title: Spatial mapping of dynamic cerebral autoregulation by multichannel near-infrared spectroscopy in high-grade carotid artery disease.
abstract: The exact spatial distribution of impaired cerebral autoregulation in carotid artery disease is unknown. In this pilot study, we present a new approach of multichannel near-infrared spectroscopy (mcNIRS) for non-invasive spatial mapping of dynamic autoregulation in carotid artery disease. In 15 patients with unilateral severe carotid artery stenosis or occlusion, cortical hemodynamics in the bilateral frontal cortex were assessed from changes in oxyhemoglobin concentration using 52-channel NIRS (spatial resolution ∼2 cm). Dynamic autoregulation was graded by the phase shift between respiratory-induced 0.1 Hz oscillations of blood pressure and oxyhemoglobin. Ten of 15 patients showed regular phase values in the expected (patho) physiological range.Five patients had clearly outlying irregular phase values mostly due to artifacts. In patients with a regular phase pattern, a significant side-to-side difference of dynamic autoregulation was observed for the cortical border zone area between the middle and anterior cerebral artery (p < 0.05). In conclusion, dynamic cerebral autoregulation can be spatially assessed from slow hemodynamic oscillations with mcNIRS. In high-grade carotid artery disease,cortical dynamic autoregulation is affected mostly in the vascular border zone. Spatial mapping of dynamic autoregulation may serve as a powerful tool for identifying brain regions at specific risks for hemodynamic infarction.
authors.affiliation: University Medical Center Freiburg, Department of Neurology, D-79106 Freiburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Reinhard
authors.affiliation: University Medical Center Freiburg, Department of Neurology, D-79106 Freiburg, GermanybUniversity of Freiburg, BrainLinks-BrainTools Cluster of Excellence, D-79104 Freiburg, GermanycUniversity of Freiburg, Freiburg Brain Imaging Center, D-79106 Freiburg.
authors.forename: F Konrad
authors.initials: FK
authors.lastname: Schumacher
authors.affiliation: University Medical Center Freiburg, Department of Neurology, D-79106 Freiburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rutsch
authors.affiliation: University Medical Center Freiburg, Department of Neurology, D-79106 Freiburg, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Oeinck
authors.affiliation: University of Freiburg, Center for Data Analysis and Modeling, D-79104 Freiburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Timmer
authors.affiliation: University Medical Center Freiburg, Department of Neuroradiology, D-79106 Freiburg, Germany.
authors.forename: Irina
authors.initials: I
authors.lastname: Mader
authors.affiliation: University of Freiburg, BrainLinks-BrainTools Cluster of Excellence, D-79104 Freiburg, GermanycUniversity of Freiburg, Freiburg Brain Imaging Center, D-79106 Freiburg, GermanyeUniversity of Freiburg, Center for Data Analysis and Modeling, D-79104 Freiburg.
authors.forename: Björn
authors.initials: B
authors.lastname: Schelter
authors.affiliation: University Medical Center Freiburg, Department of Neurology, D-79106 Freiburg, GermanybUniversity of Freiburg, BrainLinks-BrainTools Cluster of Excellence, D-79104 Freiburg, GermanycUniversity of Freiburg, Freiburg Brain Imaging Center, D-79106 Freiburg.
authors.forename: Cornelius
authors.initials: C
authors.lastname: Weiller
authors.affiliation: University Medical Center Freiburg, Department of Neurology, D-79106 Freiburg, GermanybUniversity of Freiburg, BrainLinks-BrainTools Cluster of Excellence, D-79104 Freiburg, GermanycUniversity of Freiburg, Freiburg Brain Imaging Center, D-79106 Freiburg.
authors.forename: Christoph P
authors.initials: CP
authors.lastname: Kaller
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001931:Brain Mapping / Q000379:methods*; D002340:Carotid Artery Diseases / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010108:Oxyhemoglobins / Q000032:analysis*; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
chemical_list: D010108:Oxyhemoglobins