Dynamic cerebral autoregulation measured by diffuse correlation spectroscopy.
Dynamic cerebral autoregulation measured by diffuse correlation spectroscopy.
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DOI：
10.1177/0271678x231153728
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发表时间：
2023-08
影响因子：
6.3
通讯作者：
Yodh, Arjun G.
中科院分区：
文献类型：
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作者：
Favilla, Christopher G.;Mullen, Michael T.;Kahn, Farhan;Rasheed, Izad-Yar Daniel;Messe, Steven R.;Parthasarathy, Ashwin B.;Yodh, Arjun G.
关键词：
动态脑自动调节（dCA）可以从动脉血压（ABP）和脑血流量（CBF）的自发振荡中导出。经颅多普勒（TCD）测量CBF速度，通常用于评估dCA。扩散相关光谱（DCS）是一种很有前途的光学技术，用于无创CBF监测，所以在这里，我们的目的是验证DCS作为定量dCA的工具。对33例健康成人和17例急性缺血性脑卒中患者进行了高速（20 Hz）DCS和TCD同步监测。通过使用ABP和CBF（或CBF-速度）的傅立叶分解的传递函数分析计算dCA参数。在健康志愿者（r = 0.73，p < 0.001）和中风患者（r = 0.76，p = 0.003）中发现DCS和TCD测量的增益（调节幅度）之间存在强相关性。DCS增益在两组中都保持了较强的重测信度（ICC分别为0.87和0.82）。DCS和TCD衍生相（调节潜伏期）在健康志愿者中无显著相关性（r = 0.12，p = 0.50），但在卒中患者中中度相关（r = 0.65，p = 0.006）。两组的DCS衍生相位均可重现（ICC分别为0.88和0.90）。高频DCS是一种很有前途的非侵入性床边技术，可以利用它来量化静息状态数据中的dCA，但TCD和DCS衍生相位之间的差异需要进一步研究。
Dynamic cerebral autoregulation (dCA) can be derived from spontaneous oscillations in arterial blood pressure (ABP) and cerebral blood flow (CBF). Transcranial Doppler (TCD) measures CBF-velocity and is commonly used to assess dCA. Diffuse correlation spectroscopy (DCS) is a promising optical technique for non-invasive CBF monitoring, so here we aimed to validate DCS as a tool for quantifying dCA. In 33 healthy adults and 17 acute ischemic stroke patients, resting-state hemodynamic were monitored simultaneously with high-speed (20 Hz) DCS and TCD. dCA parameters were calcaulated by a transfer function analysis using a Fourier decomposition of ABP and CBF (or CBF-velocity). Strong correlation was found between DCS and TCD measured gain (magnitude of regulation) in healthy volunteers (r = 0.73, p < 0.001) and stroke patients (r = 0.76, p = 0.003). DCS-gain retained strong test-retest reliability in both groups (ICC 0.87 and 0.82, respectively). DCS and TCD-derived phase (latency of regulation) did not significantly correlate in healthy volunteers (r = 0.12, p = 0.50) but moderately correlated in stroke patients (r = 0.65, p = 0.006). DCS-derived phase was reproducible in both groups (ICC 0.88 and 0.90, respectively). High-frequency DCS is a promising non-invasive bedside technique that can be leveraged to quantify dCA from resting-state data, but the discrepancy between TCD and DCS-derived phase requires further investigation.