Quantitative analysis of similarity between cerebral arterial blood volume and intracranial pressure pulse waveforms during intracranial pressure plateau waves

Ziółkowski, Arkadiusz; Kasprowicz, Magdalena; Kazimierska, Agnieszka; Czosnyka, Marek

doi:10.1016/j.bas.2024.102832

Cited by 3 publications

References 29 publications

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Relationship between the amplitudes of cerebral blood flow velocity and intracranial pressure using linear and non-linear approach

Pelah,

Najdek,

Czosnyka

et al. 2024

J Clin Monit Comput

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Intracranial pressure (ICP), cerebral blood flow and volume are affected by craniospinal elasticity and cerebrospinal fluid dynamics, interacting in complex, nonlinear ways. Traumatic brain injury (TBI) may significantly alter this relationship. This retrospective study investigated the relationship between the vascular and parenchymal intracranial compartments by analysing two amplitudes: cerebral blood flow velocity (AmpCBFV) and ICP (AMP) during hypocapnia manoeuvre in TBI patients. Twenty-nine TBI patients hospitalised at Addenbrooke’s Hospital, whose ICP and CBFV were monitored during mild hypocapnia, were included. A linear metric of the relationship was defined as a moving-window correlation (R) between AmpCBFV and AMP, named RAMP. Nonlinear metrics were based on the Joint Symbolical Analysis (JSA) algorithm, which transforms AmpCBFV and AMP into sequences of symbols (‘words’) using a binary scheme with word lengths of three. The mean AmpCBFV and AMP were not significantly correlated at baseline (r = − 0.10) or during hypocapnia (r = − 0.19). However, the RAMP index was significantly higher at baseline (0.64 ± 0.04) compared to hypocapnia (0.57 ± 0.04, p = 0.035). The relative frequency of symmetrical word types (JSAsym) describing the AmpCBFV–AMP interaction decreased during hypocapnia (0.35 ± 0.30) compared to baseline (0.44 ± 0.030; p = 0.004). Our results indicate that while the grouped-averaged AmpCBFV and AMP were not significantly correlated, either at baseline or during hypocapnia, significant changes were observed when using RAMP and JSA indices. Further validation of these new parameters, which reflect the association between the vascular and parenchymal intracranial compartments, is needed in a larger cohort.

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Relationship between the amplitudes of cerebral blood flow velocity and intracranial pressure using linear and non-linear approach

Pelah,

Najdek,

Czosnyka

et al. 2024

J Clin Monit Comput

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Prospective comparative clinical trials of novel non-invasive intracranial pressure pulse wave monitoring technologies: preliminary clinical data

Putnynaite,

Chaleckas,

Deimantavicius

et al. 2024

Interface Focus.

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Intracranial pressure (ICP) monitoring is crucial in the management of traumatic brain injury (TBI) and other neurological conditions. Elevated ICP or too low intracranial compliance (ICC) can compromise brain perfusion. Simultaneous monitoring of ICP and ICC is needed to optimize patient-specific brain perfusion in pathological conditions. Surrogate ICC changes can be extracted by analysis of ICP pulse wave morphology. Non-invasive, fully passive sensor and ICC changes monitoring are needed. This study introduces Archimedes, a novel, fully passive, non-invasive ICP wave monitor that utilizes mechanical pulsatile movement of the eyeball to assess ICP pulse waveforms. Preliminary findings indicate a high correlation r = [0.919; 0.96] between non-invasive and invasive ICP pulse wave morphologies, demonstrating the device’s potential for accurate ICP pulse waveform monitoring. Additionally, the monitor can discern ICC changes, providing valuable insights for TBI and normal tension glaucoma patients according to the shape of non-invasive measured ICP pulse wave. The k-nearest neighbours algorithm used in preliminary glaucoma studies yielded promising diagnostic performance, with an accuracy of 0.89, sensitivity of 0.82, specificity of 1.0 and area under curve 0.91. Ethical approvals for ongoing studies have been secured. Initial results indicate that Archimedes real-time ICC non-invasive monitor is safe, cost-effective alternative to conventional monitoring techniques.

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Relationship between the amplitudes of cerebral blood flow velocity and intracranial pressure during mild hypocapnia

Pelah,

Najdek,

Czosnyka

et al. 2024

Preprint

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Purpose The amplitude of the intracranial pressure pulse waveform (AMP) has been a focal point of current research. A pulsatile component with distinct morphology is also present in the cerebral blood flow velocity (CBFV) signal. While the amplitude of the CBFV (AmpCBFV) has been used in indices like the pulsatility index, the relationship between AmpCBFV and AMP has not been established. This study aimed to investigate this relationship via a novel linear moving-window correlation index (RAMP) and a nonlinear joint symbolic analysis (JSA). Methods Twenty-nine traumatic brain injury (TBI) patients at Addenbrooke’s Hospital, whose intracranial pressure (ICP) and CBFV were monitored, underwent mild hypocapnia to test cerebrovascular reactivity. RAMP was defined as a moving-window correlation between AmpCBFV and AMP. JSA transformed AmpCBFV and AMP into sequences of symbols (‘words’), using a binary scheme with word lengths of three. Results The mean AmpCBFV and AMP were not significantly correlated at baseline (r=-0.10) or during hypocapnia (r=-0.19). However, the RAMP index was significantly higher at baseline (0.64 ± 0.04) than during hypocapnia (0.57 ± 0.04, p = 0.035). Synchronisation in the AmpCBFV–AMP interaction, quantified by JSA, decreased during hypocapnia (0.35 ± 0.3) compared to baseline (0.44 ± 0.03; p = 0.004). Conclusions Our results indicate that while the mean AmpCBFV and AMP were not significantly correlated, either at baseline or during hypocapnia, significant changes were observed when the JSA and RAMP indicies, new parameters reflecting the association between the vascular and parenchymal intracranial compartments, were used. Further validation in a larger cohort is needed.

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Quantitative analysis of similarity between cerebral arterial blood volume and intracranial pressure pulse waveforms during intracranial pressure plateau waves

Cited by 3 publications

References 29 publications

Relationship between the amplitudes of cerebral blood flow velocity and intracranial pressure using linear and non-linear approach

Relationship between the amplitudes of cerebral blood flow velocity and intracranial pressure using linear and non-linear approach

Prospective comparative clinical trials of novel non-invasive intracranial pressure pulse wave monitoring technologies: preliminary clinical data

Relationship between the amplitudes of cerebral blood flow velocity and intracranial pressure during mild hypocapnia

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