1
|
Lin S, Wang D, Sang H, Xiao H, Yan K, Wang D, Zhang Y, Yi L, Shao G, Shao Z, Yang A, Zhang L, Sun J. Predicting poststroke dyskinesia with resting-state functional connectivity in the motor network. NEUROPHOTONICS 2023; 10:025001. [PMID: 37025568 PMCID: PMC10072005 DOI: 10.1117/1.nph.10.2.025001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
SIGNIFICANCE Motor function evaluation is essential for poststroke dyskinesia rehabilitation. Neuroimaging techniques combined with machine learning help decode a patient's functional status. However, more research is needed to investigate how individual brain function information predicts the dyskinesia degree of stroke patients. AIM We investigated stroke patients' motor network reorganization and proposed a machine learning-based method to predict the patients' motor dysfunction. APPROACH Near-infrared spectroscopy (NIRS) was used to measure hemodynamic signals of the motor cortex in the resting state (RS) from 11 healthy subjects and 31 stroke patients, 15 with mild dyskinesia (Mild), and 16 with moderate-to-severe dyskinesia (MtS). The graph theory was used to analyze the motor network characteristics. RESULTS The small-world properties of the motor network were significantly different between groups: (1) clustering coefficient, local efficiency, and transitivity: MtS > Mild > Healthy and (2) global efficiency: MtS < Mild < Healthy. These four properties linearly correlated with patients' Fugl-Meyer Assessment scores. Using the small-world properties as features, we constructed support vector machine (SVM) models that classified the three groups of subjects with an accuracy of 85.7%. CONCLUSIONS Our results show that NIRS, RS functional connectivity, and SVM together constitute an effective method for assessing the poststroke dyskinesia degree at the individual level.
Collapse
Affiliation(s)
- Shuoshu Lin
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Dan Wang
- Beijing Rehabilitation Hospital of Capital Medical University, Department of Traditional Chinese Medicine, Beijing, China
| | - Haojun Sang
- Chinese Institute for Brain Research, Beijing, China
| | - Hongjun Xiao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Kecheng Yan
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Dongyang Wang
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Yizheng Zhang
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Li Yi
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Guangjian Shao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Zhiyong Shao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Aoran Yang
- Beijing Rehabilitation Hospital of Capital Medical University, Department of Traditional Chinese Medicine, Beijing, China
| | - Lei Zhang
- Chinese Institute for Brain Research, Beijing, China
- Capital Medical University, School of Biomedical Engineering, Beijing, China
| | - Jinyan Sun
- Foshan University, School of Medicine, Foshan, China
| |
Collapse
|
2
|
Zipfel J, Bantle SJ, Magunia H, Schlensak C, Neunhoeffer F, Schuhmann MU, Lescan M. Non-Invasive Cerebral Autoregulation Monitoring During Awake Carotid Endarterectomy Identifies Clinically Significant Brain Ischaemia. Eur J Vasc Endovasc Surg 2020; 60:647-654. [DOI: 10.1016/j.ejvs.2020.07.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 11/16/2022]
|
3
|
Othman MH, Bhattacharya M, Møller K, Kjeldsen S, Grand J, Kjaergaard J, Dutta A, Kondziella D. Resting-State NIRS-EEG in Unresponsive Patients with Acute Brain Injury: A Proof-of-Concept Study. Neurocrit Care 2020; 34:31-44. [PMID: 32333214 DOI: 10.1007/s12028-020-00971-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Neurovascular-based imaging techniques such as functional MRI (fMRI) may reveal signs of consciousness in clinically unresponsive patients but are often subject to logistical challenges in the intensive care unit (ICU). Near-infrared spectroscopy (NIRS) is another neurovascular imaging technique but low cost, can be performed serially at the bedside, and may be combined with electroencephalography (EEG), which are important advantages compared to fMRI. Combined NIRS-EEG, however, has never been evaluated for the assessment of neurovascular coupling and consciousness in acute brain injury. METHODS We explored resting-state oscillations in eight-channel NIRS oxyhemoglobin and eight-channel EEG band-power signals to assess neurovascular coupling, the prerequisite for neurovascular-based imaging detection of consciousness, in patients with acute brain injury in the ICU (n = 9). Conscious neurological patients from step-down units and wards served as controls (n = 14). Unsupervised adaptive mixture-independent component analysis (AMICA) was used to correlate NIRS-EEG data with levels of consciousness and clinical outcome. RESULTS Neurovascular coupling between NIRS oxyhemoglobin (0.07-0.13 Hz) and EEG band-power (1-12 Hz) signals at frontal areas was sensitive and prognostic to changing consciousness levels. AMICA revealed a mixture of five models from EEG data, with the relative probabilities of these models reflecting levels of consciousness over multiple days, although the accuracy was less than 85%. However, when combined with two channels of bilateral frontal neurovascular coupling, weighted k-nearest neighbor classification of AMICA probabilities distinguished unresponsive patients from conscious controls with > 90% accuracy (positive predictive value 93%, false discovery rate 7%) and, additionally, identified patients who subsequently failed to recover consciousness with > 99% accuracy. DISCUSSION We suggest that NIRS-EEG for monitoring of acute brain injury in the ICU is worthy of further exploration. Normalization of neurovascular coupling may herald recovery of consciousness after acute brain injury.
Collapse
Affiliation(s)
- Marwan H Othman
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Mahasweta Bhattacharya
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Kirsten Møller
- Department of Neuroanesthesiology, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Kjeldsen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Johannes Grand
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jesper Kjaergaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anirban Dutta
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Daniel Kondziella
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
4
|
Andersen AV, Simonsen SA, Schytz HW, Iversen HK. Assessing low-frequency oscillations in cerebrovascular diseases and related conditions with near-infrared spectroscopy: a plausible method for evaluating cerebral autoregulation? NEUROPHOTONICS 2018; 5:030901. [PMID: 30689678 PMCID: PMC6156398 DOI: 10.1117/1.nph.5.3.030901] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/02/2018] [Indexed: 05/08/2023]
Abstract
BACKGROUND Cerebral autoregulation (CA) is the brain's ability to always maintain an adequate and relatively constant blood supply, which is often impaired in cerebrovascular diseases. Near-infrared spectroscopy (NIRS) examines oxygenated hemoglobin (OxyHb) in the cerebral cortex. Low- and very low-frequency oscillations ( LFOs ≈ 0.1 Hz and VLFOs ≈ 0.05 to 0.01 Hz) in OxyHb have been proposed to reflect CA. AIM To systematically review published results on OxyHb LFOs and VLFOs in cerebrovascular diseases and related conditions measured with NIRS. APPROACH A systematic search was performed in the MEDLINE database, which generated 36 studies relevant for inclusion. RESULTS Healthy people have relatively stable LFOs. LFO amplitude seems to reflect myogenic CA being decreased by vasomotor paralysis in stroke, by smooth muscle damage or as compensatory action in other conditions but can also be influenced by the sympathetic tone. VLFO amplitude is believed to reflect neurogenic and metabolic CA and is lower in stroke, atherosclerosis, and with aging. Both LFO and VLFO synchronizations appear disturbed in stroke, while the former is also altered in internal carotid stenosis and hypertension. CONCLUSION We conclude that amplitudes of LFOs and VLFOs are relatively robust measures for evaluating mechanisms of CA and synchronization analyses can show temporal disruption of CA. Further research and more coherent methodologies are needed.
Collapse
Affiliation(s)
- Adam Vittrup Andersen
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
- Address all correspondence to: Adam Vittrup Andersen, E-mail:
| | - Sofie Amalie Simonsen
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| | - Henrik Winther Schytz
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| | - Helle Klingenberg Iversen
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| |
Collapse
|
5
|
Goltsov A, Anisimova AV, Zakharkina M, Krupatkin AI, Sidorov VV, Sokolovski SG, Rafailov E. Bifurcation in Blood Oscillatory Rhythms for Patients with Ischemic Stroke: A Small Scale Clinical Trial using Laser Doppler Flowmetry and Computational Modeling of Vasomotion. Front Physiol 2017; 8:160. [PMID: 28386231 PMCID: PMC5362641 DOI: 10.3389/fphys.2017.00160] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/02/2017] [Indexed: 11/18/2022] Open
Abstract
We describe application of spectral analysis of laser Doppler flowmetry (LDF) signals to investigation of cerebrovascular haemodynamics in patients with post-acute ischemic stroke (AIS) and cerebrovascular insufficiency. LDF was performed from 3 to 7 days after the onset of AIS on forehead in the right and left supraorbital regions in patients. Analysis of LDF signals showed that perfusion in the microvasculature in AIS patients was lower than that in patients with cerebrovascular insufficiency. As a result of wavelet analysis of the LDF signals we obtained activation of the vasomotion in the frequency range of myogenic oscillation of 0.1 Hz and predominantly nutritive regime microcirculation after systemic thrombolytic therapy of the AIS patients. In case of significant stroke size, myogenic activity, and nutritive pattern microhaemodynamics were reduced, in some cases non-nutritive pattern and/or venular stasis was revealed. Wavelet analysis of the LDF signals also showed asymmetry in wavelet spectra of the LDF signals obtained in stroke-affected and unaffected hemispheres in the AIS patients. A mechanism underlying the observed asymmetry was analyzed by computational modeling of vasomotion developed in Arciero and Secomb (2012). We applied this model to describe relaxation oscillation of arteriole diameter which is forced by myogenic oscillation induced by synchronous calcium oscillation in vascular smooth muscle cells. Calculation showed that vasomotion frequency spectrum at the low-frequency range (0.01 Hz) is reciprocally modulated by myogenic oscillation (0.1 Hz) that correlates with experimental observation of inter-hemispheric variation in the LDF spectrum.
Collapse
Affiliation(s)
- Alexey Goltsov
- Division of Science, School of Science, Engineering and Technology, Abertay University Dundee, UK
| | - Anastasia V Anisimova
- Department of Neurology, Neurosurgery and Medical Genetics, Pirogov Russian National Research Medical University, First City Hospital Moscow, Russia
| | - Maria Zakharkina
- Department of Neurology, Neurosurgery and Medical Genetics, Pirogov Russian National Research Medical University, First City Hospital Moscow, Russia
| | - Alexander I Krupatkin
- Department of Functional Diagnostics, Priorov's Central Institute of Traumatology and Orthopedics Moscow, Russia
| | | | - Sergei G Sokolovski
- Optoelectronics and Biomedical Photonics Group, Photonics and Nanoscience Group, Aston Institute of Photonic Technologies, Aston University Birmingham, UK
| | - Edik Rafailov
- Optoelectronics and Biomedical Photonics Group, Photonics and Nanoscience Group, Aston Institute of Photonic Technologies, Aston University Birmingham, UK
| |
Collapse
|
6
|
Oldag A, Neumann J, Goertler M, Hinrichs H, Heinze HJ, Kupsch A, Sweeney-Reed CM, Kopitzki K. Near-infrared spectroscopy and transcranial sonography to evaluate cerebral autoregulation in middle cerebral artery steno-occlusive disease. J Neurol 2016; 263:2296-2301. [PMID: 27544503 DOI: 10.1007/s00415-016-8262-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 08/06/2016] [Accepted: 08/08/2016] [Indexed: 10/21/2022]
Abstract
The measurement of autoregulatory delay by near-infrared spectroscopy (NIRS) has been proposed as an alternative technique to assess cerebral autoregulation, which is routinely assessed via transcranial Doppler sonography (TCD) in most centers. Comparitive studies of NIRS and TCD, however, are largely missing. We investigated whether cerebrovascular reserve (CVR), as assessed via TCD, correlates with the delay of the autoregulatory response to changes in arterial blood pressure (ABP) as assessed by NIRS, i.e., if impaired upstream vasomotor reactivity is reflected by downstream cortical autoregulation. Twenty patients with unilateral high-grade steno-occlusion of the middle cerebral artery (MCA) underwent bilateral multichannel NIRS of the cortical MCA distributions over a period of 6 min while breathing at a constant rate of 6 cycles/min to induce stable oscillations in ABP. The phase shift φ between ABP and cortical blood oxygenation was calculated as a measure of autoregulatory latency. In a subgroup of 13 patients, CO2 reactivity of the MCAs was determined by TCD to assess CVR in terms of normalized autoregulatory response (NAR). Mean phase shift between ABP and blood oxygenation was significantly increased over the hemisphere ipsilateral to the steno-occlusion (n = 20, p = 0.042). The interhemispheric difference Δφ in phase shift was significantly larger in patients with markedly diminished or exhausted CVR (NAR < 10) than in patients with normal NAR values (NAR ≥ 10) (p = 0.007). Within the MCA core distribution territory, a strong correlation existed between Δφ and CO2 reactivity of the affected MCA (n = 13, r = -0.78, p = 0.011). NIRS may provide an alternative or supplementary approach to evaluate cerebral autoregulation in risk assessment of ischemic events in steno-occlusive disease of cerebral arteries, especially in patients with insufficient bone windows for TCD.
Collapse
Affiliation(s)
- Andreas Oldag
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Jens Neumann
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Michael Goertler
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany.,Leibniz Institute for Neurobiology, Brenneckestrasse 6, 39118, Magdeburg, Germany
| | - Hermann Hinrichs
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany.,Leibniz Institute for Neurobiology, Brenneckestrasse 6, 39118, Magdeburg, Germany
| | - Hans-Jochen Heinze
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany.,Leibniz Institute for Neurobiology, Brenneckestrasse 6, 39118, Magdeburg, Germany.,German Center for Neurodegenerative Diseases (DZNE), Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Andreas Kupsch
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Catherine M Sweeney-Reed
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Klaus Kopitzki
- Clinic for Neurology and Stereotactic Neurosurgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany. .,Leibniz Institute for Neurobiology, Brenneckestrasse 6, 39118, Magdeburg, Germany.
| |
Collapse
|
7
|
Guhathakurta D, Dutta A. Computational Pipeline for NIRS-EEG Joint Imaging of tDCS-Evoked Cerebral Responses-An Application in Ischemic Stroke. Front Neurosci 2016; 10:261. [PMID: 27378836 PMCID: PMC4913108 DOI: 10.3389/fnins.2016.00261] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/23/2016] [Indexed: 12/22/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) modulates cortical neural activity and hemodynamics. Electrophysiological methods (electroencephalography-EEG) measure neural activity while optical methods (near-infrared spectroscopy-NIRS) measure hemodynamics coupled through neurovascular coupling (NVC). Assessment of NVC requires development of NIRS-EEG joint-imaging sensor montages that are sensitive to the tDCS affected brain areas. In this methods paper, we present a software pipeline incorporating freely available software tools that can be used to target vascular territories with tDCS and develop a NIRS-EEG probe for joint imaging of tDCS-evoked responses. We apply this software pipeline to target primarily the outer convexity of the brain territory (superficial divisions) of the middle cerebral artery (MCA). We then present a computational method based on Empirical Mode Decomposition of NIRS and EEG time series into a set of intrinsic mode functions (IMFs), and then perform a cross-correlation analysis on those IMFs from NIRS and EEG signals to model NVC at the lesional and contralesional hemispheres of an ischemic stroke patient. For the contralesional hemisphere, a strong positive correlation between IMFs of regional cerebral hemoglobin oxygen saturation and the log-transformed mean-power time-series of IMFs for EEG with a lag of about -15 s was found after a cumulative 550 s stimulation of anodal tDCS. It is postulated that system identification, for example using a continuous-time autoregressive model, of this coupling relation under tDCS perturbation may provide spatiotemporal discriminatory features for the identification of ischemia. Furthermore, portable NIRS-EEG joint imaging can be incorporated into brain computer interfaces to monitor tDCS-facilitated neurointervention as well as cortical reorganization.
Collapse
Affiliation(s)
| | - Anirban Dutta
- Department of Psychology and Neurosciences, IfADo - Leibniz Research Centre for Working Environment and Human Factors Dortmund, Germany
| |
Collapse
|
8
|
Dullaart RP, Al-Daghri NM, Ashina M, Bouzas-Mosquera A, Brunetti ND, Buechler C, Chen HS, Corrales JJ, D'Archivio M, Dei Cas A, Pino GG, Gómez-Abril SA, Győri D, Haslacher H, Herder C, Kerstens MN, Koutsilieris M, Lombardi C, Lupattelli G, Mócsai A, Msaouel P, Orfao A, Ormazabal P, Pacher R, Perkmann T, Peteiro J, Plischke M, Reynaert NL, Ricci MA, Robles NR, Rocha M, Rutten EP, Sabico S, Santamaria F, Santoro F, Schmid A, Schmidt M, Schytz HW, Shyu KG, Tada H, Thorand B, Valerio G, Vesely DL, Wu TE, Yamagishi M, Yeh YT. Research update for articles published in EJCI in 2012. Eur J Clin Invest 2014. [DOI: 10.1111/eci.12319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|