The effect of acetazolamide and carbon dioxide on cerebral hemodynamic changes on near-infrared spectroscopy in young rabbits

Neurovascular coupling in humans: Physiology, methodological advances and clinical implications

Neurovascular coupling reflects the close temporal and regional linkage between neural activity and cerebral blood flow. Although providing mechanistic insight, our understanding of neurovascular coupling is largely limited to non-physiologicalex vivopreparations and non-human models using sedatives/anesthetics with confounding cerebrovascular implications. Herein, with particular focus on humans, we review the present mechanistic understanding of neurovascular coupling and highlight current approaches to assess these responses and the application in health and disease. Moreover, we present new guidelines for standardizing the assessment of neurovascular coupling in humans. To improve the reliability of measurement and related interpretation, the utility of new automated software for neurovascular coupling is demonstrated, which provides the capacity for coalescing repetitive trials and time intervals into single contours and extracting numerous metrics (e.g., conductance and pulsatility, critical closing pressure, etc.) according to patterns of interest (e.g., peak/minimum response, time of response, etc.). This versatile software also permits the normalization of neurovascular coupling metrics to dynamic changes in arterial blood gases, potentially influencing the hyperemic response. It is hoped that these guidelines, combined with the newly developed and openly available software, will help to propel the understanding of neurovascular coupling in humans and also lead to improved clinical management of this critical physiological function.

Breath holding reveals differences in fMRI BOLD signal in children and adults

Application of fMRI to studies of cognitive development is of growing interest because of its sensitivity and non-invasive nature. However, interpretation of fMRI results in children is presently based on vascular dynamics that have been studied primarily in healthy adults. Comparison of the neurological basis of cognitive development is valid to the extent that the neurovascular responsiveness between children and adults is equal. The present study was designed to detect age-related vascular differences that may contribute to altered BOLD fMRI signal responsiveness. We examined BOLD signal changes in response to breath holding, a global, systemic state change in brain oxygenation. Children exhibited greater percent signal changes than adults in grey and white matter, and this was accompanied by an increase in noise. Consequently, the volume of activation exceeding statistical threshold was reduced in children. The reduced activation in children was well modeled by adding noise to adult data. These findings raise the possibility that developmental differences in fMRI findings between children and adults could, under some circumstances, reflect greater noise in the BOLD response in the brains of children than adults. BOLD responses varied across brain regions, but showed similar regional variation in children and adults.

Assessment of spatially resolved spectroscopy during cardiopulmonary bypass

Controversy remains about which tissue is primarily responsible for light attenuation of near infrared spectroscopy (NIRS) in the adult, the spatial resolution provided and the preferred algorithm for quantification. Until recently, changes in NIRS have not been fully quantified and have been difficult to interpret without sophisticated computation. A new development by Hamamatsu Photonics, the spatially resolved spectrometer (SRS), may be able to give a quantitative measure of oxygen saturation. We have incorporated the SRS into a multimodality monitoring system for the purpose of direct validation against jugular bulb oxygen saturation (SjO2) in patients undergoing routine cardiopulmonary bypass (CPB). The importance of this investigation is in the development of the SRS machine which shows potential as a useful clinical tool. The results demonstrated good correlation between SRS and SjO2 in 12 out of the 24 patients studied. Although these results are encouraging, this study suggests that the SRS, in its present form, is not a reliable clinical monitor of cerebral oxygen saturation during CPB. © 1999 Society of Photo-Optical Instrumentation Engineers.