Research Papers: Sensing

Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope

[+] Author Affiliations
Ran Cheng, Yu Shang, Siqi Wang, Joyce M. Evans, Guoqiang Yu

University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506

Abner Rayapati

University of Kentucky, Department of Psychiatry, Lexington, Kentucky 40509

David C. Randall

University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506

University of Kentucky, Department of Physiology, Lexington, Kentucky 40536

J. Biomed. Opt. 19(1), 017001 (Jan 08, 2014). doi:10.1117/1.JBO.19.1.017001
History: Received September 12, 2013; Revised December 1, 2013; Accepted December 10, 2013
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Abstract.  Significant drops in arterial blood pressure and cerebral hemodynamics have been previously observed during vasovagal syncope (VVS). Continuous and simultaneous monitoring of these physiological variables during VVS is rare, but critical for determining which variable is the most sensitive parameter to predict VVS. The present study used a novel custom-designed diffuse correlation spectroscopy flow-oximeter and a finger plethysmograph to simultaneously monitor relative changes of cerebral blood flow (rCBF), cerebral oxygenation (i.e., oxygenated/deoxygenated/total hemoglobin concentration: r[HbO2]/r[Hb]/rTHC), and mean arterial pressure (rMAP) during 70 deg head-up tilt (HUT) in 14 healthy adults. Six subjects developed presyncope during HUT. Two-stage physiological responses during HUT were observed in the presyncopal group: slow and small changes in measured variables (i.e., Stage I), followed by rapid and dramatic decreases in rMAP, rCBF, r[HbO2], and rTHC (i.e., Stage II). Compared to other physiological variables, rCBF reached its breakpoint between the two stages earliest and had the largest decrease (76±8%) during presyncope. Our results suggest that rCBF has the best sensitivity for the assessment of VVS. Most importantly, a threshold of 50% rCBF decline completely separated the subjects from those without presyncope, suggesting its potential for predicting VVS.

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© 2014 Society of Photo-Optical Instrumentation Engineers

Citation

Ran Cheng ; Yu Shang ; Siqi Wang ; Joyce M. Evans ; Abner Rayapati, et al.
"Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope", J. Biomed. Opt. 19(1), 017001 (Jan 08, 2014). ; http://dx.doi.org/10.1117/1.JBO.19.1.017001


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