Assessment of cerebrovascular development and intraventricular hemorrhages in preterm infants with optical measures of the brain arterial pulse wave

Antonio M. Chiarelli, Mahdi Mahmoudzadeh, Kathy A. Low, Edward L. Maclin, Guy Kongolo, Sabrina Goudjil, Monica Fabiani, Fabrice Wallois, Gabriele Gratton

Research output: Contribution to journalArticle

Abstract

Preterm infants (born at 24–34 weeks of gestational age) suffer from a high incidence of neurological complications. Cerebrovascular lesions (intraventricular hemorrhages, IVH, and ischemic injury) due to the immaturity of the vascular system and its inability to adapt to the extra-uterine environment are the major causes of adverse neurological outcomes. We investigated the feasibility of assessing cerebrovascular status in preterm infants using a novel non-invasive optical procedure, pulse-DOT, usable within the incubator. Pulse-DOT, validated in adults, provides estimates of cerebral arterial status based on optical measurements of the pulse wave. These measurements are taken with a high-density optode montage and provide accurate spatial and temporal information. We found that two pulse parameters (pulse relaxation function, PReFx, and pulse rise time, PRT) in the investigated frontotemporal region, correlated with infant’s age at recording, indexing cerebrovascular development. Moreover, PRT differentiated infants with and without concurrent IVH (sensitivity = 100%, specificity = 70%). These values are at least as high as those of the resistivity index obtained with transcranial Doppler of the middle cerebral artery, the current clinical method of choice for investigating arterial elasticity in preterm infants. This makes pulse-DOT a promising tool for investigating cerebrovascular risk factors and related pathologies in preterm infants.

Original languageEnglish (US)
Pages (from-to)466-480
Number of pages15
JournalJournal of Cerebral Blood Flow and Metabolism
Volume39
Issue number3
DOIs
StatePublished - Mar 1 2019

Keywords

  • Preterm infants
  • brain arterial pulse wave (pulse-DOT)
  • cerebrovascular development
  • diffuse optical tomography
  • intraventricular brain hemorrhages

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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