Non-invasive characterization of secondary brain injuries after severe acute brain injury using integrated functional optical imaging and electroencephalography

使用集成功能光学成像和脑电图对严重急性脑损伤后继发性脑损伤进行非侵入性表征

• 批准号: 10064369
• 负责人: Ulas Sunar
• 金额: $ 8.56万
• 依托单位: WRIGHT STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10064369
• 关键词: Acute; Acute Brain Injuries; Address; Blood flow; Brain; Brain Injuries; Brain region; Caring; Cerebrovascular Circulation; Cerebrum; Clinical; Color; Computer software; Custom; Device or Instrument Development; Devices; Diffuse; Diffusion; Electroencephalogram; Electroencephalography; Enrollment; FDA approved; Feedback; Goals; Gold; Human; Hypoxia; Injury; Intensive Care Units; Intervention; Investigation; Ischemia; Ischemic Stroke; Lead; Location; Measurement; Measures; Medicine; Metabolic; Monitor; Optics; Outcome; Oxygen; Patients; Physiologic pulse; Pilot Projects; Populations at Risk; Public Health; Records; Reporting; Scalp structure; Secondary to; Seizures; Severities; Signal Transduction; Site; Spectrum Analysis; Subarachnoid Hemorrhage; Survivors; System; TBI Patients; Technology; Testing; Time; Tissues; Traumatic Brain Injury; Trephine hole; base; brain electrical activity; brain tissue; cerebral oxygenation; computerized data processing; cost; data acquisition; data fusion; effective therapy; electric field; hemodynamics; high risk; imaging approach; improved; injury-related death; instrument; instrumentation; interest; light intensity; monitoring device; multidisciplinary; multimodality; optical imaging; programs; temporal measurement; tissue oxygenation; tool; validation studies

PROJECT SUMMARY/ABSTRACT There is a need for improved monitoring tools for the brain in TBI patients. Survivors of severe brain injuries may require care in an intensive care unit (ICU), where the brain is vulnerable to secondary brain injuries, defined by a mismatch between the metabolic supply and demand that creates ischemia. Existing technologies for monitoring secondary brain injuries are inadequate: continuous scalp EEG is noninvasive and detects seizures, but only indirectly reflects cerebral blood flow compromise. In some cases, invasive probes are placed within the brain to detect cerebral blood flow and brain tissue oxygenation directly. However, this strategy can be risky and only monitors a small region of the brain. Thus, there is a need for real-time, noninvasive, multimodal measurements of the brain’s electrical activity, oxygenation, and hemodynamics in humans. Our goal is to address this need through combined measurements of EEG and functional optical spectroscopy (EEG-Optical) instrumentation and analysis to provide a complementary fusion of data on brain activity and function. EEG records the brain’s local electrical field potentials with exquisite temporal resolution. Optical imaging uses low- intensity light to quantify cerebral blood flow (CBF) and cerebral oxygen saturation (StO2). In Aim 1, we will adapt our DCS current instrument for continuous for longitudinal monitoring of TBI patients alongside to clinical instruments. In Aim2, we will perform a validation study to evaluate this new, integrated, noninvasive technology by comparing directly with the gold standard, FDA-approved invasive measurement of brain blood flow and oxygenation in patients with TBI undergoing clinically-standard invasive monitoring. This study will lead directly to further device development and investigational device application, with a goal for a device that will allow for brain blood flow and oxygenation monitoring in all patients with acute brain injuries in order to guide management.

项目摘要/摘要 需要改善TBI患者大脑的监测工具。严重脑损伤的幸存者可能 需要在重症监护病房（ICU）中进行护理，其中大脑容易受到继发性脑损伤的影响 产生缺血的代谢供应与需求之间的不匹配。现有技术 监测继发性脑损伤不足：连续的头皮脑电图是无创的，检测到癫痫发作， 但仅间接反映了脑血流损害。在某些情况下，侵入性问题被放置在 大脑直接检测脑血流和脑组织氧合。但是，此策略可能是风险的，并且 仅监视大脑的一小部分。那是需要实时，无创，多模式的 人类中大脑的电活动，氧合和血液动力学的测量。我们的目标是 通过脑电图和功能光谱法（EEG - 光学）的联合测量来满足这一需求 仪器和分析提供有关大脑活动和功能的数据的完整融合。脑电 通过独家临时分辨率记录大脑的当地电场电位。光学成像使用低 - 量化大脑血流（CBF）和脑氧饱和度（STO2）的强度光。在AIM 1中，我们将适应 我们的DCS当前工具用于连续进行TBI患者的纵向监测与临床 在AIM2中，我们将进行验证研究，以评估这项新的，集成的无创技术 通过直接与金标准，FDA批准的脑血流的侵入性测量 TBI患者接受临床标准浸润性监测的患者中氧合。这项研究将直接领导 进一步开发设备开发和调查设备应用，其目标是设备的目标 所有急性脑损伤患者的脑血流和氧合监测，以指导 管理。