Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic Intolerance
The head-up tilt table test (HUT) is one of the primary clinical examinations for evaluating orthostatic intolerance (OI). HUT can be divided into three phases: dynamic tilt phase (supine to tilt up), static tilt phase (remain tilted at 70°), and post tilt phase (tilt down back to supine position)....
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Frontiers Media S.A.
2019-02-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fnhum.2019.00055/full |
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| author | Yoo Hwan Kim Yoo Hwan Kim Seung-ho Paik Zephaniah Phillips V Nam-Joon Jeon Byung-Jo Kim Byung-Jo Kim Beop-Min Kim |
| author_facet | Yoo Hwan Kim Yoo Hwan Kim Seung-ho Paik Zephaniah Phillips V Nam-Joon Jeon Byung-Jo Kim Byung-Jo Kim Beop-Min Kim |
| author_sort | Yoo Hwan Kim |
| collection | DOAJ |
| description | The head-up tilt table test (HUT) is one of the primary clinical examinations for evaluating orthostatic intolerance (OI). HUT can be divided into three phases: dynamic tilt phase (supine to tilt up), static tilt phase (remain tilted at 70°), and post tilt phase (tilt down back to supine position). Commonly, blood pressure (BP) and heart rate (HR) are monitored to observe for OI symptoms, but are indirect measurements of cerebral perfusion and can lead to inaccurate HUT evaluation. In this study, we implemented a 108-channel near-infrared spectroscopy (NIRS) probe to characterize HUT performance by monitoring cerebral hemodynamic changes for healthy controls (HCs), OI patients with normal HUT results, and OI patients with positive HUT results: vasovagal syncope (VS), postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension (OH), and orthostatic hypertension (OHT). By the end of the static tilt phase, OI patients typically did not show a complete recovery back to baseline cerebral oxygenation and total blood volume compared to HCs. We characterized the return to cerebral homeostasis by polynomial fitting total blood volume changes and determining the inflection point. The OI patients with normal HUT results, VS, OH, or OHT showed a delay in the return to cerebral homeostasis compared to the HC group during HUT. |
| first_indexed | 2024-12-21T21:33:45Z |
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| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-12-21T21:33:45Z |
| publishDate | 2019-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-f706e7170327436faa6a4bf85f0f648d2022-12-21T18:49:34ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612019-02-011310.3389/fnhum.2019.00055430645Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic IntoleranceYoo Hwan Kim0Yoo Hwan Kim1Seung-ho Paik2Zephaniah Phillips V3Nam-Joon Jeon4Byung-Jo Kim5Byung-Jo Kim6Beop-Min Kim7Department of Neurology, Hallym University College of Medicine, Seoul, South KoreaDepartment of Neurology, Korea University Medical Center, Seoul, South KoreaDepartment of Bio-convergence Engineering, Korea University College of Health Science, Seoul, South KoreaDepartment of Bio-convergence Engineering, Korea University College of Health Science, Seoul, South KoreaNeurophysiology Laboratory, Korea University Anam Hospital, Seoul, South KoreaDepartment of Neurology, Korea University Medical Center, Seoul, South KoreaBrain Convergence Research Center, Korea University Anam Hospital, Seoul, South KoreaDepartment of Bio-convergence Engineering, Korea University College of Health Science, Seoul, South KoreaThe head-up tilt table test (HUT) is one of the primary clinical examinations for evaluating orthostatic intolerance (OI). HUT can be divided into three phases: dynamic tilt phase (supine to tilt up), static tilt phase (remain tilted at 70°), and post tilt phase (tilt down back to supine position). Commonly, blood pressure (BP) and heart rate (HR) are monitored to observe for OI symptoms, but are indirect measurements of cerebral perfusion and can lead to inaccurate HUT evaluation. In this study, we implemented a 108-channel near-infrared spectroscopy (NIRS) probe to characterize HUT performance by monitoring cerebral hemodynamic changes for healthy controls (HCs), OI patients with normal HUT results, and OI patients with positive HUT results: vasovagal syncope (VS), postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension (OH), and orthostatic hypertension (OHT). By the end of the static tilt phase, OI patients typically did not show a complete recovery back to baseline cerebral oxygenation and total blood volume compared to HCs. We characterized the return to cerebral homeostasis by polynomial fitting total blood volume changes and determining the inflection point. The OI patients with normal HUT results, VS, OH, or OHT showed a delay in the return to cerebral homeostasis compared to the HC group during HUT.https://www.frontiersin.org/article/10.3389/fnhum.2019.00055/fullorthostatic intolerancenear-infrared spectroscopytilt table testcerebral blood flowhemodynamics |
| spellingShingle | Yoo Hwan Kim Yoo Hwan Kim Seung-ho Paik Zephaniah Phillips V Nam-Joon Jeon Byung-Jo Kim Byung-Jo Kim Beop-Min Kim Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic Intolerance Frontiers in Human Neuroscience orthostatic intolerance near-infrared spectroscopy tilt table test cerebral blood flow hemodynamics |
| title | Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic Intolerance |
| title_full | Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic Intolerance |
| title_fullStr | Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic Intolerance |
| title_full_unstemmed | Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic Intolerance |
| title_short | Cerebral Perfusion Monitoring Using Near-Infrared Spectroscopy During Head-Up Tilt Table Test in Patients With Orthostatic Intolerance |
| title_sort | cerebral perfusion monitoring using near infrared spectroscopy during head up tilt table test in patients with orthostatic intolerance |
| topic | orthostatic intolerance near-infrared spectroscopy tilt table test cerebral blood flow hemodynamics |
| url | https://www.frontiersin.org/article/10.3389/fnhum.2019.00055/full |
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