Noninvasive continuous monitoring of cerebral oxygenation periictally using near-infrared spectroscopy

A preliminary report

P. David Adelson, Edwin Nemoto, Mark Scheuer, Michael Painter, John Christopher Morgan, Howard Yonas

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Purpose: To report on the use of near-infrared spectroscopy (NIRS) to examine the changes in cerebral oxygenation in the periictal period in patients with seizures. Methods: Cerebral hemoglobin oxygen availability was monitored continuously and noninvasively with NIRS in three patients (one in the pediatric intensive care unit (ICU) and two in epilepsy-monitoring units) in conjunction with continuous EEG monitoring. Ictal events were recorded and compared with the pre-, intra-, and postictal periods for cerebral oxygen availability, as defined by oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (Hb), and the redox state of cytochrome oxidase (cytox). Results: Several important preliminary observations were made by using this technology. First, a preictal increase in cerebral oxygenation began between 1 and 2 h and >10 h before the ictal event. Second, despite adequate perfusion, based on an observed increased HbO2, reduction in cytox indicates a perfusion-metabolism mismatch during seizure activity. Third, continued seizure activity and even isolated ictal events were associated with decreased cerebral oxygen availability. Fourth, differences in cerebral oxygen availability were noted between different types of seizures (e.g., electrographic seizures were accompanied by rapid reductions in HbO2 and cerebral blood volume without reduction of cytox, whereas electroclinical seizures were characterized by marked increases in HbO2 with or without reduction of cytox). Conclusions: In this preliminary report on the use of NIRS for patients with seizures, we believe that NIRS allows continuous and noninvasive monitoring of changes in cerebral oxygenation periictally, thereby permitting investigations into the pathophysiology of seizures and the exploration of the potential of cerebral oximetry as a tool for seizure localization.

Original languageEnglish (US)
Pages (from-to)1484-1489
Number of pages6
JournalEpilepsia
Volume40
Issue number11
DOIs
StatePublished - Nov 17 1999
Externally publishedYes

Fingerprint

Near-Infrared Spectroscopy
Seizures
Electron Transport Complex IV
Oxygen
Hemoglobins
Stroke
Perfusion
Pediatric Intensive Care Units
Oximetry
Oxidation-Reduction
Electroencephalography
Epilepsy
Technology

Keywords

  • Epilepsy
  • Near-infrared spectroscopy
  • Seizure localization
  • Surgery

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Noninvasive continuous monitoring of cerebral oxygenation periictally using near-infrared spectroscopy : A preliminary report. / Adelson, P. David; Nemoto, Edwin; Scheuer, Mark; Painter, Michael; Morgan, John Christopher; Yonas, Howard.

In: Epilepsia, Vol. 40, No. 11, 17.11.1999, p. 1484-1489.

Research output: Contribution to journalArticle

Adelson, P. David ; Nemoto, Edwin ; Scheuer, Mark ; Painter, Michael ; Morgan, John Christopher ; Yonas, Howard. / Noninvasive continuous monitoring of cerebral oxygenation periictally using near-infrared spectroscopy : A preliminary report. In: Epilepsia. 1999 ; Vol. 40, No. 11. pp. 1484-1489.
@article{6b9ec0a9c48743e7b72719a32d1fd679,
title = "Noninvasive continuous monitoring of cerebral oxygenation periictally using near-infrared spectroscopy: A preliminary report",
abstract = "Purpose: To report on the use of near-infrared spectroscopy (NIRS) to examine the changes in cerebral oxygenation in the periictal period in patients with seizures. Methods: Cerebral hemoglobin oxygen availability was monitored continuously and noninvasively with NIRS in three patients (one in the pediatric intensive care unit (ICU) and two in epilepsy-monitoring units) in conjunction with continuous EEG monitoring. Ictal events were recorded and compared with the pre-, intra-, and postictal periods for cerebral oxygen availability, as defined by oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (Hb), and the redox state of cytochrome oxidase (cytox). Results: Several important preliminary observations were made by using this technology. First, a preictal increase in cerebral oxygenation began between 1 and 2 h and >10 h before the ictal event. Second, despite adequate perfusion, based on an observed increased HbO2, reduction in cytox indicates a perfusion-metabolism mismatch during seizure activity. Third, continued seizure activity and even isolated ictal events were associated with decreased cerebral oxygen availability. Fourth, differences in cerebral oxygen availability were noted between different types of seizures (e.g., electrographic seizures were accompanied by rapid reductions in HbO2 and cerebral blood volume without reduction of cytox, whereas electroclinical seizures were characterized by marked increases in HbO2 with or without reduction of cytox). Conclusions: In this preliminary report on the use of NIRS for patients with seizures, we believe that NIRS allows continuous and noninvasive monitoring of changes in cerebral oxygenation periictally, thereby permitting investigations into the pathophysiology of seizures and the exploration of the potential of cerebral oximetry as a tool for seizure localization.",
keywords = "Epilepsy, Near-infrared spectroscopy, Seizure localization, Surgery",
author = "Adelson, {P. David} and Edwin Nemoto and Mark Scheuer and Michael Painter and Morgan, {John Christopher} and Howard Yonas",
year = "1999",
month = "11",
day = "17",
doi = "10.1111/j.1528-1157.1999.tb02030.x",
language = "English (US)",
volume = "40",
pages = "1484--1489",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Noninvasive continuous monitoring of cerebral oxygenation periictally using near-infrared spectroscopy

T2 - A preliminary report

AU - Adelson, P. David

AU - Nemoto, Edwin

AU - Scheuer, Mark

AU - Painter, Michael

AU - Morgan, John Christopher

AU - Yonas, Howard

PY - 1999/11/17

Y1 - 1999/11/17

N2 - Purpose: To report on the use of near-infrared spectroscopy (NIRS) to examine the changes in cerebral oxygenation in the periictal period in patients with seizures. Methods: Cerebral hemoglobin oxygen availability was monitored continuously and noninvasively with NIRS in three patients (one in the pediatric intensive care unit (ICU) and two in epilepsy-monitoring units) in conjunction with continuous EEG monitoring. Ictal events were recorded and compared with the pre-, intra-, and postictal periods for cerebral oxygen availability, as defined by oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (Hb), and the redox state of cytochrome oxidase (cytox). Results: Several important preliminary observations were made by using this technology. First, a preictal increase in cerebral oxygenation began between 1 and 2 h and >10 h before the ictal event. Second, despite adequate perfusion, based on an observed increased HbO2, reduction in cytox indicates a perfusion-metabolism mismatch during seizure activity. Third, continued seizure activity and even isolated ictal events were associated with decreased cerebral oxygen availability. Fourth, differences in cerebral oxygen availability were noted between different types of seizures (e.g., electrographic seizures were accompanied by rapid reductions in HbO2 and cerebral blood volume without reduction of cytox, whereas electroclinical seizures were characterized by marked increases in HbO2 with or without reduction of cytox). Conclusions: In this preliminary report on the use of NIRS for patients with seizures, we believe that NIRS allows continuous and noninvasive monitoring of changes in cerebral oxygenation periictally, thereby permitting investigations into the pathophysiology of seizures and the exploration of the potential of cerebral oximetry as a tool for seizure localization.

AB - Purpose: To report on the use of near-infrared spectroscopy (NIRS) to examine the changes in cerebral oxygenation in the periictal period in patients with seizures. Methods: Cerebral hemoglobin oxygen availability was monitored continuously and noninvasively with NIRS in three patients (one in the pediatric intensive care unit (ICU) and two in epilepsy-monitoring units) in conjunction with continuous EEG monitoring. Ictal events were recorded and compared with the pre-, intra-, and postictal periods for cerebral oxygen availability, as defined by oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (Hb), and the redox state of cytochrome oxidase (cytox). Results: Several important preliminary observations were made by using this technology. First, a preictal increase in cerebral oxygenation began between 1 and 2 h and >10 h before the ictal event. Second, despite adequate perfusion, based on an observed increased HbO2, reduction in cytox indicates a perfusion-metabolism mismatch during seizure activity. Third, continued seizure activity and even isolated ictal events were associated with decreased cerebral oxygen availability. Fourth, differences in cerebral oxygen availability were noted between different types of seizures (e.g., electrographic seizures were accompanied by rapid reductions in HbO2 and cerebral blood volume without reduction of cytox, whereas electroclinical seizures were characterized by marked increases in HbO2 with or without reduction of cytox). Conclusions: In this preliminary report on the use of NIRS for patients with seizures, we believe that NIRS allows continuous and noninvasive monitoring of changes in cerebral oxygenation periictally, thereby permitting investigations into the pathophysiology of seizures and the exploration of the potential of cerebral oximetry as a tool for seizure localization.

KW - Epilepsy

KW - Near-infrared spectroscopy

KW - Seizure localization

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=0032730265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032730265&partnerID=8YFLogxK

U2 - 10.1111/j.1528-1157.1999.tb02030.x

DO - 10.1111/j.1528-1157.1999.tb02030.x

M3 - Article

VL - 40

SP - 1484

EP - 1489

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 11

ER -