Transcranial optical monitoring for detecting intracranial pressure alterations in children with benign external hydrocephalus: a proof-of-concept study

Maruccia, Federica; Tagliabue, Susanna; Fischer, Jonas; Kacprzak, Michał; Pérez-Hoyos, Santi; Rosas, Katiuska; Álvarez, Ignacio; Sahuquillo, Juan; Durdurán, Turgut; Poca, María

doi:10.1117/1.nph.9.4.045005

Cited by 5 publications

(3 citation statements)

References 70 publications

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“…The use of optical neuromonitoring may aid in monitoring the efficacy of therapeutic strategies to reduce inflammation, and subsequent injury, during and following CPB. Advanced optical techniques to non-invasively estimate intracranial pressure are under development and could provide further discrimination in the future [77][78][79][80][81][82].…”

Section: Cerebral Metabolism and Injury During Post-cpb Survival (0-2...mentioning

confidence: 99%

Diffuse Optical Monitoring of Cerebral Hemodynamics and Oxygen Metabolism during and after Cardiopulmonary Bypass: Hematocrit Correction and Neurological Vulnerability

Benson,

Aronowitz,

Forti

et al. 2023

Metabolites

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Cardiopulmonary bypass (CPB) provides cerebral oxygenation and blood flow (CBF) during neonatal congenital heart surgery, but the impacts of CPB on brain oxygen supply and metabolic demands are generally unknown. To elucidate this physiology, we used diffuse correlation spectroscopy and frequency-domain diffuse optical spectroscopy to continuously measure CBF, oxygen extraction fraction (OEF), and oxygen metabolism (CMRO2) in 27 neonatal swine before, during, and up to 24 h after CPB. Concurrently, we sampled cerebral microdialysis biomarkers of metabolic distress (lactate–pyruvate ratio) and injury (glycerol). We applied a novel theoretical approach to correct for hematocrit variation during optical quantification of CBF in vivo. Without correction, a mean (95% CI) +53% (42, 63) increase in hematocrit resulted in a physiologically improbable +58% (27, 90) increase in CMRO2 relative to baseline at CPB initiation; following correction, CMRO2 did not differ from baseline at this timepoint. After CPB initiation, OEF increased but CBF and CMRO2 decreased with CPB time; these temporal trends persisted for 0–8 h following CPB and coincided with a 48% (7, 90) elevation of glycerol. The temporal trends and glycerol elevation resolved by 8–24 h. The hematocrit correction improved quantification of cerebral physiologic trends that precede and coincide with neurological injury following CPB.

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Section: Cerebral Metabolism and Injury During Post-cpb Survival (0-2...mentioning

confidence: 99%

Diffuse Optical Monitoring of Cerebral Hemodynamics and Oxygen Metabolism during and after Cardiopulmonary Bypass: Hematocrit Correction and Neurological Vulnerability

Benson,

Aronowitz,

Forti

et al. 2023

Metabolites

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show abstract

“… 16 – 19 Parallelly, a related diffuse optical technique called diffusion correlation spectroscopy has been used in pediatric subjects with hydrocephalus for rapid and noninvasive assessment of intracranial pressure. 20 – 24 However, to the best of our knowledge optical sensing has not been applied or explored in the realm of shuntodynia thus far. Additionally, most previous studies that have used optical sensing for pain studies have mostly focused on using these methods for detecting functional changes (such as blood oxygenation, volume, or tissue perfusion) from deep tissue layers.…”

Section: Introductionmentioning

confidence: 99%

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Kline,

Vishwanath,

Colbrunn

et al. 2024

J. Biomed. Opt.

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Shuntodynia is patient reported pain at the site of the implanted ventriculoperitoneal (VP) shunt. Pediatric hydrocephalus requiring shunt placement is a chronic and prevalent standard of care treatment and requires lifetime management. Shuntodynia is a subjective measure of shunt dysfunction. Quantitative, white-light tissue spectroscopy could be used to objectively identify this condition in the clinic.Aim: Pediatric subjects were recruited for optical sensing during routine clinical follow-up visits, post-VP shunt implantations. Acquired optical signals were translated into skin-hemodynamic signatures and were compared between subjects that reported shuntodynia versus those that did not.Approach: Diffuse reflectance spectroscopy (DRS) measurements were collected between 450 and 700 nm using a single-channel fiber-optical probe from (N ¼ 35) patients. Multiple reflectance spectra were obtained by the attending physician from regions both proximal and distal to the VP shunt sites and from a matched contralateral site for each subject. Acquired reflectance spectra were processed quantitatively into functional tissue optical endpoints. A two-way, repeated measures analysis of variance was used to assess whether and which of the optical variables were statistically separable, across subjects with shuntodynia versus those without.Results: Analyses indicated that intrapatient differences in vascular oxygen saturation measured between shunt sites relative to that obtained at the scar or contralateral sites was significantly lower in the pain group. We also find that the total hemoglobin concentrations at the shunt site were lowest relative to the other sites for subjects reporting pain. These findings suggest that shuntodynia pain arises in the scalp tissue around the implanted shunts and may be caused due to hypoxia and inflammation.Conclusions: Optically derived hemodynamic variables were statistically significantly different in subjects presenting with shuntodynia relative to those without. DRS could provide a viable mode in routine bedside monitoring of subjects with VP shunts for clinical management and assessment of shuntodynia.

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“…Optical spectroscopic methods have also been widely used to monitor and assess pain in exercise science and sports-medicine [16][17][18][19] . Parallelly, a related diffuse optical technique called diffusion correlation spectroscopy (DCS) has been used in pediatric subjects with hydrocephalus for rapid and non-invasive assessment of intracranial pressure (ICP) [20][21][22][23][24] . However, to the best of our knowledge optical sensing has not been applied or explored in the realm of shuntodynia this far.…”

Section: Introductionmentioning

confidence: 99%

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Kline,

Vishwanath,

Colbrunn

et al. 2023

Preprint

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Significance: Shuntodynia is patient reported pain at the site of the implanted ventriculo-peritoneal (VP) shunt. Pediatric hydrocephalus requiring shunt placement is a chronic and prevalent standard of care treatment and requiring lifetime management. Shuntodynia is a subjective measure of shunt dysfunction. Quantitative, white-light tissue spectroscopy could be used to objectively identify this condition in the clinic. Aim: Pediatric subjects were recruited for optical sensing during routine clinical follow-up visits, post VP shunt implantations. Acquired optical signals were translated into skin-hemodynamic signatures and were compared between subjects that reported shuntodynia vs. those that did not. Approach: Diffuse reflectance spectroscopy (DRS) measurements were collected between 450-700 nm using a single-channel fiber-optical probe from (N=35) patients. Multiple reflectance spectra were obtained by the attending physician from regions both proximal and distal to the VP shunt sites, and from a matched contralateral site for each subject. Acquired reflectance spectra were processed quantitatively into functional tissue optical endpoints. A two-way, repeated measures analysis of variance (ANOVA) was used to assess whether and which of the optical variables were statistically separable, across subjects with shuntodynia vs. those without. Results: Results showed that vascular oxygen saturation was significantly lower in subjects reporting shuntodynia, when measured proximal to shunt sites. Subjects with shuntodynia also had lower total hemoglobin at the shunt site relative to distal sites. Both patient groups showed higher tissue scattering at the shunt sites in comparison to the contralateral sites. Conclusions: Optically derived hemodynamic variables were statistically significantly different in subjects presenting with shuntodynia relative to those without. DRS could provide a viable mode in routine bedside monitoring of subjects with VP shunts for clinical management and risk assessment of shuntodynia.

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Transcranial optical monitoring for detecting intracranial pressure alterations in children with benign external hydrocephalus: a proof-of-concept study

Cited by 5 publications

References 70 publications

Diffuse Optical Monitoring of Cerebral Hemodynamics and Oxygen Metabolism during and after Cardiopulmonary Bypass: Hematocrit Correction and Neurological Vulnerability

Diffuse Optical Monitoring of Cerebral Hemodynamics and Oxygen Metabolism during and after Cardiopulmonary Bypass: Hematocrit Correction and Neurological Vulnerability

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

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