Near-infrared spectroscopy in evaluation of cerebral oxygenation during vasovagal syncope

Near-infrared spectroscopy (NIRS) offers a non-invasive, real-time monitoring of cerebral oxygenation. This method is based on the oxygenation and the light wavelength dependent absorption of near-infrared light by tissue chromophores, e.g. oxyhaemoglobin and deoxyhaemoglobin. The objective of the present study was the application of NIRS for evaluation of the brain function during vasovagal syncope (VVS). The VVS is a clinical syndrome affecting ca 3.5% of the population and for which the widely used diagnostic examination in this disease entity is the head-up tilt table test (HUT). In this study 69 patients with a history of VVS were examined using HUT. In 42 patients VVS was provoked. Results of the examination have shown that the changes in cerebral oxygenation measured by the NIRS technique are distinctly visible before the syncope. A gradual decrease of oxyhaemoglobin followed by its sudden drop was observed in all the VVS patients. Changes in the oxyhaemoglobin concentration measured by NIRS were observed on average 3.3 min before the syncope. They preceded the presyncope symptoms about 1.3 min (p < 0.005), the blood pressure and heart rate drop 2.2 min (p < 0.0001) and the arterial blood saturation 2.6 min (p < 0.00001).