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Journal of Biomedical Optics • Open Access

Optical bedside monitoring of cerebral perfusion: technological and methodological advances applied in a study on acute ischemic stroke
Author(s): Oliver Steinkellner; Clemens Gruber; Heidrun Wabnitz; Alexander Jelzow; Jens M. Steinbrink; Jochen B. Fiebach; Rainer Macdonald; Hellmuth Obrig

Paper Abstract

We present results of a clinical study on bedside perfusion monitoring of the human brain by optical bolus tracking. We measure the kinetics of the contrast agent indocyanine green using time-domain near-IR spectroscopy (tdNIRS) in 10 patients suffering from acute unilateral ischemic stroke. In all patients, a delay of the bolus over the affected when compared to the unaffected hemisphere is found (mean: 1.5 s, range: 0.2 s to 5.2 s). A portable time-domain near-IR reflectometer is optimized and approved for clinical studies. Data analysis based on statistical moments of time-of-flight distributions of diffusely reflected photons enables high sensitivity to intracerebral changes in bolus kinetics. Since the second centralized moment, variance, is preferentially sensitive to deep absorption changes, it provides a suitable representation of the cerebral signals relevant for perfusion monitoring in stroke. We show that variance-based bolus tracking is also less susceptible to motion artifacts, which often occur in severely affected patients. We present data that clearly manifest the applicability of the tdNIRS approach to assess cerebral perfusion in acute stroke patients at the bedside. This may be of high relevance to its introduction as a monitoring tool on stroke units.

Paper Details

Date Published: 1 November 2010
PDF: 10 pages
J. Biomed. Opt. 15(6) 061708 doi: 10.1117/1.3505009
Published in: Journal of Biomedical Optics Volume 15, Issue 6
Show Author Affiliations
Oliver Steinkellner, Physikalisch-Technische Bundesanstalt (Germany)
Clemens Gruber, Charité Universitätsmedizin Berlin (Germany)
Heidrun Wabnitz, Physikalisch-Technische Bundesanstalt (Germany)
Alexander Jelzow, Physikalisch-Technische Bundesanstalt (Germany)
Jens M. Steinbrink, Charité Universitätsmedizin Berlin (Germany)
Jochen B. Fiebach, Charité Universitätsmedizin Berlin (Germany)
Rainer Macdonald, Physikalisch-Technische Bundesanstalt (Germany)
Hellmuth Obrig, Charité Universitätsmedizin Berlin (Germany)


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