[go: up one dir, main page]

WO2023288094A1 - Dispositif portable destiné à la mesure quantitative d'autorégulation tissulaire et de couplage neurovasculaire à l'aide d'eeg, de métabolisme et de diagnostic de débit sanguin - Google Patents

Dispositif portable destiné à la mesure quantitative d'autorégulation tissulaire et de couplage neurovasculaire à l'aide d'eeg, de métabolisme et de diagnostic de débit sanguin Download PDF

Info

Publication number
WO2023288094A1
WO2023288094A1 PCT/US2022/037361 US2022037361W WO2023288094A1 WO 2023288094 A1 WO2023288094 A1 WO 2023288094A1 US 2022037361 W US2022037361 W US 2022037361W WO 2023288094 A1 WO2023288094 A1 WO 2023288094A1
Authority
WO
WIPO (PCT)
Prior art keywords
tissue
cmro
flow
cerebral
perfusion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2022/037361
Other languages
English (en)
Inventor
Yama AKBARI
Robert H. WILSON
Christian CROUZET
Thomas Milner
Bernard Choi
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of California Berkeley
University of California San Diego UCSD
Original Assignee
University of California Berkeley
University of California San Diego UCSD
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US17/377,123 external-priority patent/US12213770B2/en
Priority claimed from US17/690,866 external-priority patent/US12310916B2/en
Priority claimed from US17/706,217 external-priority patent/US20220223257A1/en
Priority claimed from US17/735,903 external-priority patent/US20220262496A1/en
Application filed by University of California Berkeley, University of California San Diego UCSD filed Critical University of California Berkeley
Publication of WO2023288094A1 publication Critical patent/WO2023288094A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/369—Electroencephalography [EEG]
    • A61B5/384—Recording apparatus or displays specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0075—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
    • A61B5/026—Measuring blood flow
    • A61B5/0261—Measuring blood flow using optical means, e.g. infrared light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14552—Details of sensors specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14553—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases specially adapted for cerebral tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0077—Devices for viewing the surface of the body, e.g. camera, magnifying lens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/03—Measuring fluid pressure within the body other than blood pressure, e.g. cerebral pressure ; Measuring pressure in body tissues or organs
    • A61B5/031—Intracranial pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/369—Electroencephalography [EEG]
    • A61B5/377—Electroencephalography [EEG] using evoked responses
    • A61B5/378—Visual stimuli
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/369—Electroencephalography [EEG]
    • A61B5/377—Electroencephalography [EEG] using evoked responses
    • A61B5/38—Acoustic or auditory stimuli
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/369—Electroencephalography [EEG]
    • A61B5/377—Electroencephalography [EEG] using evoked responses
    • A61B5/383—Somatosensory stimuli, e.g. electric stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7271—Specific aspects of physiological measurement analysis
    • A61B5/7282—Event detection, e.g. detecting unique waveforms indicative of a medical condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/004—Magnetotherapy specially adapted for a specific therapy
    • A61N2/006—Magnetotherapy specially adapted for a specific therapy for magnetic stimulation of nerve tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N2005/0632—Constructional aspects of the apparatus
    • A61N2005/0633—Arrangements for lifting or hinging the frame which supports the light sources
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0613—Apparatus adapted for a specific treatment
    • A61N5/0622—Optical stimulation for exciting neural tissue

Definitions

  • Neurovascular coupling refers to the relationship between hemodynamic changes (e.g., changes in blood flow, oxygenation, and metabolism) and changes in cerebral electrical activity (e.g., EEG “bursts” and increases in EEG amplitude or entropy). Mismatches or prolonged delays between hemodynamic and cerebral electrical changes may be a sign of impaired autoregulation. Impaired autoregulation in any organ can lead to either ischemic damage resulting in cell death, inflammation, and organ failure or hyperperfusion damage, which can also result in inflammation and severe cellular and tissue injury.
  • AMS altered mental status
  • a diagnostic workup for AMS involves a detailed history, physical exam, neurological exam, serum or cerebrospinal fluid testing in a lab, and additional tests such as an EEG, CT scan of the head, MRI of the brain, transcranial Doppler ultrasound, and/or additional neurological tests.
  • additional tests such as an EEG, CT scan of the head, MRI of the brain, transcranial Doppler ultrasound, and/or additional neurological tests.
  • the current invention also suggests that using the combination of EEG, blood flow, and oximetry parameters (as well as other parameters described in this application) has the potential to provide surprisingly better diagnostic and prognostic power than any one of these parameters individually.
  • FIG. 6B shows a diagram of a portable EEG, blood flow, and oximetry measurement device comprising a leg capable of serving as the source fiber for measuring both oximetry and blood flow.
  • FIG. 6C shows a diagram of a portable EEG, blood flow, and oximetry measurement device comprising an electrical-optical transducer and an optical-electrical transducer.
  • FIG. 6D shows a diagram of a portable EEG, blood flow, and oximetry measurement device comprising a plurality of movable clamps for retracting and extracting fibers.
  • FIG. 7A shows a flow chart of oximetry measurement instructions of a signal processing component.
  • FIG. 7A shows a flow chart of oximetry measurement instructions of a signal processing component.
  • a craniectomy ( ⁇ 6 mm x 4 mm area) is performed to provide direct access to the brain for optical imaging.
  • SFDI light-emitting diodes
  • LEDs light-emitting diodes
  • a scientific CMOS camera detects the backscattered light.
  • LSI an 809 nm laser illuminates the brain with coherent light, and the remitted speckle pattern is captured at 60 fps with a CCD camera.
  • FIG.17 shows an embodiment showing absolute CMRO 2 ( ⁇ M O 2 /min) maps of a ⁇ 6 mm x 4 mm region of the rat brain at different time points during a CA/CPR experiment. Metabolic activity increases as anesthesia is being washed out (between “Baseline” and “Start Ischemia”), followed by a sharp decrease during ischemia.
  • FIG. 21 shows an embodiment where blood flow and oxygenation data are combined into a derivation of a different equation for absolute tissue metabolic rate of oxygen without the need to induce a “zero-flow” ischemic perturbation in the subject.
  • this embodiment shows significant additional clinical translational potential by enabling non-invasive measurement of tissue metabolism in physiological units without perturbing the subject.
  • This embodiment involves multiplying the tissue deoxy-hemoglobin concentration (ctHb) by the volume of tissue being oxygenated per unit time to calculate tissue metabolic rate of oxygen.
  • FIG. 27 shows an embodiment where the measured blood flow index can be corrected for tissue absorption and scattering (using a method similar to that in FIG.13) to obtain a spatially-resolved map of either the Brownian diffusion coefficient Db or the directed-flow speed vc. It is important to note that this method can also be used to map either or both of these coefficients as a function of time, and that these coefficients can be extracted simultaneously, along with weighting coefficients characterizing the relative contributions of each type of flow to the measured blood flow index. Types of flow in this model could include other flow equations besides those described here for diffuse and directed flow.
  • FIG. 27 also shows an embodiment where the directed flow speed vc is used in a modified version of the absolute CMRO2 equation described in FIG.21.
  • the term “intracranial measurement” refers to the measurement of tissue (such as brain tissue) inside the skull, by a probe which may be positioned outside the skull (i.e. the measurement is taken through the skull in a non-invasive manner).
  • the present invention features a system for quantitative intracranial measurement of cerebral blood flow, oxygenation, metabolism, autoregulation, or a combination thereof.
  • the system may comprise: a device body; one or more light sources; one or more detectors, a microprocessor, and a memory component.
  • the quantitative value of cerebral autoregulation may be calculated by dividing the quantitative value of the absolute perfusion metric (e.g. CBF) by the quantitative value of the absolute metabolic metric (e.g. CMRO 2 ).
  • the quantitative value of cerebral autoregulation may be calculated by dividing the rate of change of an absolute or relative perfusion metric by the rate of change of an absolute or relative metabolic metric.
  • the quantitative value of cerebral autoregulation may be calculated by creating a coordinate in a multi-dimensional space in which the “x-axis” is the absolute perfusion metric, the “y-axis” is the absolute metabolic metric, and other axes (dimensions) may include the rate of change in perfusion, the rate of change in metabolism, and the absolute values and/or rates of change in oxygenated hemoglobin concentration, deoxygenated hemoglobin concentration, total hemoglobin concentration, tissue oxygenation, tissue scattering coefficient, and tissue water content.
  • these autoregulation metrics are not limited to the brain and can be applied to other organs so long as a perfusion metric and metabolic metric is obtainable.
  • a perturbation e.g.
  • detection of the EEG signal may allow for quantification of cerebral electrical activity via parameters including, but not limited to, root-mean-squared (RMS) intensity, information quantity (IQ) and other entropy-based measures, burst frequency, coherence, and phase-amplitude coupling, either in a specific sub-band (or a ratio of two sub-bands) or over a wider range of frequencies, using either values at individual time points or changes in these values over a period of time.
  • RMS root-mean-squared
  • IQ information quantity
  • phase-amplitude coupling either in a specific sub-band (or a ratio of two sub-bands) or over a wider range of frequencies, using either values at individual time points or changes in these values over a period of time.
  • the device may comprise two or more detectors with different source-detector separations, and the different source-detector separations may allow the device to distinguish between signals from different depths, for example, between signals from the scalp/skull and signals from the brain.
  • the device may distinguish between signals from the skull and signals from the brain by using (either individually or in combination) different wavelengths, different modulation frequencies, different angles of the source and detector fibers, or time-gating approaches.
  • Location of the source and detector on particular areas of the skull may also enable optimization of signal detection. For example, the temporal bone is thinner.
  • the orbital socket including the eye and, in particular the retina, can also enable better detection of an optical signal that can provide direct or indirect data about the brain.
  • the components may comprise: a tissue absorption component; a tissue scattering component; and a dynamic scattering flow component.
  • the decoupled components of the backscattered light signals may allow for determination of an absolute value of the tissue metric.
  • the absolute value of the tissue metric may provide information on the perfusion or metabolism of an organ, or may be indicative of tissue autoregulation.
  • the device may allow for comparative analysis of the autoregulation of two or more body parts. For example, on COVID-19 patients, the device could measure the autoregulation of the lung versus the brain to quantify the degree to which respiratory impairment is affecting the brain.
  • the device may feature an adjustable clamping mechanism for retracting and extracting optical or electronic fibers.
  • the present invention may feature a portable device for therapeutic photobiomodulation and blood flow, oximetry, and/or electrical activity (e.g. from brain or other tissue) measurement.
  • the device may comprise: a body; a plurality of legs comprising: one or more legs having one or more optical source fibers, wherein each leg is pivotably connected to the body by a hinge.
  • the photobiomodulation light sources may produce a wide range or specific range of light including but not limited to visible light, near-infrared light, short-wave infrared light, or infrared light.
  • the photobiomodulation light sources may promote a variety of perfusion and metabolism changes including but not limited to increased cellular metabolism of oxygen, generation of ATP, vasodilation, and enhanced perfusion of tissue.
  • the changes produced by the photobiomodulation light sources may be monitored using methods including but not limited to real time detection or delayed detection by the photodetector.
  • the present invention features a device with only electrical monitoring capabilities. While for some situations, it may be desirable to have both optical and electrical data, for many situations, electrical data alone may be sufficient.
  • the electrical monitoring herein is capable of measuring an evoked potential wherein the stimulus used to evoke a potential may also be provided by the said device or another device.
  • an evoked potential may include, but is not limited to, a visual evoked potential, somatosensory evoked potential, auditory evoked potential, steady-state evoked potential, laser evoked potential, motor evoked potential, evoked compound motor action potential or sensory nerve action potential as seen in nerve conduction studies.
  • the detected signals from the two measurement electrodes and the reference electrode are filtered to remove noise or to narrow the signal down to the desired range (e.g. for the clinical indication), calibrated by using the signal from the reference electrode (via common-average referencing or a similar technique).
  • an oximetry optical source fiber may be capable of delivering electrical signals and the oximetry optical detection fiber may be capable of collecting electrical signals.
  • the oximetry optical detection fiber may be connected to an electrical-optical transducer and/or an optical-electrical transducer.
  • FIG. 6C shows an embodiment of the invention where the electrical and optical signals are delivered and collected via a pair of common fibers, with the source fiber connected to an electrical-optical transducer for converting electrical inputs into optical inputs, and with the detection fiber connected to an optical-electrical transducer for converting detected optical signals into electrical signals.
  • the number of fibers is not limited to two, as additional fibers can be added to increase the number of measurement/recording EEG electrodes as well as for additional optical signals as needed.
  • the method may additionally include determining one or more fluid metrics from the detected signals.
  • the fluid metrics may be indicative of a degree of swelling or edema of the tissue.
  • Non-limiting example fluid metrics include parameters of cellular components of the tissue.
  • Non-limiting examples of parameters of cellular components of the tissue include: a shape, a size, or a refractive index of the cellular components. Determination of these fluid metrics may be advantageous because they provide information about additional structural and functional changes in tissue, including edema and changes in concentration of intracellular versus extracellular tissue components.
  • CMRO 2 hemodynamic measure of metabolism
  • structural measure of metabolism changes in sizes, shapes, and concentrations of organelles (e.g., mitochondria) in the tissue, as measured by tissue scattering and water fraction.
  • a calibrated perfusion metric may be determined using the dynamic perfusion metric.
  • the dynamic perfusion metric may be calibrated via the tissue absorption coefficient and the tissue scattering coefficient in order to yield the calibrated perfusion metric.
  • the calibrated perfusion metric may be used in the determination of the absolute value of CMRO 2 .
  • the dynamic perfusion metric may be a speckle flow index (SFI) or a blood flow index (BFI)
  • the calibrated perfusion metric may be a Brownian diffusion coefficient (Db), a directed flow speed (v c ), a cerebral blood flow (CBF) or a combination thereof.
  • the present invention features a method of determining an absolute value of cerebral metabolic rate of oxygen (CMRO 2 ) using a zero-flow calibration.
  • the method may include calculating a calibration coefficient ( ⁇ ) based on a rate of change of deoxyhemoglobin concentration during entry into a zero-flow state (or a rate of change of oxyhemoglobin during exit from a zero-flow state), and determining an absolute value of CMRO 2 using the calibration coefficient.
  • the zero-flow state may be intentionally induced, or a subject may be monitored during a zero-flow inducing situation such as cardiac arrest or a stroke.
  • Example 5 Use of a device of the present invention to diagnose, treat, and monitor an acute cardiac event.
  • Step 1 When encountering a patient who is suspected of a potential heart attack and CPR is being initiated by other bystanders (e.g. basic life support) or health care providers (e.g. advanced cardiac life support), the device is deployed to the chest area to assess the cardiac electrical activity (i.e. ECG).
  • ECG cardiac electrical activity
  • the first pattern was non-modulated (i.e., DC illumination), and the three subsequent patterns were modulated at spatial frequency ⁇ 0.3 mm -1 with three distinct spatial phases to enable demodulation.
  • 3 wavelengths x 4 frames 12 frames of SFDI data for each measurement time point.
  • the detected square wave pattern could be approximated as a sinusoid, thus allowing demodulation.
  • tissue hemodynamics and CMRO 2 it was possible to reconstruct tissue hemodynamics and CMRO 2 , at an effective imaging rate of ⁇ 14 Hz.
  • the diffuse reflectance maps were then fit with a Monte Carlo model to extract the tissue absorption coefficient ⁇ a and reduced scattering coefficient ⁇ s ’ at each wavelength.
  • the average ⁇ s ’ was determined for a selected ROI and a new ⁇ a determined using diffuse reflectance with the non-modulated pattern and this average ⁇ s ’.
  • CBF is the cerebral blood flow
  • [O 2 ] a is the arterial concentration of oxygen
  • OEF is the oxygen extraction fraction, equal to ([O 2 ] a - [O 2 ] v )/[O 2 ] a , where [O 2 ] v is the venous concentration of oxygen.
  • (OEF)([O 2 ] a ) represents the molar concentration of oxygen that was extracted from that arteriole and used by the brain for metabolic processes related to the synthesis of ATP. This quantity is equivalent to the molar concentration of deoxygenated hemoglobin that arrives in a nearby venule following oxygen extraction by the brain. Therefore, within our measurement paradigm, Eq.
  • CMRO 2 4 ⁇ (v c )(ctHb v )(Hb bl / ⁇ ctHb tot > p ) (5)
  • ctHb v is the tissue concentration of deoxygenated hemoglobin in a region of interest atop a large vein in the ctHb maps obtained from SFDI.
  • the factor of 4 accounts for the fact that the hemoglobin molecule has four binding sites for oxygen. Since v c is a characteristic flow parameter and not an absolute value of blood flow, it is necessary to include the proportionality constant ⁇ in the equation to convert v c into a quantity with units of absolute flow speed.
  • the factor (Hb bl / ⁇ ctHb tot > p ) accounts for partial-volume effects caused by the diffuse nature of light propagation in the brain.
  • Eq. (4) requires an intra-vascular oxygen concentration, but SFDI measures a bulk tissue deoxyhemoglobin concentration.
  • a blood-volume fraction term is required to convert between these two quantities.
  • the numerator, Hb bl is the concentration of hemoglobin in the blood sampled from the femoral artery of the animal during the arterial blood gas measurement (ABG).
  • the denominator, ⁇ ctHb tot > p is the mean total tissue hemoglobin concentration in the parenchyma during the period that the ABG was acquired.
  • CMRO 2 models of diffuse light transport implicitly assume that the concentration of deoxygenated hemoglobin is that within the veins specifically, and not the bulk tissue.
  • most diffuse optics-based CMRO 2 measurements are unable to satisfy this condition, as they typically use fiber-based spectroscopic techniques that sample the bulk tissue and thus cannot distinguish between venous and mixed arterial-venous parenchymal regions.
  • the use of diffuse optical imaging allows the use of deoxyhemoglobin concentrations measured in a venous ROI to overcome this limitation and thus obtain more accurate quantitative values of CMRO 2 .
  • Correction of CMRO 2 Data for Partial-Volume Effects Simply selecting a ROI that is coincident with a venule is not enough.
  • Hb bl total hemoglobin
  • CMRO 2 absolute cerebral metabolic rate of oxygen
  • descriptions of the inventions described herein using the phrase “comprising” includes embodiments that could be described as “consisting essentially of” or “consisting of”, and as such the written description requirement for claiming one or more embodiments of the present invention using the phrase “consisting essentially of” or “consisting of” is met.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • Optics & Photonics (AREA)
  • Psychology (AREA)
  • Psychiatry (AREA)
  • Neurology (AREA)
  • Hematology (AREA)
  • Cardiology (AREA)
  • Physiology (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

La présente invention concerne un dispositif portable destiné à la mesure quantitative de l'autorégulation tissulaire et du couplage neurovasculaire par mesure portable du débit sanguin, de l'oxygéanation, du métabolisme et/ou des signaux d'EEG et des procédés faisant appel audit dispositif. Le dispositif peut comprendre un corps et une pluralité de pieds fixés de manière pivotante au corps. La pluralité de pieds peut comprendre au moins un pied d'électrode de référence et au moins un pied d'électrode de mesure servant à une mesure électrique, et un pied de fibre de détection optique et au moins un pied de fibre de source optique servant à la mesure optique du débit sanguin, de l'oxygénation et du métabolisme. La présente invention concerne en outre un dispositif portable destiné à la mesure du débit sanguin et du photobiomodulation thérapeutique. Le dispositif peut comprendre un corps et une pluralité de pieds. La pluralité de pieds peut comprendre au moins un pied de fibre de détection optique et au moins un pied de fibre de source optique et au moins un pied servant à la photobiomodulation thérapeutique.
PCT/US2022/037361 2021-07-15 2022-07-15 Dispositif portable destiné à la mesure quantitative d'autorégulation tissulaire et de couplage neurovasculaire à l'aide d'eeg, de métabolisme et de diagnostic de débit sanguin Ceased WO2023288094A1 (fr)

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US17/377,123 2021-07-15
US17/377,123 US12213770B2 (en) 2019-04-01 2021-07-15 Portable device for quantitative measurement of tissue autoregulation and neurovascular coupling using EEG, metabolism, and blood flow diagnostics
US17/690,866 US12310916B2 (en) 2018-09-21 2022-03-09 Real-time methods to enable precision-guided CPR to improve neurological outcome and predict brain damage after ischemic injury and reperfusion
US17/690,866 2022-03-09
US17/706,217 US20220223257A1 (en) 2018-09-21 2022-03-28 Generation of personalized neuroprotective and cardioprotective nutrition programs featuring caloric restriction
US17/706,217 2022-03-28
US17/735,903 2022-05-03
US17/735,903 US20220262496A1 (en) 2018-09-21 2022-05-03 Generation of personalized neuroprotective and cardioprotective nutrition programs featuring caloric restriction

Publications (1)

Publication Number Publication Date
WO2023288094A1 true WO2023288094A1 (fr) 2023-01-19

Family

ID=84919663

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2022/037361 Ceased WO2023288094A1 (fr) 2021-07-15 2022-07-15 Dispositif portable destiné à la mesure quantitative d'autorégulation tissulaire et de couplage neurovasculaire à l'aide d'eeg, de métabolisme et de diagnostic de débit sanguin

Country Status (1)

Country Link
WO (1) WO2023288094A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090062685A1 (en) * 2006-03-16 2009-03-05 Trustees Of Boston University Electro-optical sensor for peripheral nerves
US20140018649A1 (en) * 2011-03-31 2014-01-16 Region Midtjylland System for assessing tissue substance extraction
US20140316218A1 (en) * 2013-04-23 2014-10-23 Patrick L. Purdon Systems and methods for monitoring brain metabolism and activity using electroencephalogram and optical imaging
US20180103861A1 (en) * 2015-04-09 2018-04-19 The General Hospital Corporation System and method for non-invasively monitoring intracranial pressure
US20200367761A1 (en) * 2019-04-01 2020-11-26 The Regents Of The University Of California Portable device for quantitative measurement of tissue autoregulation and neurovascular coupling using eeg, metabolism, and blood flow diagnostics

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090062685A1 (en) * 2006-03-16 2009-03-05 Trustees Of Boston University Electro-optical sensor for peripheral nerves
US20140018649A1 (en) * 2011-03-31 2014-01-16 Region Midtjylland System for assessing tissue substance extraction
US20140316218A1 (en) * 2013-04-23 2014-10-23 Patrick L. Purdon Systems and methods for monitoring brain metabolism and activity using electroencephalogram and optical imaging
US20180103861A1 (en) * 2015-04-09 2018-04-19 The General Hospital Corporation System and method for non-invasively monitoring intracranial pressure
US20200367761A1 (en) * 2019-04-01 2020-11-26 The Regents Of The University Of California Portable device for quantitative measurement of tissue autoregulation and neurovascular coupling using eeg, metabolism, and blood flow diagnostics

Similar Documents

Publication Publication Date Title
US12213770B2 (en) Portable device for quantitative measurement of tissue autoregulation and neurovascular coupling using EEG, metabolism, and blood flow diagnostics
US20200367761A1 (en) Portable device for quantitative measurement of tissue autoregulation and neurovascular coupling using eeg, metabolism, and blood flow diagnostics
CN112043287B (zh) 一种脑血氧无创监测方法及监测装置
Mancini et al. Validation of near-infrared spectroscopy in humans
Franceschini et al. Noninvasive measurement of neuronal activity with near-infrared optical imaging
Franceschini et al. Near-infrared spiroximetry: noninvasive measurements of venous saturation in piglets and human subjects
Kowalchuk et al. The effect of resistive breathing on leg muscle oxygenation using near-infrared spectroscopy during exercise in men
US11826559B2 (en) Cardiac output control apparatus and method of use thereof
US20140316218A1 (en) Systems and methods for monitoring brain metabolism and activity using electroencephalogram and optical imaging
Tsai et al. A noncontact skin oxygen-saturation imaging system for measuring human tissue oxygen saturation
JP2022534386A (ja) 正確にガイドされるｃｐｒが神経学的結果を改善し脳損傷を予測することを可能にするリアルタイムの方法
WO2023245149A2 (fr) Système et procédé pour mesurer la pression artérielle de manière non invasive à l'aide de la lumière
CN109009064A (zh) 一种颅内压无创监测装置及方法
Mantri et al. Monitoring peripheral hemodynamic response to changes in blood pressure via photoacoustic imaging
US20220079840A1 (en) Real-time methods to enable precision-guided cpr to improve neurological outcome and predict brain damage after ischemic injury and reperfusion
US20250268785A1 (en) Real-time methods to enable precision-guided cpr to improve neurological outcome and predict brain damage after ischemic injury and reperfusion
US20250134405A1 (en) Portable device for quantitative measurement of tissue autoregulation and neurovascular coupling using eeg, metabolism, and blood flow diagnostics
Ozgoren et al. Effect of body position on NIRS based hemodynamic measures from prefrontal cortex
Favilla et al. Perfusion enhancement with respiratory impedance after stroke (PERI-Stroke)
US20240285224A1 (en) Wearable Device And Method For Non-Invasive Assessment Of Glymphatic Flow
WO2023288094A1 (fr) Dispositif portable destiné à la mesure quantitative d'autorégulation tissulaire et de couplage neurovasculaire à l'aide d'eeg, de métabolisme et de diagnostic de débit sanguin
Li et al. Correlation and asynchronization of electroencephalogram and cerebral blood flow in active and passive stimulations
Ward Hybrid optical–electrical brain computer interfaces, practices and possibilities
Rashid et al. Hemodynamic monitoring in the human temporalis muscle using near-infrared spectroscopy
Kinoshita et al. Tissue oxygenation index reflects changes in forearm blood flow after brief ischemia

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 22842949

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 22842949

Country of ref document: EP

Kind code of ref document: A1