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: r1/2HbO 2/r1/2Hb/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, r1/2HbO2and 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.
|Journal||Journal of Biomedical Optics|
|State||Published - Jan 2014|
Bibliographical noteFunding Information:
We acknowledge the support from the National Institutes of Health R01 NS039774-04-07 (D.C.R.), R01 CA149274 (G.Y.), and R21 AR062356 (G.Y.). We also thank Daniel Irwin for his help in preparing the manuscript.
- cerebral blood flow
- cerebral oxygenation
- diffuse correlation spectroscopy
- near-infrared spectroscopy
- vasovagal syncope
ASJC Scopus subject areas
- Electronic, Optical and Magnetic Materials
- Atomic and Molecular Physics, and Optics
- Biomedical Engineering