Hemodynamic changes associated with common EEG patterns in critically ill patients: Pilot results from continuous...

Area of Science:

• Neuroscience
• Critical Care Medicine
• Biomedical Engineering

Background:

• Functional near-infrared spectroscopy (fNIRS) enables non-invasive, long-term cerebral hemodynamic monitoring.
• Status epilepticus (SE), burst suppression (BS), and periodic discharges (PDs) are critical EEG patterns in neurocritical care.

Purpose of the Study:

• To evaluate the feasibility of combined continuous electroencephalography-functional near-infrared spectroscopy (cEEG-fNIRS) for studying cortical hemodynamic changes.
• To investigate hemodynamic responses associated with SE, BS, and PDs in comatose patients.

Main Methods:

• Eleven comatose patients with SE underwent simultaneous cEEG-fNIRS monitoring.
• Changes in oxygenated (HbO) and deoxygenated hemoglobin (HbR) concentrations were measured.
• Correlation between EEG patterns and hemodynamic responses was analyzed.

Main Results:

• Seizures (SE) correlated with significant increases in HbO and decreases in HbR, proportional to seizure duration.
• Hemodynamic changes during BS showed increased HbO and decreased HbR during bursts compared to suppression.
• PDs induced widespread increases in HbO and decreases in HbR.
• Neurovascular coupling was partially retained but highly variable.

Conclusions:

• Long-term cEEG-fNIRS monitoring is feasible in critically ill patients, covering large cortical areas.
• This technique offers new insights into hemodynamic changes associated with abnormal EEG patterns.
• Improved understanding and management of SE, BS, and PDs in the neuroICU are potential outcomes.