Intracranial pressure pulse waveform correlates with aqueductal cerebrospinal fluid stroke volume
Intracranial pressure pulse waveform correlates with aqueductal cerebrospinal fluid stroke volume
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DOI：
10.1152/japplphysiol.00357.2012
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发表时间：
2012-11-01
影响因子：
3.3
通讯作者：
Bergsneider, Marvin
中科院分区：
文献类型：
--
作者：
Hamilton, Robert;Baldwin, Kevin;Bergsneider, Marvin
HAMILTON R，Baldwin K，Fuller J，Vespa P，Hu X，Bergsneider M.颅内压脉搏波与导水管脑脊液每搏量相关。应用生理学杂志113：1560-1566,2012。2012年9月20日首次发布；doi：10.1152/japplPhysiol.00357.2012。-这项研究确定了通过大脑导水管的脑脊液(CSF)每搏量与颅内脉搏(ICP)波形特征峰值之间的新关系。近年来，颅内压波形分析已变得更加先进；然而，临床实践仍然局限于平均颅内压，这主要是由于缺乏对颅内压波形的生理学了解。因此，本研究旨在通过对连续颅内脉搏(MOCAIP)算法的形态聚类和分析得出的颅内压形态指标与一个明确定义的生理变量--脑脊液通过脑导水管的每搏量--之间的关系，来揭示其生理意义。7名患者接受了过夜的颅内压监测和脑导水管的相位对比磁共振成像(PC-MRI)，以量化导水管的每搏输出量(ASV)。采用MOCAIP算法对颅内压信号进行波形形态分析。在从颅内压信号中提取形态指标后，通过Spearman等级相关将9个时间指标和2个基于幅度的指标与ASV进行比较。在与ASV相关的9个时间指标中，只有P2区的宽度(ICPWi2)达到显著水平。此外，颅内压脉压幅值和平均颅内压均未达到显著水平。在这项研究中，我们发现，脑脊液通过脑导水管的流量与脑脊液脉搏波第二峰的宽度(ICPWi2)呈正相关。这一发现是弥合颅内压波形形态研究和临床实践之间差距的第一步。
Hamilton R, Baldwin K, Fuller J, Vespa P, Hu X, Bergsneider M. Intracranial pressure pulse waveform correlates with aqueductal cerebrospinal fluid stroke volume. J Appl Physiol 113: 1560-1566, 2012. First published September 20, 2012; doi:10.1152/japplphysiol.00357.2012.-This study identifies a novel relationship between cerebrospinal fluid (CSF) stroke volume through the cerebral aqueduct and the characteristic peaks of the intracranial pulse (ICP) waveform. ICP waveform analysis has become much more advanced in recent years; however, clinical practice remains restricted to mean ICP, mainly due to the lack of physiological understanding of the ICP waveform. Therefore, the present study set out to shed some light on the physiological meaning of ICP morphological metrics derived by the morphological clustering and analysis of continuous intracranial pulse (MOCAIP) algorithm by investigating their relationships with a well defined physiological variable, i.e., the stroke volume of CSF through the cerebral aqueduct. Seven patients received both overnight ICP monitoring along with a phase-contrast MRI (PC-MRI) of the cerebral aqueduct to quantify aqueductal stroke volume (ASV). Waveform morphological analysis of the ICP signal was performed by the MOCAIP algorithm. Following extraction of morphological metrics from the ICP signal, nine temporal ICP metrics and two amplitude-based metrics were compared with the ASV via Spearman's rank correlation. Of the nine temporal metrics correlated with the ASV, only the width of the P2 region (ICP-Wi2) reached significance. Furthermore, both ICP pulse pressure amplitude and mean ICP did not reach significance. In this study, we showed the width of the second peak (ICP-Wi2) of an ICP pulse wave is positively related to the volume of CSF movement through the cerebral aqueduct. This finding is an initial step in bridging the gap between ICP waveform morphology research and clinical practice.