Epidural Oscillating Cardiac-Gated Intracranial Implant Modulates Cerebral Blood Flow.
Epidural Oscillating Cardiac-Gated Intracranial Implant Modulates Cerebral Blood Flow.
复制标题
硬膜外振荡心门控颅内植入物调节脑血流。
DOI：
10.1093/neuros/nyaa188
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发表时间：
2020
期刊：
影响因子：
4.8
通讯作者：
Loth,Francis
中科院分区：
文献类型：
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作者：
Luciano,MarkG;Dombrowski,StephenM;El-Khoury,Serge;Yang,Jun;Thyagaraj,Suraj;Qvarlander,Sara;Khalid,Syed;Suk,Ian;Manbachi,Amir;Loth,Francis
背景我们以前已经报道了一种方法和装置，能够操纵ICP脉动，同时最小限度地影响平均ICP. ObjectiveTest的假设，即颅内压（ICP）脉冲波形的不同调制将有不同的影响脑血流（CBF）.MethodsUsing硬膜外球囊导管连接到心脏门控振荡泵，13只犬受试者接受ICP波形操作，比较连续动物的不同振荡序列。将硬膜外球囊单侧植入到外侧裂沟的上级。受试者接受ICP脉冲增强，减少和反转协议，直接比较系统激活和失活的时间段。测量双侧沿着颅内压和脑血流量，同时测量体循环压和心率。结果心门控球囊植入后，同侧/对侧ICP脉冲幅度随植入时间延长而增加（分别为217%/202%，P<0.01），对侧ICP脉冲幅度随植入时间延长而增加（分别为217%/202%，P<0.01）。0005）和倒置（139%/120%，P<. 0005）。与ICP平均值相关的观察到的变化较小，随着增加而增加（23%/31%，P<0.05）。0001），而随着倒置而降低（7%/11%，P=. 006/. 0003）和减少（4%/5%，P<. 0005）。倒置法和复位法均使脑血流量增加（28%/7.4%，P<0.05）。0001/P=. 006和2.4%/1.3%，P<0.05。0001/P=. 003），但不是增强协议。在CBF的变化与ICP脉冲幅度和收缩期峰值的变化，而不是与平均ICP或全身变量（心率，动脉血压）的变化。ConclusionCardiac-gated操纵ICP脉动允许颅内脉动动力学的研究，并提供了一个潜在的手段改变CBF。
BackgroundWe have previously reported a method and device capable of manipulating ICP pulsatility while minimally effecting mean ICP.ObjectiveTo test the hypothesis that different modulations of the intracranial pressure (ICP) pulse waveform will have a differential effect on cerebral blood flow (CBF).MethodsUsing an epidural balloon catheter attached to a cardiac-gated oscillating pump, 13 canine subjects underwent ICP waveform manipulation comparing different sequences of oscillation in successive animals. The epidural balloon was implanted unilaterally superior to the Sylvian sulcus. Subjects underwent ICP pulse augmentation, reduction and inversion protocols, directly comparing time segments of system activation and deactivation. ICP and CBF were measured bilaterally along with systemic pressure and heart rate. CBF was measured using both thermal diffusion, and laser doppler probes.ResultsThe activation of the cardiac-gate balloon implant resulted in an ipsilateral/contralateral ICP pulse amplitude increase with augmentation (217%/202% respectively, P<. 0005) and inversion (139%/120%, P<. 0005). The observed changes associated with the ICP mean values were smaller, increasing with augmentation (23%/31%, P<. 0001) while decreasing with inversion (7%/11%, P=. 006/. 0003) and reduction (4%/5%, P<. 0005). CBF increase was observed for both inversion and reduction protocols (28%/7.4%, P<. 0001/P=. 006 and 2.4%/1.3%, P<. 0001/P=. 003), but not the augmentation protocol. The change in CBF was correlated with ICP pulse amplitude and systolic peak changes and not with change in mean ICP or systemic variables (heart rate, arterial blood pressure).ConclusionCardiac-gated manipulation of ICP pulsatility allows the study of intracranial pulsatile dynamics and provides a potential means of altering CBF.