Diffuse Optics for Acute Stroke Management

描述(由申请人提供)：生物工程研究伙伴关系(BRP)将具有脑血管生理学和人类中风专业知识的生物医学科学家和临床医生与具有光学、电子学、数学和计算专业知识的生物物理学科学家和工程师结合在一起。这些合作伙伴将开发和验证一种新型光学仪器，用于在床边监测急性中风患者的脑血流量(CBF)和相关的血流动力学。在今天的美国，缺血性中风是导致残疾和死亡的主要原因，每年影响大约70万人，预计每十年的成本超过4000亿美元。治疗的主要挑战之一是相对无法获得脑组织的生理监测。CT、MRI和PET扫描等成像手段需要大型且昂贵的仪器，严重限制了它们在患者住院期间的使用。因此，旨在增加卒中区域及其周围血流量的卒中干预措施，通常是根据经验或临床恶化而开出的。通过提供在床边连续测量CBF和相关血流动力学的技术，漫反射光学技术有可能极大地改变患者的护理，从而允许根据组织反应为每个患者优化和个性化管理干预措施。在动物模型和人体受试者中获得的初步数据证明了这种方法的可行性。宾夕法尼亚大学的四个研究小组将合作进一步开发并在临床上验证这种方法。由P.I.Arjun Yodh领导的生物医学光学小组将发挥核心作用，参与和协调项目活动。设备开发将与理查德·范·伯格领导的电子仪器小组合作进行。动物模型的验证将与乔尔·格林伯格领导的动物研究小组合作进行。将与John Detre领导的临床研究小组合作，对正常志愿者和急性中风患者的MRI和SPECT血流测量进行验证。动物和人体数据将被用来指导仪器设计和信号处理的改进，并为未来的临床试验开发样本量估计，这些临床试验将明确证明床边CBF监测在中风护理中的有效性。技术转让中心主任Michael Cleare将推动技术商业化和传播。用于急性卒中治疗的漫反射光学。 公共卫生相关性：在当今美国，缺血性中风是导致残疾和死亡的主要原因。没有技术可以监测中风患者在中风后的几个小时和几天内的大脑血流。本项目的目标是开发和验证一种在急性中风患者出现新症状之前在床边监测脑血流和氧合的仪器，以方便他们的临床管理。

DESCRIPTION (provided by applicant): This Bioengineering Research Partnership (BRP) couples biomedical scientists & clinicians with expertise in cerebrovascular physiology and human stroke with biophysical scientists & engineers with expertise in optics, electronics, mathematics and computation. These partners will develop and validate a novel optical instrument for bedside monitoring of cerebral blood flow (CBF) and associated hemodynamics in acute stroke patients. Ischemic stroke is the leading cause of disability and a leading cause of mortality in the US today, affecting approximately 700,000 people annually with a projected cost of over $400 billion per decade. One of the major treatment challenges is the relative inaccessibility of brain tissue to physiological monitoring. Imaging modalities such as CT, MRI, and PET scanning require large and costly instrumentation that severely limit their use during patient hospitalization. Thus stroke interventions, intended to increase blood flow in and around the stroke region, are usually prescribed empirically or in response to clinical deterioration. Diffuse optics holds potential to dramatically change patient care by providing technology to measure CBF and associated hemodynamics continuously at the bedside, thereby permitting management interventions to be optimized and individualized for each patient based on tissue response. Preliminary data acquired in animal models and human subjects demonstrate the feasibility of this approach. Four research groups at the University of Pennsylvania will partner to further develop and validate this approach in the clinic. The Biomedical Optics Group led by P.I. Arjun Yodh will assume a central role participating in and coordinating project activities. Device development will be carried out in collaboration with the Electronic Instrumentation Group, led by Richard Van Berg. Validation in animal models will be carried out in collaboration with the Animal Studies Group, led by Joel Greenberg. Validation against MRI and SPECT blood flow measures in normal volunteers and in patients with acute stroke will be carried out in collaboration with the Clinical Studies Group, led by John Detre. Animal and human data will be used to guide refinements in instrument design and signal processing, and to develop sample size estimates for future clinical trials that will definitively demonstrate the efficacy of bedside CBF monitoring in stroke care. Technology commercialization and dissemination will be facilitated by Michael Cleare, Director of the Center for Technology Transfer. Diffuse Optics for Acute Stroke Management. PUBLIC HEALTH RELEVANCE: Ischemic stroke is the leading cause of disability and a leading cause of mortality in the United States today. There is no technique for monitoring blood flow in the brain of stroke victims in the hours and days following their stroke. The goal of this project is to develop and validate an instrument for monitoring blood flow and oxygenation in the brain of acute stroke patients at the bedside prior to the onset of new symptoms so as to facilitate their clinical management.