Abstract
Inadequate cerebral perfusion is a risk factor for cerebral ischemia in patients with large artery steno-occlusion. We investigated whether prefrontal oxyhemoglobin oscillation (ΔHbO2, 0.6–2 Hz) was associated with decreased vascular reserve in patients with steno-occlusion in the large anterior circulation arteries. Thirty-six patients with steno-occlusion in the anterior circulation arteries (anterior cerebral artery, middle cerebral artery, and internal carotid artery) were included and compared to thirty-six control subjects. Patients were categorized into two groups (deteriorated vascular reserve vs. preserved vascular reserve) based on the results of Diamox single- photon emission computed tomography imaging. HbO2 data were collected using functional near-infrared spectroscopy. The slope of ΔHbO2 and the ipsilateral/contralateral slope ratio of ΔHbO2 were analyzed. Among the included patients (n = 36), 25 (69.4%) had deteriorated vascular reserve. Patients with deteriorated vascular reserve had a significantly higher average slope of ΔHbO2 on the ipsilateral side (5.01 ± 2.14) and a higher ipsilateral/contralateral ratio (1.44 ± 0.62) compared to those with preserved vascular reserve (3.17 ± 1.36, P = 0.014; 0.93 ± 0.33, P = 0.016, respectively) or the controls (3.82 ± 1.69, P = 0.019; 0.94 ± 0.29, P = 0.001). The ipsilateral/contralateral ΔHbO2 ratio could be used as a surrogate for vascular reserve in patients with severe steno-occlusion in the anterior circulation arteries.
Highlights
Inadequate cerebral perfusion is a risk factor for cerebral ischemia in patients with large artery steno-occlusion
Regarding the vascular risk factors, there was no significant difference between groups with preserved and deteriorated vascular reserve
We showed that the ΔHbO2 slope on the ipsilateral side to the significant steno-occlusive artery was higher in patients with deteriorated vascular reserve compared to those with preserved vascular reserve or controls, suggesting a possible role of ΔHbO2 as a surrogate marker of vascular reserve capacity and vascular compliance
Summary
Inadequate cerebral perfusion is a risk factor for cerebral ischemia in patients with large artery steno-occlusion. Previous studies showed that changes of amplitude or phase shift of the arterial pulse wave of the cerebral microvascular oscillation measured by NIRS were associated with impaired cerebral perfusion or h ypoxia[17,18,19]. These oscillations of HbO2 (ΔHbO2, 0.6-2 Hz) could be regarded as a surrogate for vascular compliance and cerebral autoregulation in cerebral microvessels, especially in a rterioles[17,18,19,20,21,22,23,24,25]. We hypothesized that the slope of ΔHbO2 signals from the fNIRS could be used to identify patients with cerebral hemodynamic failure
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