PHILADELPHIA – A University of Pennsylvania team has completed the first successful demonstration of a noninvasive optical device to monitor cerebral blood flow in patients with acute stroke, a leading cause of disability and death.
The ultimate goal of this research is to improve the management of patients with stroke and other brain disorders by providing continuous bedside monitoring of brain blood flow and metabolism.
“Our preliminary study demonstrates that blood flow changes can be reliably detected from stroke patients and also suggests that blood flow responses vary significantly from patient to patient,” lead author Turgut Durduran said.
Ischemic stroke is the leading cause of morbidity and long-term disability in the United States, with projected cost of stroke care estimated at trillions of dollars during the next five decades. Stroke accounts for nearly 10 percent of deaths in the western hemisphere and about 5 percent of health-care costs.
The device being developed uses embedded optical probes that are placed over major cortical blood vessels in each hemisphere of the brain. The technology, diffuse correlation spectroscopy is a non-invasive system that uses lasers, photon-counting detectors, radio-frequency electronics, data processors and a computer monitor to display user-friendly images of functional information to physicians and nurses.
“What we have demonstrated is a working prototype of a non-invasive brain probe that uses diffusing light to detect physiological changes such as blood flow, blood-oxygen saturation and hemoglobin concentration to inform clinicians about their treatments,” Arjun Yodh, professor of physics in the School of Arts and Sciences at Penn and principal investigator of the study, said.
The study is part of a $2.8 million, five-year Bioengineering Research Partnership grant from the National Institutes of Health and the University of Pennsylvania Health System Comprehensive Neuroscience Center. BRP grants are awarded to interdisciplinary teams that combine basic, applied and translational research for important biological or medical problems. Yodh is joined by Rick Van Berg from the High Energy group of the Department of Physics in the School of Arts and Sciences and clinical collaborators John Detre, MD, Associate Professor of Neurology and Radiology, Joel Greenberg, PhD, Research Professor of Neurology and Scott Kasner, MD, MSCE, Associate Professor of Neurology in the School of Medicine at Penn..
“Stroke is caused by a reduction in blood flow to the brain, yet brain blood flow is rarely if ever measured in stroke patients because most existing methods to measure blood flow require costly instrumentation that is not portable,” Detre said. “The ability to quantify tissue hemodynamics at the bedside would provide new opportunities both to learn more about blood-flow changes in patients with acute stroke and to optimize interventions to increase blood flow for individual patients, potentially even allowing these interventions to be administered before the onset of new neurological symptoms.”
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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
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