Lack of irrefutable validation does not negate clinical utility of near-infrared spectroscopy monitoring: Learning to trust new technology

2009 ◽  
Vol 24 (3) ◽  
pp. 472.e1-472.e7 ◽  
Author(s):  
Jason M. Kane ◽  
David M. Steinhorn
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rashid Afkhami ◽  
Frederick R. Walker ◽  
Saadallah Ramadan ◽  
Rachel Wong ◽  
Sarah J. Johnson

AbstractNear-infrared spectroscopy (NiRS) is a relatively new technology of brain imaging with its potential in the assessment of cerebrovascular health only recently discovered. Encouraging early results suggest that NiRS can be used as an inexpensive and portable cerebrovascular health tracking device using a recently proposed pulse relaxation function (PReFx). In this paper, we propose a new NiRS timing index, $$\text {TI}_{\rm NiRS}$$ TI NiRS , of cerebrovascular health. $$\text {TI}_{\rm NiRS}$$ TI NiRS is a novel use of the NiRS technology. $$\text {TI}_{\rm NiRS}$$ TI NiRS is motivated by the previously proved relationship of the timing of the reflected wave with vascular resistance and compliance in the context of pressure waveforms. We correlated both $$\text {TI}_{\rm NiRS}$$ TI NiRS and PReFx against age, a non-exercise cardiorespiratory fitness (CRF) index, and two existing indices of cerebrovascular health, namely transcranial Doppler (TCD) augmentation index, $$\text {AI}_{\rm TCD}$$ AI TCD , and magnetic resonance imaging (MRI) blood flow pulsatility index, $$\text {PI}_{\rm MRI}$$ PI MRI . The $$\text {TI}_{\rm NiRS}$$ TI NiRS correlations with Age, CRF, $$\text {PI}_{\rm MRI}$$ PI MRI and $$\text {AI}_{\rm TCD}$$ AI TCD all are significant, i.e., $$r=0.53$$ r = 0.53 ($$p=0.002$$ p = 0.002 ), $$r=-0.44$$ r = - 0.44 ($$p=0.011$$ p = 0.011 ), $$r=0.45$$ r = 0.45 ($$p=0.012$$ p = 0.012 ) and $$r=0.46$$ r = 0.46 ($$p=0.010$$ p = 0.010 ), respectively. PReFx, however, did not have significant correlations with any of the vascular health factors. The proposed timing index is a reliable indicator of cerebrovascular aging factors in the NiRS waveform.


2021 ◽  
Author(s):  
Rashid Afkhami ◽  
Frederick Rohan Walker ◽  
Saadallah Ramadan ◽  
Rachel Wong ◽  
Sarah Johnson

Near-infrared spectroscopy (NiRS) is a relatively new technology of brain imaging with its potential in the assessment of cerebrovascular health only recently discovered. Encouraging early results suggest that NiRS can be used as an inexpensive and portable cerebrovascular health tracking device using a recently proposed pulse relaxation function (PReFx). In this paper, we propose a new NiRS timing index, TI-NiRS, of cerebrovascular health. TI-NiRS is a novel use of the NiRS technology. TI-NiRS is motivated by the previously proved relationship of the timing of the reflected wave with vascular resistance and compliance in the context of pressure waveforms. We correlated both TI-NiRS and PReFx against age, a non-exercise cardiorespiratory fitness (CRF) index, and two existing indices of cerebrovascular health, namely Transcranial Doppler (TCD) augmentation index, AI-TCD, and magnetic resonance imaging (MRI) blood flow pulsatility index, PI-MRI. The TI-NiRS correlations with Age, CRF, PI-MRI and AI-TCD all are significant, i.e., r = 0.53 (p = 0.002), r = 0.44 (p = 0.011), r = 0.45 (p = 0.012) and r = 0.46 (p = 0.010), respectively. PReFx, however, did not have significant correlations with any of the vascular health factors. The proposed timing index is a reliable indicator of cerebrovascular aging factors in the NiRS waveform.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Zhihua He ◽  
Craig M Gardner ◽  
Sean P Madden ◽  
Edward L Hull ◽  
Jennifer B Lisauskas ◽  
...  

A catheter-based near infrared spectroscopy (NIRS) system has recently been cleared by the FDA for detection of lipid core containing plaques of interest (LCP) and lipid core burden index (LCBI) in patients undergoing coronary arteriography. NIRS data are plotted as a map (chemogram) of pullback distance versus rotation, with yellow indicating lipid (see below). Analyses for LCP were based on a 2mm block chemogram and LCBI. An algorithm has been developed to perform automated enhancement of the chemogram and facilitate calculation of the number of LCPs (nLCP) in a segment of artery. The goal is to determine if the enhanced algorithm performs as well as the previously validated LCP and LCBI measures, as determined by histology in human coronary autopsy specimens. NIRS data were obtained from 181 segments from 78 hearts and compared with histology at 2 mm intervals. The image analysis was applied to the chemogram and the nLCP calculated. The ROC analysis of the nLCP versus presence of fibroatheroma in each segment yielded an AUC of 0.84 (95% CI 0.77– 0.89). When one or more LCP was detected, 87% sensitivity and 70% specificity were observed for detection of fibroatheroma. The Spearman correlation between nLCP and LCBI was 0.83 (p-value ≤0.0001). The correlation coefficient of nLCP between repeat pullbacks was 0.83 (p-value ≤0.0001). The number of NIRS-detected LCP in chemograms identified with image enhancement correlates well with previously validated measures and the presence of fibroatheroma by histology. This method has the potential to enhance the clinical utility of the chemogram.


2021 ◽  
Vol 12 ◽  
Author(s):  
Y. Q. Lee ◽  
Gabrielle W. N. Tay ◽  
Cyrus S. H. Ho

Introduction: Suicide is a pressing psychiatric concern worldwide with no established biomarker. While there is some evidence of the clinical utility of functional near-infrared spectroscopy (fNIRS) in assessing and predicting suicidality, no systematic review of such evidence has been conducted to date. Therefore, this review aimed to systematically review and gather evidence from existing studies that used fNIRS signals to assess suicidality and its associated changes in the brain, and those that examined how such signals correlated with suicide symptomatology.Methods: PubMed, EMBASE, and Cochrane Library databases were used in a systematic literature search for English-language articles published between 2000 and December 19, 2020 that focused on the utility of fNIRS for (i) assessing suicidality and its associated changes in the brain, and (ii) correlating with suicide symptomatology. Studies were included if they utilised fNIRS to evaluate variations in fNIRS-measured cerebral hemodynamic responses in patients with different mental disorders (e.g., major depressive disorder, schizophrenia), as well as in healthy controls, of any age group. Quality of evidence was assessed using the Newcastle-Ottawa quality assessment scale.Results: A total of 7 cross-sectional studies were included in this review, all of which had acceptable quality. Across all studies, fNIRS demonstrated reduced cerebral hemodynamic changes in suicidal individuals when compared to non-suicidal individuals. One study also demonstrated the potential of fNIRS signals in correlating with the severity of suicidality.Conclusions: This review provides a comprehensive, updated review of evidence supporting the clinical utility of fNIRS in the assessment and prediction of suicidality. Further studies involving larger sample sizes, standardised methodology, and longitudinal follow-ups are needed.


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