, space, and environmental medicine.

[62]  Xiao Hu,et al.  Semi-supervised detection of intracranial pressure alarms using waveform dynamics , 2013, Physiological measurement.

[63]  K. Barlow Traumatic brain injury. , 2013, Handbook of clinical neurology.

[64]  C. A. Figueroa,et al.  Sequential identification of boundary support parameters in a fluid-structure vascular model using patient image data , 2012, Biomechanics and Modeling in Mechanobiology.

[65]  A. Stuart,et al.  Ensemble Kalman methods for inverse problems , 2012, 1209.2736.