Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope

Ran Cheng, Yu Shang, Siqi Wang, Joyce M. Evans, Abner Rayapati, David C. Randall, Guoqiang Yu

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

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.

Original languageEnglish
Article number017001
JournalJournal of Biomedical Optics
Volume19
Issue number1
DOIs
StatePublished - Jan 2014

Bibliographical note

Funding 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.

Keywords

  • cerebral blood flow
  • cerebral oxygenation
  • diffuse correlation spectroscopy
  • near-infrared spectroscopy
  • vasovagal syncope

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Biomedical Engineering

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