title: Phase-shift between arterial flow and ICP pulse during infusion test.
abstract: BACKGROUND
  The dynamic relationship between pulse waveform of intracranial pressure (ICP) and transcranial Doppler (TCD) cerebral blood flow velocity (CBFV) may contain information about cerebrospinal compliance. This study investigated the possibility by focusing on the phase shift between fundamental harmonics of CBFV and ICP.
  
  
  METHODS
  Thirty-seven normal pressure hydrocephalus patients (20 men, mean age 58) underwent the cerebrospinal fluid (CSF) infusion tests. The infusion was performed via pre-implanted Ommaya reservoir. The TCD FV was recorded in the middle cerebral artery. Resulting continuous ICP and pressure-volume (PV) signals were analyzed by ICM+ software.
  
  
  RESULTS
  In initial stage of the CSF infusion, the phase shift was negative (median value = -11°, range = +60 to -117). There was significant inverse association of phase shift with brain elasticity (R = -0.51; p = 0.0009). In all tests, phase shift consistently decreased during gradual elevation of ICP (p = 0.00001). Magnitude of decrease in phase shift was inversely related to the peak-to-peak amplitude of ICP pulse waveform at a baseline (R = -0.51; p = 0.001).
  
  
  CONCLUSIONS
  Phase shift between fundamental harmonics of ICP and TCD waveforms decreases during elevation of ICP. This is caused by an increase of time delay between systolic peak of flow velocity wave and ICP pulse.
authors: Departments of Brain and Cognitive Engineering, Korea University, Anam-dong, Seongbu-gu, 136-713, Seoul, South Korea, dongjookim@korea.ac.kr.
authors: Dong-Joo
authors: DJ
authors: Kim
authors: Marek
authors: M
authors: Czosnyka
authors: Hakseung
authors: H
authors: Kim
authors: Olivier
authors: O
authors: Balédent
authors: Piotr
authors: P
authors: Smielewski
authors: Matthew R
authors: MR
authors: Garnett
authors: Zofia
authors: Z
authors: Czosnyka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000098:blood supply; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000503:physiopathology*; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged