Hemodynamic Response Patterns Research Articles

Exploring the feasibility of tensor decomposition for analysis of fNIRS signals: a comparative study with grand averaging method.

The analysis of functional near-infrared spectroscopy (fNIRS) signals has not kept pace with the increased use of fNIRS in the behavioral and brain sciences. The popular grand averaging method collapses the oxygenated hemoglobin data within a predefined time of interest window and across multiple channels within a region of interest, potentially leading to a loss of important temporal and spatial information. On the other hand, the tensor decomposition method can reveal patterns in the data without making prior assumptions of the hemodynamic response and without losing temporal and spatial information. The aim of the current study was to examine whether the tensor decomposition method could identify significant effects and novel patterns compared to the commonly used grand averaging method for fNIRS signal analysis. We used two infant fNIRS datasets and applied tensor decomposition (i.e., canonical polyadic and Tucker decompositions) to analyze the significant differences in the hemodynamic response patterns across conditions. The codes are publicly available on GitHub. Bayesian analyses were performed to understand interaction effects. The results from the tensor decomposition method replicated the findings from the grand averaging method and uncovered additional patterns not detected by the grand averaging method. Our findings demonstrate that tensor decomposition is a feasible alternative method for analyzing fNIRS signals, offering a more comprehensive understanding of the data and its underlying patterns.

Distinct hemodynamic and functional connectivity features of fatigue in clinically isolated syndrome and multiple sclerosis: accounting for the confounding effect of concurrent depression symptoms

PurposeThis study aims to identify common and distinct hemodynamic and functional connectivity (FC) features for self-rated fatigue and depression symptoms in patients with clinically isolated syndrome (CIS) and relapsing–remitting multiple sclerosis (RR-MS).MethodsTwenty-four CIS, 29 RR-MS patients, and 39 healthy volunteers were examined using resting-state fMRI (rs-fMRI) to obtain whole-brain maps of (i) hemodynamic response patterns (through time shift analysis), (ii) FC (via intrinsic connectivity contrast maps), and (iii) coupling between hemodynamic response patterns and FC. Each regional map was correlated with fatigue scores, controlling for depression, and with depression scores, controlling for fatigue.ResultsIn CIS patients, the severity of fatigue was associated with accelerated hemodynamic response in the insula, hyperconnectivity of the superior frontal gyrus, and evidence of reduced hemodynamics–FC coupling in the left amygdala. In contrast, depression severity was associated with accelerated hemodynamic response in the right limbic temporal pole, hypoconnectivity of the anterior cingulate gyrus, and increased hemodynamics–FC coupling in the left amygdala. In RR-MS patients, fatigue was associated with accelerated hemodynamic response in the insula and medial superior frontal cortex, increased functional role of the left amygdala, and hypoconnectivity of the dorsal orbitofrontal cortex, while depression symptom severity was linked to delayed hemodynamic response in the medial superior frontal gyrus; hypoconnectivity of the insula, ventromedial thalamus, dorsolateral prefrontal cortex, and posterior cingulate; and decreased hemodynamics–FC coupling of the medial orbitofrontal cortex.ConclusionThere are distinct FC and hemodynamic responses, as well as different magnitude and topography of hemodynamic connectivity coupling, associated with fatigue and depression in early and later stages of MS.

Atypical frontotemporal cortical activity in first-episode adolescent-onset schizophrenia during verbal fluency task: A functional near-infrared spectroscopy study.

Frontotemporal cortex dysfunction has been found to be associated with cognitive impairment in patients with schizophrenia (SCZ). In patients with adolescent-onset SCZ, a more serious type of SCZ with poorer functional outcome, cognitive impairment appeared to occur at an early stage of the disease. However, the characteristics of frontotemporal cortex involvement in adolescent patients with cognitive impairment are still unclear. In the present study, we aimed to illustrate the frontotemporal hemodynamic response during a cognitive task in adolescents with first-episode SCZ. Adolescents with first-episode SCZ who were aged 12-17 and demographically matched healthy controls (HCs) were recruited. We used a 48-channel functional near-infrared spectroscopy (fNIRS) system to record the concentration of oxygenated hemoglobin (oxy-Hb) in the participants' frontotemporal area during a verbal fluency task (VFT) and analyzed its correlation with clinical characteristics. Data from 36 adolescents with SCZ and 38 HCs were included in the analyses. Significant differences were found between patients with SCZ and HCs in 24 channels, mainly covering the dorsolateral prefrontal cortex, superior and middle temporal gyrus and frontopolar area. Adolescents with SCZ showed no increase of oxy-Hb concentration in most channels, while the VFT performance was comparable between the two groups. In SCZ, the intensity of activation was not associated with the severity of symptoms. Finally, receiver operating characteristic analysis indicated that the changes in oxy-Hb concentration could help distinguish the two groups. Adolescents with first-episode SCZ showed atypical cortical activity in the frontotemporal area during the VFT, and fNIRS features might be more sensitive indicators in cognitive assessment, indicating that the characteristic hemodynamic response pattern might be potential imaging biomarkers for this population.

Aging effects on electrical and hemodynamic responses in the sensorimotor network during unilateral proximal upper limb functional tasks

Healthy aging leads to poorer performance in upper limb (UL) daily living movements. Understanding the neural correlates linked with UL functional movements may help to better understand how healthy aging affects motor control. Two non-invasive neuroimaging methods allow for monitoring the movement-related brain activity: functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), respectively based on the hemodynamic response and electrical activity of brain regions. Coupled, they provide a better spatiotemporal mapping. The aim of this study was to evaluate the effect of healthy aging on the bilateral sensorimotor (SM1) activation patterns of functional proximal UL movements. Twenty-one young and 21 old healthy participants realized two unilateral proximal UL movements during: i) a paced reaching target task and ii) a circular steering task to capture the speed-accuracy trade-off. Combined fNIRS-EEG system was synchronised with movement capture system to record SM1 activation while moving. The circular steering task performance was significantly lower for the older group. The rate of increase in hemodynamic response was longer in the older group with no difference on the amplitude of fNIRS signal for the two tasks. The EEG results showed aging related reduction of the alpha-beta rhythms synchronisation but no desynchronisation modification. In conclusion, this study uncovers the age-related changes in brain electrical and hemodynamic response patterns in the bilateral sensorimotor network during two functional proximal UL movements using two complementary neuroimaging methods. This opens up the possibility to utilise combined fNIRS-EEG for monitoring the movement-related neuroplasticity in clinical practice.

Distributed networks for auditory memory differentially contribute to recall precision

Re-directing attention to objects in working memory can enhance their representational fidelity. However, how this attentional enhancement of memory representations is implemented across distinct, sensory and cognitive-control brain network is unspecified. The present fMRI experiment leverages psychophysical modelling and multivariate auditory-pattern decoding as behavioral and neural proxies of mnemonic fidelity. Listeners performed an auditory syllable pitch-discrimination task and received retro-active cues to selectively attend to a to-be-probed syllable in memory. Accompanied by increased neural activation in fronto-parietal and cingulo-opercular networks, valid retro-cues yielded faster and more perceptually sensitive responses in recalling acoustic detail of memorized syllables. Information about the cued auditory object was decodable from hemodynamic response patterns in superior temporal sulcus (STS), fronto-parietal, and sensorimotor regions. However, among these regions retaining auditory memory objects, neural fidelity in the left STS and its enhancement through attention-to-memory best predicted individuals’ gain in auditory memory recall precision. Our results demonstrate how functionally discrete brain regions differentially contribute to the attentional enhancement of memory representations.

Clinical Usefulness of Simultaneous Electroencephalography and Functional Magnetic Resonance Imaging in Children With Focal Epilepsy.

Background and PurposeThe current study analyzed the interictal epileptiform discharge (IED)-related hemodynamic response and aimed to determine the clinical usefulness of simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI) in defining the epileptogenic zone (EZ) in children with focal epilepsy.MethodsPatients with focal epilepsy showing IEDs on conventional EEG were evaluated using EEG-fMRI. Statistical analyses were performed using the times of spike as events modeled with multiple hemodynamic response functions. The area showing the most significant t-value for blood-oxygen-level-dependent (BOLD) changes was compared with the presumed EZ. Moreover, BOLD responses between -9 and +9 s around the spike times were analyzed to track the hemodynamic response patterns over time.ResultsHalf (n=13) of 26 EEG-fMRI investigations of 19 patients were successful. Two patients showed 2 different types of spikes, resulting in 15 analyses. The maximum BOLD response was concordant with the EZ in 11 (73.3%) of the 15 analyses. In 10 (66.7%) analyses, the BOLD response localized the EZs more specifically. Focal BOLD responses in the EZs occurred before IEDs in 11 analyses and were often widespread after IEDs. Hemodynamic response patterns were consistent in the same epilepsy syndrome or when repeating the investigation in the same patients.ConclusionsEEG-fMRI can provide additional information for localizing the EZ in children with focal epilepsy, and also reveal the pathogenesis of pediatric epilepsy by evaluating the patterns in the hemodynamic response across time windows of IEDs.

Approaches to antihypertensive therapy in patients predisposed to symptomatic hypotension and syncope

The management of a hypertensive patient with a history of syncope is aimed at maintaining a balance between cardiovascular and hypotensive (syncope) risks. The article presents an analysis of the literature data regarding the relationship between these clinical problems, and also draws practical conclusions that allow to ensure the optimal reduction in blood pressure in the interests of preventing cardiovascular diseases without the threat of drug-related hypotension (fainting). Variants of syncope in patients with arterial hypertension are summarized, depending on the association with antihypertensive therapy. There presented an expert opinion on the recommended target level of systolic blood pressure (120 mm Hg) in hypertensive patients under 70 years of age with a low syncope but high cardiovascular risk, as well as the target level of systolic blood pressure (140 mm Hg) in patients with high syncope and low cardiovascular risk or in elderly and / or frail individuals with hypertension. There noted the admissibility of bringing the systolic blood pressure to the target value up to 160 mm Hg in persons with severe frailty or disability. Examples of normal and pathological (hypotensive) patterns of hemodynamic response in persons with hypertension to long-term passive orthostasis obtained during the tilt test and influencing the decision-making on the activity of antihypertensive therapy are given. The importance of an interdisciplinary team approach with the participation of experts in regulatory circulatory disorders and geriatrics, which can significantly improve the quality of management of patients with a combination of hypertension and syncope, is stated.

The duration of intrauterine development influences discrimination of speech prosody in infants.

Auditory speech discrimination is essential for normal language development. Children born preterm are at greater risk of language developmental delays. Using functional near-infrared spectroscopy at term-equivalent age, the present study investigated early discrimination of speech prosody in 62 neonates born between week 23 and 41 of gestational age (GA). We found a significant positive correlation between GA at birth and neural discrimination of forward versus backward speech at term-equivalent age. Cluster analysis identified a critical threshold at around week 32 of GA, pointing out the existence of subgroups. Infants born before week 32 of GA exhibited a significantly different pattern of hemodynamic response to speech stimuli compared to infants born at or after week 32 of GA. Thus, children born before the GA of 32weeks are especially vulnerable to early speech discrimination deficits. To support their early language development, we therefore suggest a close follow-up and additional speech and language therapy especially in the group of children born before week 32 of GA.

Use of Functional Near Infrared Spectroscopy to Assess Syntactic Processing by Monolingual and Bilingual Adults and Children.

This exploratory study assessed the use of functional Near Infrared Spectroscopy (fNIRS) to examine hemodynamic response patterns during sentence processing. Four groups of participants: monolingual English children, bilingual Chinese-English children, bilingual Chinese-English adults and monolingual English adults were given an agent selection syntactic processing task. Bilingual child participants were classified as simultaneous or sequential bilinguals to examine the impact of first language, age of second-language acquisition (AoL2A), and the length of second language experience on behavioral performance and cortical activation. Participants were asked to select the agent of four types of sentences: subject-verb-object (SVO), passive (PAS), subject-extracted relative clause (SR), and object-extracted relative clause (OR) adopted from the “Whatdunit” task by Montgomery et al. (2016). Semantic cues were removed by using inanimate nouns for agents and patients, which constrained participants to make decisions based on syntactic knowledge. Behavioral results showed greater accuracy for canonical SVO and SR sentence types than for noncanonical OR and PAS sentence types, which aligns with prior studies. Neuroimaging results revealed greater hemodynamic responses to relative clauses (i.e., SR and OR sentences) than to simple sentences (SVO and PAS), especially for Chinese-English bilinguals suggesting first-language transfer influencing sentence processing in English. The effects AoL2A and the length of second language experience showed no significant differences between simultaneous and sequential bilinguals or between bilingual adults and children for identifying the correct agent in each sentence. However, neuroimaging results demonstrated greater hemodynamic responses in right dorsolateral prefrontal cortex (DLPFC) and left inferior parietal lobule (IPL) in simultaneous bilinguals compared to sequential bilinguals and greater hemodynamic responses in left and right DLPFC and left IPL among bilingual adults. Different behavioral and neural hemodynamic response patterns afford new insights into the effects of syntactic knowledge on sentence processing.

Individual Differences in Hemodynamic Responses Measured on the Head Due to a Long-Term Stimulation Involving Colored Light Exposure and a Cognitive Task: A SPA-fNIRS Study.

When brain activity is measured by neuroimaging, the canonical hemodynamic response (increase in oxygenated hemoglobin ([O2Hb]) and decrease in deoxygenated hemoglobin ([HHb]) is not always seen in every subject. The reason for this intersubject-variability of the responses is still not completely understood. This study is performed with 32 healthy subjects, using the systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS) approach. We investigate the intersubject variability of hemodynamic and systemic physiological responses, due to a verbal fluency task (VFT) under colored light exposure (CLE; blue and red). Five and seven different hemodynamic response patterns were detected in the subgroup analysis of the blue and red light exposure, respectively. We also found that arterial oxygen saturation and mean arterial pressure were positively correlated with [O2Hb] at the prefrontal cortex during the CLE-VFT independent of the color of light and classification of the subjects. Our study finds that there is substantial intersubject-variability of cerebral hemodynamic responses, which is partially explained by subject-specific systemic physiological changes induced by the CLE-VFT. This means that both subgroup analyses and the additional assessment of systemic physiology are of crucial importance to achieve a comprehensive understanding of the effects of a CLE-VFT on human subjects.

Long-Term Blue Light Exposure Changes Frontal and Occipital Cerebral Hemodynamics: Not All Subjects React the Same.

In modern society, we are increasingly exposed to numerous sources of blue light, including screens (e.g., TVs, computers, laptops, smartphones, tablets) and light from fluorescent and LED lamps. Due to this wide range of applications, the effects of blue light exposure (BLE) on the human physiology need to be thoroughly studied. To investigate the impact of long-term BLE on frontal and occipital human cerebral hemodynamics and oxygenation using functional near-infrared spectroscopy (fNIRS) neuroimaging. 32 healthy right-handed subjects (20 females, 12 males; age: 23.8±2.2years) were exposed to blue LED light for 15minutes. Before (baseline, 8min) and after (recovery, 10min) the BLE, subjects were in darkness. We measured the concentration changes of oxyhemoglobin ([O2Hb]) and deoxyhemoglobin ([HHb]) at the prefrontal cortex (PFC) and visual cortex (VC) by fNIRS during the experiment. Subjects were then classified into different groups based on their hemodynamic response pattern of [O2Hb] at the PFC and VC during BLE. On the group level (32 subjects), we found an increase in [O2Hb] and a decrease in [HHb] at both cortices during BLE. Evoked changes of [O2Hb] were higher at the VC compared to the PFC. Eight different hemodynamic response patterns were detected in the subgroup analysis, while an increase of [O2Hb] in both cortices was the most common pattern (8 out of 32 cases, 25%) during BLE. Our study showed that the hemodynamic and oxygenation changes at the PFC and VC during BLE (i) were generally higher in the VC compared to the PFC, (ii) showed an intersubject variability with respect to their magnitudes and shapes, and (iii) can be classified into eight groups. We conclude that blue light affects humans differently. It is essential to consider this when assessing the impact of the BLE on society.

Characterizing hemodynamic response alterations during basketball dribbling.

Knowledge on neural processing during complex non-stationary motion sequences of sport-specific movements still remains elusive. Hence, we aimed at investigating hemodynamic response alterations during a basketball slalom dribbling task (BSDT) using multi-distance functional near-infrared spectroscopy (fNIRS) in 23 participants (12 females). Additionally, we quantified how the brain adapts its processing as a function of altered hand use (dominant right hand (DH) vs. non-dominant left hand (NDH) vs. alternating hands (AH)) and pace of execution (slow vs. fast) in BSDT. We found that BSDT activated bilateral premotor cortex (PMC), supplementary motor cortex (SMA), primary motor cortex (M1) as well as inferior parietal cortex and somatosensory association cortex. Slow dominant hand dribbling (DHslow) evoked lower contralateral hemodynamic responses in sensorimotor regions compared to fast dribbling (DHfast). Furthermore, during DHslow dribbling, we found lower hemodynamic responses in ipsilateral M1 as compared to dribbling with alternating hands (AHslow). Hence, altered task complexity during BSDT induced differential hemodynamic response patterns. Furthermore, a correlation analysis revealed that lower levels of perceived task complexity are associated with lower hemodynamic responses in ipsilateral PMC-SMA, which is an indicator for neuronal efficiency in participants with better basketball dribbling skills. The present study extends previous findings by showing that varying levels of task complexity are reflected by specific hemodynamic response alterations even during sports-relevant motor behavior. Taken together, we suggest that quantifying brain activation during complex movements is a prerequisite for assessing brain-behavior relations and optimizing motor performance.

Differences in Respiratory Muscle Responses to Hyperpnea or Loaded Breathing in COPD

We aimed to compare acute mechanical and metabolic responses of the diaphragm and rib cage inspiratory muscles during two different types of respiratory loading in patients with chronic obstructive pulmonary disease. In 16 patients (age, 65 ± 13 yr; 56% male; forced expiratory volume in the first second, 60 ± 6%pred; maximum inspiratory pressure, 82 ± 5%pred), assessments of respiratory muscle EMG, esophageal pressure (Pes) and gastric pressures, breathing pattern, and noninvasive assessments of systemic (V˙O2, cardiac output, oxygen delivery and extraction) and respiratory muscle hemodynamic and oxygenation responses (blood flow index, oxygen delivery index, deoxyhemoglobin concentration, and tissues oxygen saturation [StiO2]), were performed during hyperpnea and loaded breathing. During hyperpnea, breathing frequency, minute ventilation, esophageal and diaphragm pressure-time product per minute, cardiac output, and V˙O2 were higher than during loaded breathing (P < 0.05). Average inspiratory Pes and transdiaphragmatic pressure per breath, scalene (SCA), sternocleidomastoid, and intercostal muscle activation were higher during loading breathing compared with hyperpnea (P < 0.05). Higher transdiaphragmatic pressure during loaded breathing compared with hyperpnea was mostly due to higher inspiratory Pes (P < 0.05). Diaphragm activation, inspiratory and expiratory gastric pressures, and rectus abdominis muscle activation did not differ between the two conditions (P > 0.05). SCA-blood flow index and oxygen delivery index were lower, and SCA-deoxyhemoglobin concentration was higher during loaded breathing compared with hyperpnea. Furthermore, SCA and intercostal muscle StiO2 were lower during loaded breathing compared with hyperpnea (P < 0.05). Greater inspiratory muscle effort during loaded breathing evoked larger rib cage and neck muscle activation compared with hyperpnea. In addition, lower SCA and intercostal muscle StiO2 during loaded breathing compared with hyperpnea indicates a mismatch between inspiratory muscle oxygen delivery and utilization induced by the former condition.

Mapping optogenetically-driven single-vessel fMRI with concurrent neuronal calcium recordings in the rat hippocampus

Extensive in vivo imaging studies investigate the hippocampal neural network function, mainly focusing on the dorsal CA1 region given its optical accessibility. Multi-modality fMRI with simultaneous hippocampal electrophysiological recording reveal broad cortical correlation patterns, but the detailed spatial hippocampal functional map remains lacking given the limited fMRI resolution. In particular, hemodynamic responses linked to specific neural activity are unclear at the single-vessel level across hippocampal vasculature, which hinders the deciphering of the hippocampal malfunction in animal models and the translation to critical neurovascular coupling (NVC) patterns for human fMRI. We simultaneously acquired optogenetically-driven neuronal Ca2+ signals with single-vessel blood-oxygen-level-dependent (BOLD) and cerebral-blood-volume (CBV)-fMRI from individual venules and arterioles. Distinct spatiotemporal patterns of hippocampal hemodynamic responses were correlated to optogenetically evoked and spreading depression-like calcium events. The calcium event-related single-vessel hemodynamic modeling revealed significantly reduced NVC efficiency upon spreading depression-like (SDL) events, providing a direct measure of the NVC function at various hippocampal states.

Hemodynamic responses are abnormal in isolated cervical dystonia.

Neuroimaging studies using functional magnetic resonance imaging (fMRI), which measures brain activity by detecting the changes in blood oxygenation levels, are advancing our understanding of the pathophysiology of dystonia. Neurobiological disturbances in dystonia, however, may affect neurovascular coupling and impact the interpretability of fMRI studies. We evaluated here whether the hemodynamic response patterns during a behaviorally matched motor task are altered in isolated cervical dystonia (CD). Twenty-five CD patients and 25 healthy controls (HCs) underwent fMRI scanning during a paced finger tapping task (nondystonic task in patients). Imaging data were analyzed using a constrained principal component analysis-a statistical method that combines regression analysis and principal component analysis and enables the extraction of task-related functional networks and determination of the spatial and temporal hemodynamic response patterns associated with the task performance. Data from three patients and two controls were removed due to excessive movement. No significant differences in demographics or motor performance were observed. Three task-associated functional brain networks were identified. During task performance, reduced hemodynamic responses were seen in a sensorimotor network and in a network that included key nodes of the default mode, executive control and visual networks. During rest, reductions in hemodynamic responses were seen in the cognitive/visual network. Lower hemodynamic responses within the primary sensorimotor network in patients were correlated with the increased dystonia severity. Pathophysiological disturbances in isolated CD, such as alterations in inhibitory signaling and dopaminergic neurotransmission, may impact neurovascular coupling. Not accounting for hemodynamic response differences in fMRI studies of dystonia could lead to inaccurate results and interpretations.

Modeling Brain Diverse and Complex Hemodynamic Response Patterns via Deep Recurrent Autoencoder

For decades, a variety of task-based functional MRI (tfMRI) data analysis approaches have been developed, including the general linear model (GLM), sparse representations, and independent component analysis (ICA). However, these methods are mainly shallow models and are limited in faithfully modeling the complex, diverse, and concurrent spatial–temporal functional brain activities. Recently, recurrent neural networks (RNNs) have demonstrated great superiority in modeling temporal dependency of signals, while autoencoder models have been proven to be effective in automatically estimating the optimal representations of the original data. These characteristics of RNNs and autoencoders naturally meet the requirement of modeling hemodynamic response patterns in tfMRI data. Thus, we propose a novel unsupervised framework of deep recurrent autoencoder (DRAE) for modeling hemodynamic response patterns in this article. The basic idea of the DRAE model is to combine the deep RNN and the autoencoder to automatically characterize the meaningful functional brain networks and corresponding diverse and complex hemodynamic response patterns simultaneously. The experimental results demonstrate the superiority of the proposed DRAE model in automatically estimating the diverse and complex hemodynamic response patterns.

P4511Characteristic hemodynamic and metabolic response patterns differ between patients with stable chronic left vs right heart failure

Abstract Background Patients with chronic left and right heart failure show a reduction in peak oxygen uptake (VO2), even with optimal medical therapy. A non-invasive determination whether the mechanism of exercise limitation is primarily due to left or right-heart failure may be a challenge in clinical practice. The simultaneous analysis of metabolic and hemodynamic responses during exercise may allow an improved differentiation of exercise limitation. However, only little is known about the combined hemodynamic/metabolic exercise response patterns in these patients. OBJECTIVES We sought to characterize the simultaneous hemodynamic and metabolic response to exercise in stable patients with chronic, isolated left vs right heart failure. Methods We analyzed a cohort of highly selected patients with isolated right heart failure (group 1) and isolated left heart failure (group 2). All patients were in functional class II and III, and under stable medical Treatment. All patients had received right heart catheterization before enrollment. All of the patients in group 1 and none of the patients in group 2 showed an elevated pulmonary vascular resistance (PVR). All patients received a cardiopulmonary exercise test (CPET) with a ramp protocol up to maximal exercise tolerance. During a second visit, a combined CPET/stress echocardiography was performed with a two step constant work rate protocol. For step 1, a workrate below the patients' anaerobic threshold was chosen. For step 2, 80% of the patients' maximum workrate from the ramp test was chosen. Each step was performed until a complete echocardiographic image acquisition was obtained. Echocardiographic parameters, including stroke volume measurements, were obtained once at rest and for each of the two exercise steps. Results We recruited 18 patients (n=9 in group 1, n=9 in group 2). There were no significant differences in demographic baseline characteristics. There were no adverse events. In the inital ramp CPET, both groups showed a moderate reduction in peak VO2 (53,0±12,4 vs 63,3±12,8% of predicted). The absolute peak VO2 values, corrected for body weight, showed no significant difference (16,7±4,5 vs 16,5±5,1 ml/min/kg). While the increase in VO2 (Figure 1A) and cardiac index (Figure 1B) during step 1 and step 2 of the simultaneous CPET/stress echocardiography was similar between both groups, the increase of stroke volume index with exercise was significantly reduced in the group with right heart failure, while the group with left heart failure increased stroke volume index during exercise (Figure 1C). Figure 1 Conclusions The simultaneous evaluation of hemodynamic and metabolic parameters by CPET/stress echocardiography is safe and may reveal characteristic response patterns to exercise in patients with chronic left vs right heart failure. Patients with right heart failure seem to be less able to increase stroke volume during exercise than patients with left heart failure. Acknowledgement/Funding This project was partly funded by Actelion Pharmaceuticals

Non-invasive hemodynamic profiling of patients undergoing hemodialysis - a multicenter observational cohort study

BackgroundIntradialytic blood pressure (BP) measurement is currently the main parameter used for monitoring hemodynamics during hemodialysis (HD). Since BP is dependent on cardiac output and total peripheral resistance, knowledge of these parameters throughout the HD treatment would potentially be valuable.MethodsThe use of a novel non-invasive monitoring system for profiling hemodynamic response patterns during HD was explored: a whole-body bio-impedance system was used to assess cardiac index (CI), total peripheral resistance index (TPRI), cardiac power index (CPI) among other parameters in chronic HD patients from 4 medical centers. Measurements were made pre, during and post dialysis. Patients were grouped into 5 hemodynamic profiles based on their main hemodynamic response during dialysis i.e. high TPRI; high CPI; low CPI; low TPRI and those with normal hemodynamics. Comparisons were made between the groups for baseline characteristics and 1-year mortality.ResultsIn 144 patients with mean age of 67.3 ± 12.1 years pre-dialysis hemodynamic measurements were within normal limits in 35.4% but only 6.9% overall remained hemodynamically stable during dialysis. Intradialytic BP decreased in 65 (45.1%) in whom, low CPI (47 (72.3%)) and low TPRI (18 (27.7%) were recorded. At 1-year follow-up, mortality rates were highest in patients with low CPI (23.4%) and low TPRI (22.2%).ConclusionsNon-invasive assessment of patients’ response to HD provides relevant hemodynamic information that exceeds that provided by currently used BP measurements. Use of these online analyses could potentially improve the safety and performance standards of dialysis by guiding appropriate interventions, particularly in responding to hypertension and hypotension.

The Differences Between Winners and Losers in Competition: the Relation of Cognitive and Emotional Aspects During a Competition to Hemodynamic Responses

Sympathetic nervous activity plays an important role in behavior related to competition. However, the hemodynamic response patterns of winners and losers during competition remain largely unknown. This study examined the differences between winners’ and losers’ hemodynamic and psychological responses (their evaluation of perceived demands and resources and their positive and negative emotions) to competition. The participants included 30 university students, who completed a competitive mirror-drawing task (three times) in pairs as their cardiac output (CO) and total peripheral resistance (TPR) were measured. Additionally, they were required to answer a question regarding their subjective psychological state before and during the competition. The participants were assigned to a Winner or a Loser group based on outcomes. The Winner group presented greater CO changes than the Loser group, while the Loser group displayed greater TPR changes than the Winner group. Moreover, the Winner group scored significantly higher on resource/demand evaluation than the Loser group. Although we observed no significant differences in terms of negative emotion, only the Winner group showed increased positive emotions from precompetition to competition. This evidence suggests that winners and losers display different patterns of enhanced sympathetic-cardiovascular responses to competition; winners are characterized by a myocardial response pattern, while losers are characterized by a vascular response pattern. The psychological responses that depend on one’s position during a competition provide information on the quality of hemodynamic responses to competition.

Early Detection of Alzheimer's Disease Using Non-invasive Near-Infrared Spectroscopy.

Mild cognitive impairment (MCI) is a cognitive disorder characterized by memory impairment, wherein patients have an increased likelihood of developing Alzheimer’s disease (AD). The classification of MCI and different AD stages is therefore fundamental for understanding and treating the disease. This study aimed to comprehensively investigate the hemodynamic response patterns among various subject groups. Functional near-infrared spectroscopy (fNIRS) was employed to measure signals from the frontal and bilateral parietal cortices of healthy controls (n = 8), patients with MCI (n = 9), mild (n = 6), and moderate/severe AD (n = 7) during a digit verbal span task (DVST). The concentration changes of oxygenated hemoglobin (HbO) in various subject groups were thoroughly explored and tested. Result revealed that abnormal patterns of hemodynamic response were observed across all subject groups. Greater and steeper reductions in HbO concentration were consistently observed across all regions of interest (ROIs) as disease severity developed from MCI to moderate/severe AD. Furthermore, all the fNIRS-derived indexes were found to be significantly and positively correlated to the clinical scores in all ROIs (R ≥ 0.4, P < 0.05). These findings demonstrate the feasibility of utilizing fNIRS for the early detection of AD, suggesting that fNIRS-based approaches hold great promise for exploring the mechanisms underlying the progression of AD.