Non-invasive characterization of secondary brain injuries after severe acute brain injury using integrated functional optical imaging and electroencephalography

使用集成功能光学成像和脑电图对严重急性脑损伤后继发性脑损伤进行非侵入性表征

• 批准号: 10064369
• 负责人: Ulas Sunar
• 金额: $ 8.56万
• 依托单位: WRIGHT STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10064369
• 关键词: Acute; Acute Brain Injuries; Address; Blood flow; Brain; Brain Injuries; Brain region; Caring; Cerebrovascular Circulation; Cerebrum; Clinical; Color; Computer software; Custom; Device or Instrument Development; Devices; Diffuse; Diffusion; Electroencephalogram; Electroencephalography; Enrollment; FDA approved; Feedback; Goals; Gold; Human; Hypoxia; Injury; Intensive Care Units; Intervention; Investigation; Ischemia; Ischemic Stroke; Lead; Location; Measurement; Measures; Medicine; Metabolic; Monitor; Optics; Outcome; Oxygen; Patients; Physiologic pulse; Pilot Projects; Populations at Risk; Public Health; Records; Reporting; Scalp structure; Secondary to; Seizures; Severities; Signal Transduction; Site; Spectrum Analysis; Subarachnoid Hemorrhage; Survivors; System; TBI Patients; Technology; Testing; Time; Tissues; Traumatic Brain Injury; Trephine hole; base; brain electrical activity; brain tissue; cerebral oxygenation; computerized data processing; cost; data acquisition; data fusion; effective therapy; electric field; hemodynamics; high risk; imaging approach; improved; injury-related death; instrument; instrumentation; interest; light intensity; monitoring device; multidisciplinary; multimodality; optical imaging; programs; temporal measurement; tissue oxygenation; tool; validation studies

PROJECT SUMMARY/ABSTRACT There is a need for improved monitoring tools for the brain in TBI patients. Survivors of severe brain injuries may require care in an intensive care unit (ICU), where the brain is vulnerable to secondary brain injuries, defined by a mismatch between the metabolic supply and demand that creates ischemia. Existing technologies for monitoring secondary brain injuries are inadequate: continuous scalp EEG is noninvasive and detects seizures, but only indirectly reflects cerebral blood flow compromise. In some cases, invasive probes are placed within the brain to detect cerebral blood flow and brain tissue oxygenation directly. However, this strategy can be risky and only monitors a small region of the brain. Thus, there is a need for real-time, noninvasive, multimodal measurements of the brain’s electrical activity, oxygenation, and hemodynamics in humans. Our goal is to address this need through combined measurements of EEG and functional optical spectroscopy (EEG-Optical) instrumentation and analysis to provide a complementary fusion of data on brain activity and function. EEG records the brain’s local electrical field potentials with exquisite temporal resolution. Optical imaging uses low- intensity light to quantify cerebral blood flow (CBF) and cerebral oxygen saturation (StO2). In Aim 1, we will adapt our DCS current instrument for continuous for longitudinal monitoring of TBI patients alongside to clinical instruments. In Aim2, we will perform a validation study to evaluate this new, integrated, noninvasive technology by comparing directly with the gold standard, FDA-approved invasive measurement of brain blood flow and oxygenation in patients with TBI undergoing clinically-standard invasive monitoring. This study will lead directly to further device development and investigational device application, with a goal for a device that will allow for brain blood flow and oxygenation monitoring in all patients with acute brain injuries in order to guide management.

项目摘要/摘要 有必要改进脑外伤患者的大脑监测工具。严重脑损伤的幸存者可能会 需要在重症监护病房(ICU)接受护理，在ICU中，大脑容易受到继发性脑损伤，定义为 代谢供需之间的不匹配造成了缺血。现有技术可用于 监测继发性脑损伤是不够的：连续的头皮脑电是非侵入性的，可以检测癫痫发作， 但只能间接反映脑血流受损。在某些情况下，侵入性探测器被放置在 直接检测脑部血流量和脑组织氧合情况。然而，这种策略可能会有风险，而且 只监测大脑的一小块区域。因此，需要实时、非侵入式、多模式 测量人类大脑的电活动、氧合和血流动力学。我们的目标是 通过联合测量脑电和功能光学光谱(EEG-光学)来满足这一需求 仪器和分析，以提供关于大脑活动和功能的补充数据融合。脑电 以精确的时间分辨率记录大脑的局部电场电位。光学成像使用低光 强光定量脑血流量(CBF)和脑血氧饱和度(StO2)。在目标1中，我们将适应 我公司生产的连续监测颅脑损伤患者和临床的DCS型电流仪 乐器。在AIM2中，我们将进行一项验证研究，以评估这项新的、集成的、非侵入性技术 通过与金标准直接比较，FDA批准的有创脑血流测量和 接受临床标准侵入性监测的脑外伤患者的氧合情况。这项研究将直接导致 进一步的设备开发和研究设备应用，目标是一种设备将允许 急性颅脑损伤患者的脑血流和氧合监测 管理层。