Changes in cerebral blood flow after acetazolamide: an experimental study comparing near-infrared spectroscopy and SPECT.
OBJECTIVE
It is important to find a reliable and bedside method, which can estimate the cerebral blood flow (CBF) of patients in clinical settings. Estimation of CBF by calculating a blood flow index (BFI) using continuous wave near-infrared spectroscopy (CW-NIRS) and indocyanine green (ICG) as an i.v. tracer has been proposed to be a feasible and promising method. To validate if the BFI method can detect relative changes in CBF we compared data with the established method (133)Xenon single photon emission computer tomography ((133)Xe-SPECT).


METHODS
Ten healthy subjects were investigated before and after a bolus of acetazolamide. NIRS data were obtained using a multi source detector separation configuration in order to assess a corrected BFI (BFI(corr)) value, which attempts to eliminate contamination of skin blood flow.


RESULTS
Data obtained showed no significant correlation between CBF changes measured by (133)Xe-SPECT and BFI(corr) (0.133, P = 0.732). After acetazolamide, a 49% increase in CBF was detected using the (133)Xe-SPECT method, whereas no changes in any ICG variables were observed after acetazolamide.


CONCLUSIONS
The study shows that it is not possible to obtain reliable BFI data, which reflect changes in CBF after acetazolamide infusion, using the CW-NIRS and ICG method.
Schytz
H W
HW
Danish Headache Center and Department of Neurology Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Glostrup, Denmark. henrikschytz@dadlnet.dk
Wienecke
T
T
Jensen
L T
LT
Selb
J
J
Boas
D A
DA
Ashina
M
M
D000086:Acetazolamide / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D001160:Arterioles / Q000187:drug effects; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects; D002257:Carbonic Anhydrase Inhibitors / Q000494:pharmacology*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D007275:Injections, Intravenous; D008297:Male; D012039:Regional Blood Flow / Q000187:drug effects; D012867:Skin / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects; D019265:Spectroscopy, Near-Infrared; D015899:Tomography, Emission-Computed, Single-Photon; D014980:Xenon Radioisotopes; D055815:Young Adult
D002257:Carbonic Anhydrase Inhibitors; D014980:Xenon Radioisotopes; D007208:Indocyanine Green; D000086:Acetazolamide