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

项目总结/摘要 需要用于TBI患者的大脑的改进的监测工具。严重脑损伤的幸存者可能 需要在重症监护室（ICU）接受护理，在ICU中，大脑易受继发性脑损伤的影响， 新陈代谢的供给和需求之间的不匹配会造成局部缺血。现有技术 监测继发性脑损伤是不够的：连续头皮脑电图是非侵入性的，并检测癫痫发作， 但仅间接反映脑血流受损。在某些情况下，侵入性探针被放置在 brain直接检测脑血流量和脑组织氧合。然而，这种策略可能有风险， 只监控大脑的一小部分因此，需要实时、无创、多模式的 测量人类大脑的电活动、氧合和血液动力学。我们的目标是 通过EEG和功能光学光谱（EEG-光学）的组合测量满足这一需求 仪器和分析，以提供关于大脑活动和功能的数据的互补融合。EEG 以精确的时间分辨率记录了大脑的局部电场电位。光学成像使用低- 光强度以量化脑血流量（CBF）和脑氧饱和度（StO 2）。在目标1中，我们将适应 我们的DCS当前仪器用于TBI患者的连续纵向监测， 仪器.在目标2中，我们将进行验证研究，以评估这种新的、集成的、非侵入性技术 通过直接与金标准进行比较，FDA批准的脑血流量侵入性测量， 氧合作用TBI患者进行临床标准侵入性监测。这项研究将直接导致 进一步的器械开发和试验用器械应用，目标是开发一种允许 对所有急性脑损伤患者进行脑血流和氧合监测，以指导 管理

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.