Giacalone Giacomo, Zanoletti Marta, Re Rebecca, Germinario Bruno, Contini Davide, Spinelli Lorenzo, Torricelli Alessandro, Roveri Luisa
San Raffaele Scientific Institute, Neurology Department, Via Olgettina, Milan, Italy.
San Raffaele "Vita-Salute" University, Via Olgettina, Milan, Italy.
Neurophotonics. 2019 Jan;6(1):015003. doi: 10.1117/1.NPh.6.1.015003. Epub 2019 Feb 7.
Large vessel occlusion (LVO) stroke might cause different degrees of hemodynamic impairment that affects microcirculation and contributes to metabolic derangement. Time-domain near-infrared spectroscopy (TD-NIRS) estimates the oxygenation of microcirculation of cerebral outer layers. We measure hemoglobin species and tissue oxygen saturation ( ) of anterior circulation stroke patients, classified as LVO or lacunar, and assess the differences compared with controls and according to LVO recanalization status. Fiducial markers categorize the brain region below each TD-NIRS probe as ischemic or nonstroke areas. The study includes 47 consecutive acute ischemic stroke patients and 35 controls. The ischemic area has significantly higher deoxy-hemoglobin (HbR) and total hemoglobin (HbT) compared with controls in both recanalized and nonrecanalized patients but lower only in recanalized patients. Recanalized patients have significantly lower mean in the ipsilateral hemisphere compared with nonrecanalized patients. This is the first study to report TD-NIRS measurements in acute ischemic stroke patients. TD-NIRS is able to detect significant differences in hemoglobin species in LVO stroke compared with controls and according to recanalization status. This preliminary data might suggest that can serve as a surrogate functional marker of the metabolic activity of rescued brain tissue.
大血管闭塞(LVO)性卒中可能会导致不同程度的血流动力学损害,进而影响微循环并导致代谢紊乱。时域近红外光谱(TD-NIRS)可评估大脑外层微循环的氧合情况。我们对前循环卒中患者(分为LVO型或腔隙性)的血红蛋白种类和组织氧饱和度( )进行测量,并与对照组进行比较,并根据LVO再通状态评估差异。基准标记将每个TD-NIRS探头下方的脑区分类为缺血区或非卒中区。该研究纳入了47例连续的急性缺血性卒中患者和35名对照者。在再通和未再通的患者中,缺血区的脱氧血红蛋白(HbR)和总血红蛋白(HbT)均显著高于对照组,但仅在再通患者中 较低。与未再通患者相比,再通患者同侧半球的平均 显著更低。这是第一项报道急性缺血性卒中患者TD-NIRS测量结果的研究。与对照组相比,TD-NIRS能够检测出LVO卒中患者血红蛋白种类的显著差异,并能根据再通状态检测出差异。这些初步数据可能表明, 可作为获救脑组织代谢活性的替代功能标志物。