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In the United States, traumatic brain injury (TBI) is one of the leading causes of death and disability.
On average, 155 people die from TBI-related injuries every day
.
A little carelessness during exercise, production accidents or traffic accidents may cause traumatic brain injury
.
The diagnosis and evaluation of brain injury are critical to the development of a treatment plan for complications related to traumatic brain injury (called secondary brain injury)
.
These complications include changes in the level of consciousness, memory impairment, confusion, disorientation, new or worsening seizures, auditory, visual and emotional complications, and death
.
However, the current diagnostic methods for TBI-related complications are limited to self-reported symptoms and functional assessment, such as the Glasgow Coma Scale, speech test, language test, cognitive assessment, and neurophysiological test, and there is a lack of effective real-time monitoring methods
.
At present, there are two clinical monitoring methods, non-invasive and invasive
.
In non-invasive monitoring, the continuous monitoring of most ICUs is limited to the measurement of cardiopulmonary function, such as cardiac telemetry or arterial blood pressure monitoring.
There are also intracranial pressure (ICP), brain tissue oxygen tension (PbtO2) or regional cerebral blood flow (rCBF).
) Multi-mode monitoring
.
Invasive monitoring methods require a burr hole to be drilled in the skull, which increases the risk of bleeding and infection, and in severe cases can cause injuries to the patient
.
Laser Doppler flow meter (LDF), transcranial Doppler ultrasound (TCD), continuous electroencephalogram (cEEG), and thermally diffuse blood flow (TDF) are also not available due to factors such as tissue volume, skull thickness, and rapid disease progression.
Show your fists
.
Is there a non-invasive but real-time monitoring method? Previous studies have shown that diffuse reflectance optics technology can continuously and non-invasively measure the blood flow force in the blood vessels of the brain
.
Based on this technology, the Department of Neurology and Rehabilitation School of the University of Cincinnati in the United States conducted a detailed study of its clinical transformation capabilities, using a 1064nm superconducting nanowire single photon detector (SNSPD) to test the clinical application of the timed diffuse reflectance correlation spectroscopy system.
Does blood flow monitoring provide additional benefits for TBI monitoring
?
The research team published the results in "medRXiv" with the title "First-in-clinical application of a time-gated diffuse correlation spectroscopy system at 1064nm using superconducting nanowire single photondetectors"
.
https://doi.
org/10.
1101/2021.
11.
11.
21266071 The research team selected a traumatic brain injury patient admitted to the hospital due to a traffic accident.
First, through invasive multimodal intracranial monitoring (MMM) and other monitoring methods (including ICP, PbtO2, brain microdialysis and cortical electrogram, etc.
) are used in combination to directly measure rCBF
.
On the 3rd day after trauma, I started to use the portable timed diffuse reflectance correlation spectroscopy system (TG-DCS).
All four channels were connected to SNSPD to collect 1064nm reflected photons
.
The study collected a total of 1 hour and 20 minutes of data and simultaneously recorded MMM measurement data
.
Legend: TD-DCS used in NICU Legend: MMM probe data and TG-DCS front wave (EG), back wave (LG) blood flow index (BFI) 3 green lines represent: 1) Time to stop sedation , 2) Time for neurological examination, 3) Time for re-sedation.
Studies have shown that there is a Spearman coefficient relationship between TG-DCS BFI and TDF rCBF.
After stopping sedatives, LG and EG have a greater increase
.
After neurological examination, both EG and LG observed a sharp increase in CBF.
After re-use of sedatives, both TG-DCS BFI and TDF rCBF decreased
.
At high resolution (50 Hz), the BFI fluctuates more widely.
At this time, a pulsating flow-like pattern related to heart rate can be observed
.
Legend: 3 green lines represent: 1) stop sedation, 2) perform neurological examination, 3) sedation again.
In order to obtain further evidence, the researchers started with 10Hz and maintained a good signal-to-noise ratio and time resolution.
Simultaneously studied the surface and deep BFI sensitivity
.
After comparing the frequency spectrum of the TG-DCS BFI with the frequency of the heart rate (HR) signal, it is found that there is a significant correlation between the TG-DCS and HR signals
.
The results of the study verify that pulsatile blood flow can be obtained through TG-DCS, which provides additional benefits for TBI monitoring
.
In addition, the study also proved that the sampling frequency of TG-DCS is sufficient to solve related problems by linking with commercial heart rate monitors
.
Figure note: Comparison of heart rate recorded by EG and LG PSD and commercial monitors.
The above study is the first clinical application of TG-DCS with 1064nm SNSPD.
The results of the study prove the clinical utility of 1064nm TG-DCS
.
Compared with the traditional CW-DCS, TG-DCS shows obvious advantages and solves the current dilemma that the continuous and pulsating blood flow in the brain tissue can only be obtained through invasive methods
.
Although TG-DCS is at an early stage, clinical capabilities have yet to be completed and systematically established
.
However, current research shows that the 1064nm timed diffuse reflectance correlation spectroscopy system may become a portable, non-invasive, continuous bedside CBF monitor, which will bring good news to patients with brain injury
.
In order to facilitate you to continue to receive our articles, you are welcome to set us as a "star" so that you can see our news in the future
.
End reference materials: [1]First-in-clinicalapplication of a time-gated diffuse correlation spectroscopy system at 1064nmusing superconducting nanowire single photon detectors
On average, 155 people die from TBI-related injuries every day
.
A little carelessness during exercise, production accidents or traffic accidents may cause traumatic brain injury
.
The diagnosis and evaluation of brain injury are critical to the development of a treatment plan for complications related to traumatic brain injury (called secondary brain injury)
.
These complications include changes in the level of consciousness, memory impairment, confusion, disorientation, new or worsening seizures, auditory, visual and emotional complications, and death
.
However, the current diagnostic methods for TBI-related complications are limited to self-reported symptoms and functional assessment, such as the Glasgow Coma Scale, speech test, language test, cognitive assessment, and neurophysiological test, and there is a lack of effective real-time monitoring methods
.
At present, there are two clinical monitoring methods, non-invasive and invasive
.
In non-invasive monitoring, the continuous monitoring of most ICUs is limited to the measurement of cardiopulmonary function, such as cardiac telemetry or arterial blood pressure monitoring.
There are also intracranial pressure (ICP), brain tissue oxygen tension (PbtO2) or regional cerebral blood flow (rCBF).
) Multi-mode monitoring
.
Invasive monitoring methods require a burr hole to be drilled in the skull, which increases the risk of bleeding and infection, and in severe cases can cause injuries to the patient
.
Laser Doppler flow meter (LDF), transcranial Doppler ultrasound (TCD), continuous electroencephalogram (cEEG), and thermally diffuse blood flow (TDF) are also not available due to factors such as tissue volume, skull thickness, and rapid disease progression.
Show your fists
.
Is there a non-invasive but real-time monitoring method? Previous studies have shown that diffuse reflectance optics technology can continuously and non-invasively measure the blood flow force in the blood vessels of the brain
.
Based on this technology, the Department of Neurology and Rehabilitation School of the University of Cincinnati in the United States conducted a detailed study of its clinical transformation capabilities, using a 1064nm superconducting nanowire single photon detector (SNSPD) to test the clinical application of the timed diffuse reflectance correlation spectroscopy system.
Does blood flow monitoring provide additional benefits for TBI monitoring
?
The research team published the results in "medRXiv" with the title "First-in-clinical application of a time-gated diffuse correlation spectroscopy system at 1064nm using superconducting nanowire single photondetectors"
.
https://doi.
org/10.
1101/2021.
11.
11.
21266071 The research team selected a traumatic brain injury patient admitted to the hospital due to a traffic accident.
First, through invasive multimodal intracranial monitoring (MMM) and other monitoring methods (including ICP, PbtO2, brain microdialysis and cortical electrogram, etc.
) are used in combination to directly measure rCBF
.
On the 3rd day after trauma, I started to use the portable timed diffuse reflectance correlation spectroscopy system (TG-DCS).
All four channels were connected to SNSPD to collect 1064nm reflected photons
.
The study collected a total of 1 hour and 20 minutes of data and simultaneously recorded MMM measurement data
.
Legend: TD-DCS used in NICU Legend: MMM probe data and TG-DCS front wave (EG), back wave (LG) blood flow index (BFI) 3 green lines represent: 1) Time to stop sedation , 2) Time for neurological examination, 3) Time for re-sedation.
Studies have shown that there is a Spearman coefficient relationship between TG-DCS BFI and TDF rCBF.
After stopping sedatives, LG and EG have a greater increase
.
After neurological examination, both EG and LG observed a sharp increase in CBF.
After re-use of sedatives, both TG-DCS BFI and TDF rCBF decreased
.
At high resolution (50 Hz), the BFI fluctuates more widely.
At this time, a pulsating flow-like pattern related to heart rate can be observed
.
Legend: 3 green lines represent: 1) stop sedation, 2) perform neurological examination, 3) sedation again.
In order to obtain further evidence, the researchers started with 10Hz and maintained a good signal-to-noise ratio and time resolution.
Simultaneously studied the surface and deep BFI sensitivity
.
After comparing the frequency spectrum of the TG-DCS BFI with the frequency of the heart rate (HR) signal, it is found that there is a significant correlation between the TG-DCS and HR signals
.
The results of the study verify that pulsatile blood flow can be obtained through TG-DCS, which provides additional benefits for TBI monitoring
.
In addition, the study also proved that the sampling frequency of TG-DCS is sufficient to solve related problems by linking with commercial heart rate monitors
.
Figure note: Comparison of heart rate recorded by EG and LG PSD and commercial monitors.
The above study is the first clinical application of TG-DCS with 1064nm SNSPD.
The results of the study prove the clinical utility of 1064nm TG-DCS
.
Compared with the traditional CW-DCS, TG-DCS shows obvious advantages and solves the current dilemma that the continuous and pulsating blood flow in the brain tissue can only be obtained through invasive methods
.
Although TG-DCS is at an early stage, clinical capabilities have yet to be completed and systematically established
.
However, current research shows that the 1064nm timed diffuse reflectance correlation spectroscopy system may become a portable, non-invasive, continuous bedside CBF monitor, which will bring good news to patients with brain injury
.
In order to facilitate you to continue to receive our articles, you are welcome to set us as a "star" so that you can see our news in the future
.
End reference materials: [1]First-in-clinicalapplication of a time-gated diffuse correlation spectroscopy system at 1064nmusing superconducting nanowire single photon detectors
