Nonlinear analyses applied in cerebral autoregulation and blood flow changes in patients with acute intracerebral hemorrhage

Abstract Cerebral autoregulation (CA) is an important mechanism for maintaining constant cerebral blood flow during changes in blood pressure. Although previous studies have shown that CA may be impaired in patients with intracerebral hemorrhage (ICH), the variability of cerebral blood flow (CBF) in response to changes in CA has not been investigated. In the present study, we recruited twelve patients presenting with acute subcortical ICH and seven non-stroke controls. The status of CA was determined by assessing Pearson’s moving correlation coefficient between arterial blood pressure and cerebral blood flow velocity (CBFV) of the middle cerebral artery (MCA). The variability of CBFV was calculated using nonlinear sample entropy analyses. The results indicated that ICH patients significantly showed poorer CA than controls, particularly localized to the MCA ipsilateral to the ICH (controls 0.17 ± 0.13 versus ICH side 0.41 ± 0.27 and non-ICH side 0.34 ± 0.26, p = 0.044 and 0.120, respectively). Moreover, the variability of CBFV in the hemisphere ipsilateral to the ICH was significantly increased in ICH patients when compared to controls (1.145 ± 0.26 versus 1.66 ± 0.193 and 1.595 ± 0.43, p

[1]  J. Shieh,et al.  Complexity of intracranial pressure correlates with outcome after traumatic brain injury. , 2012, Brain : a journal of neurology.

[2]  J. Richman,et al.  Physiological time-series analysis using approximate entropy and sample entropy. , 2000, American journal of physiology. Heart and circulatory physiology.

[3]  Maysam F. Abbod,et al.  Sample Entropy Analysis of EEG Signals via Artificial Neural Networks to Model Patients' Consciousness Level Based on Anesthesiologists Experience , 2015, BioMed research international.

[4]  Pei-Wen Huang,et al.  Complexity of heart rate variability predicts outcome in intensive care unit admitted patients with acute stroke , 2014, Journal of Neurology, Neurosurgery & Psychiatry.

[5]  J. Pickard,et al.  Monitoring of cerebral autoregulation in head-injured patients. , 1996, Stroke.

[6]  Pei-Wen Huang,et al.  Complexity of Heart Rate Variability Can Predict Stroke-In-Evolution in Acute Ischemic Stroke Patients , 2015, Scientific Reports.

[7]  Madalena Costa,et al.  Multiscale entropy analysis of biological signals. , 2005, Physical review. E, Statistical, nonlinear, and soft matter physics.

[8]  T Brott,et al.  The ABCs of measuring intracerebral hemorrhage volumes. , 1996, Stroke.

[9]  C. Weiller,et al.  Secondary decline of cerebral autoregulation is associated with worse outcome after intracerebral hemorrhage , 2010, Intensive Care Medicine.

[10]  E. Carrera,et al.  Integration of Brain Signals in Multimodal Bedside Monitoring After Traumatic Brain Injury , 2010 .

[11]  N. Huang,et al.  The empirical mode decomposition and the Hilbert spectrum for nonlinear and non-stationary time series analysis , 1998, Proceedings of the Royal Society of London. Series A: Mathematical, Physical and Engineering Sciences.

[12]  J D Pickard,et al.  Cerebral autoregulation following head injury. , 2001, Journal of neurosurgery.

[13]  Sung-Chun Tang,et al.  Nonlinear and Conventional Biosignal Analyses Applied to Tilt Table Test for Evaluating Autonomic Nervous System and Autoregulation , 2013, The open biomedical engineering journal.

[14]  Farzaneh A. Sorond,et al.  Dynamic cerebral autoregulation after intracerebral hemorrhage: A case-control study , 2011, BMC neurology.

[15]  Optimal cerebral perfusion pressure in patients with intracerebral hemorrhage: an observational case series , 2014, Critical Care.

[16]  Madalena Costa,et al.  Multiscale entropy analysis of complex physiologic time series. , 2002, Physical review letters.

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

[18]  David W. Kaczka,et al.  The frequency response of cerebral autoregulation. , 2013, Journal of applied physiology.

[19]  C. Weiller,et al.  Dynamic Cerebral Autoregulation in Acute Intracerebral Hemorrhage , 2013, Stroke.

[20]  Bruce J West,et al.  Phase dynamics in cerebral autoregulation. , 2005, American journal of physiology. Heart and circulatory physiology.

[21]  J. Pickard,et al.  Monitoring cerebral autoregulation after head injury. Which component of transcranial Doppler flow velocity is optimal? , 2012, Neurocritical Care.

[22]  B. Bein,et al.  Nexfin Noninvasive Continuous Hemodynamic Monitoring: Validation against Continuous Pulse Contour and Intermittent Transpulmonary Thermodilution Derived Cardiac Output in Critically Ill Patients , 2013, TheScientificWorldJournal.

[23]  Sung-Chun Tang,et al.  Effect of mannitol on cerebrovascular pressure reactivity in patients with intracranial hypertension. , 2015, Journal of the Formosan Medical Association = Taiwan yi zhi.

[24]  Patrick Segers,et al.  Blood pressure waveform analysis by means of wavelet transform , 2009, Medical & Biological Engineering & Computing.

[25]  Jia Liu,et al.  Temporal Course of Dynamic Cerebral Autoregulation in Patients With Intracerebral Hemorrhage , 2016, Stroke.

[26]  J. Pickard,et al.  Critical Thresholds for Transcranial Doppler Indices of Cerebral Autoregulation in Traumatic Brain Injury , 2011, Neurocritical care.

[27]  Maysam F. Abbod,et al.  Application of Multivariate Empirical Mode Decomposition and Sample Entropy in EEG Signals via Artificial Neural Networks for Interpreting Depth of Anesthesia , 2013, Entropy.

[28]  S M Pincus,et al.  Approximate entropy as a measure of system complexity. , 1991, Proceedings of the National Academy of Sciences of the United States of America.

[29]  M Czosnyka,et al.  Cerebral autoregulation in carotid artery occlusive disease assessed from spontaneous blood pressure fluctuations by the correlation coefficient index. , 2003, Stroke.

[30]  Sung-Chun Tang,et al.  Impaired cerebral autoregulation in a case of severe acute encephalitis. , 2007, Journal of the Formosan Medical Association = Taiwan yi zhi.

[31]  Sung-Chun Tang,et al.  Dynamic cerebral autoregulation in carotid stenosis before and after carotid stenting. , 2008, Journal of vascular surgery.