Assessment of cerebral autoregulation using continuous-wave near-infrared spectroscopy during squat-stand maneuvers in subjects with symptoms of orthostatic intolerance
Orthostatic lightheadedness in healthy young adults often leads to syncope in severe cases. One suggested underlying mechanism of orthostatic lightheadedness is a drop in transient blood pressure (BP); however, a decrease in BP does not always lead to a drop in cerebral blood flow (CBF) due to cereb...
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| Published in | Scientific reports Vol. 8; no. 1; pp. 13257 - 11 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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London
Nature Publishing Group UK
05.09.2018
Nature Publishing Group |
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| Abstract | Orthostatic lightheadedness in healthy young adults often leads to syncope in severe cases. One suggested underlying mechanism of orthostatic lightheadedness is a drop in transient blood pressure (BP); however, a decrease in BP does not always lead to a drop in cerebral blood flow (CBF) due to cerebral autoregulation (CA). We present a direct assessment method of CA using a multichannel continuous-wave near-infrared spectroscopy (CW-NIRS) device that measures the temporal changes in oxy- and deoxy-hemoglobin concentrations in the prefrontal cortex. Twenty healthy young adults were recruited. During the experiment, continuous beat-to-beat BP and heart rate were simultaneously measured during repetitive squat-stand maneuvers. We introduce a new metric termed ‘time-derivative hemodynamic model (DHbT)’, which is the time-derivative of total-hemoglobin concentration change that reflects the changes of cerebral blood volume and CBF. Although the absolute levels and the variations of systolic and diastolic BPs and mean arterial pressure showed no significant difference between the two groups, the proposed model showed a distinct difference in slope variation and response time of DHbT between the subjects with frequent symptom of orthostatic intolerance and the healthy control subjects. Thus, these results clearly demonstrate the feasibility of using CW-NIRS devices as a CA performance assessment tool. |
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| AbstractList | Orthostatic lightheadedness in healthy young adults often leads to syncope in severe cases. One suggested underlying mechanism of orthostatic lightheadedness is a drop in transient blood pressure (BP); however, a decrease in BP does not always lead to a drop in cerebral blood flow (CBF) due to cerebral autoregulation (CA). We present a direct assessment method of CA using a multichannel continuous-wave near-infrared spectroscopy (CW-NIRS) device that measures the temporal changes in oxy- and deoxy-hemoglobin concentrations in the prefrontal cortex. Twenty healthy young adults were recruited. During the experiment, continuous beat-to-beat BP and heart rate were simultaneously measured during repetitive squat-stand maneuvers. We introduce a new metric termed ‘time-derivative hemodynamic model (DHbT)’, which is the time-derivative of total-hemoglobin concentration change that reflects the changes of cerebral blood volume and CBF. Although the absolute levels and the variations of systolic and diastolic BPs and mean arterial pressure showed no significant difference between the two groups, the proposed model showed a distinct difference in slope variation and response time of DHbT between the subjects with frequent symptom of orthostatic intolerance and the healthy control subjects. Thus, these results clearly demonstrate the feasibility of using CW-NIRS devices as a CA performance assessment tool. Orthostatic lightheadedness in healthy young adults often leads to syncope in severe cases. One suggested underlying mechanism of orthostatic lightheadedness is a drop in transient blood pressure (BP); however, a decrease in BP does not always lead to a drop in cerebral blood flow (CBF) due to cerebral autoregulation (CA). We present a direct assessment method of CA using a multichannel continuous-wave near-infrared spectroscopy (CW-NIRS) device that measures the temporal changes in oxy- and deoxy-hemoglobin concentrations in the prefrontal cortex. Twenty healthy young adults were recruited. During the experiment, continuous beat-to-beat BP and heart rate were simultaneously measured during repetitive squat-stand maneuvers. We introduce a new metric termed 'time-derivative hemodynamic model (DHbT)', which is the time-derivative of total-hemoglobin concentration change that reflects the changes of cerebral blood volume and CBF. Although the absolute levels and the variations of systolic and diastolic BPs and mean arterial pressure showed no significant difference between the two groups, the proposed model showed a distinct difference in slope variation and response time of DHbT between the subjects with frequent symptom of orthostatic intolerance and the healthy control subjects. Thus, these results clearly demonstrate the feasibility of using CW-NIRS devices as a CA performance assessment tool.Orthostatic lightheadedness in healthy young adults often leads to syncope in severe cases. One suggested underlying mechanism of orthostatic lightheadedness is a drop in transient blood pressure (BP); however, a decrease in BP does not always lead to a drop in cerebral blood flow (CBF) due to cerebral autoregulation (CA). We present a direct assessment method of CA using a multichannel continuous-wave near-infrared spectroscopy (CW-NIRS) device that measures the temporal changes in oxy- and deoxy-hemoglobin concentrations in the prefrontal cortex. Twenty healthy young adults were recruited. During the experiment, continuous beat-to-beat BP and heart rate were simultaneously measured during repetitive squat-stand maneuvers. We introduce a new metric termed 'time-derivative hemodynamic model (DHbT)', which is the time-derivative of total-hemoglobin concentration change that reflects the changes of cerebral blood volume and CBF. Although the absolute levels and the variations of systolic and diastolic BPs and mean arterial pressure showed no significant difference between the two groups, the proposed model showed a distinct difference in slope variation and response time of DHbT between the subjects with frequent symptom of orthostatic intolerance and the healthy control subjects. Thus, these results clearly demonstrate the feasibility of using CW-NIRS devices as a CA performance assessment tool. |
| ArticleNumber | 13257 |
| Author | Hwang, Gunpil Bae, Hyeon-Min Choi, Jong-Kwan Ji, Minsu Ko, Sang-Bae Kim, Jae-Myoung Choi, Mingyu |
| Author_xml | – sequence: 1 givenname: Jae-Myoung orcidid: 0000-0001-9538-9634 surname: Kim fullname: Kim, Jae-Myoung organization: School of Electrical Engineering, Korea Advanced Institute of Science and Technology – sequence: 2 givenname: Jong-Kwan surname: Choi fullname: Choi, Jong-Kwan organization: School of Electrical Engineering, Korea Advanced Institute of Science and Technology – sequence: 3 givenname: Mingyu surname: Choi fullname: Choi, Mingyu organization: School of Electrical Engineering, Korea Advanced Institute of Science and Technology – sequence: 4 givenname: Minsu surname: Ji fullname: Ji, Minsu organization: School of Electrical Engineering, Korea Advanced Institute of Science and Technology – sequence: 5 givenname: Gunpil surname: Hwang fullname: Hwang, Gunpil organization: School of Electrical Engineering, Korea Advanced Institute of Science and Technology – sequence: 6 givenname: Sang-Bae surname: Ko fullname: Ko, Sang-Bae organization: Department of Neurology, Seoul National University Hospital – sequence: 7 givenname: Hyeon-Min surname: Bae fullname: Bae, Hyeon-Min email: hmbae@kaist.ac.kr organization: School of Electrical Engineering, Korea Advanced Institute of Science and Technology |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30185974$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1007/s00421-015-3197-6 10.1042/CS20060091 10.1016/j.clinph.2005.02.005 10.1152/jappl.1954.6.12.731 10.1088/0967-3334/19/3/001 10.1007/s102860200017 10.1016/j.jpeds.2010.09.004 10.1093/gerona/56.5.M273 10.1161/01.STR.5.5.630 10.1016/S0166-2236(97)01132-6 10.1007/BF00691245 10.1016/j.clp.2009.07.007 10.1038/jcbfm.2015.5 10.1001/archneur.1997.00550180055012 10.1016/j.neuroimage.2012.03.049 10.1007/s10286-016-0382-6 10.1016/j.jneumeth.2015.02.006 10.1016/S0028-3932(97)00129-2 10.1002/ana.1006 10.1152/japplphysiol.00177.2005 10.1152/jappl.1990.68.3.1086 10.1007/s10286-007-1004-0 10.1088/0031-9155/33/12/008 10.1038/jcbfm.2008.13 10.1111/ene.13737 10.1117/12.875944 10.1007/s00420-002-0395-4 |
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| Title | Assessment of cerebral autoregulation using continuous-wave near-infrared spectroscopy during squat-stand maneuvers in subjects with symptoms of orthostatic intolerance |
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