Researcher: Nick Eleveld, MSc (PhD student)

Expected thesis defense: 2023

Other promotors: Dr. Jan Willem Elting, MD, PhD (Neurology, UMCG), Dr. Gea Drost, MD, PhD (Neurology, UMCG), Prof. dr. Tony Absalom (Anesthesiology, UMCG)

Funding: UMCG

Maintenance of adequate cerebral perfusion is crucial for normal brain function. One of the main mechanisms securing adequate cerebral perfusion is cerebral autoregulation (CA), which comprises the contraction and dilation of cerebral arterioles in response to changes in systemic blood pressure to keep a relatively constant cerebral blood flow (CBF). It is known that CA can be impaired in (cerebral) diseases such as stroke, traumatic brain injury, and carotid artery disease. Yet, clinical usage of CA measurements remains limited, because accuracy and reproducibility are often low, analysis techniques are variable and data interpretation is subject to debate. Recently, near-infrared spectroscopy (NIRS) was shown to provide CA estimates similar to common techniques. Moreover, NIRS measurements are easy to perform, relatively comfortable to the patient, and allow long-term monitoring. Therefore, NIRS holds the promise of being a clinically applicable CA technique. However, several issues need to be investigated to allow clinical NIRS-based CA measurements. 1) The NIRS-based CA method needs improvements and elaborate artefact handling is necessary. 2) Increased fundamental understanding of NIRS-derived perfusion dynamics is necessary via controlled challenges of the cerebral circulation. 3) The clinical applicability of NIRS-based CA in several cerebral pathologies needs to be investigated.

References

• Nick Eleveld, Cornelia Hoedemaekers, Ruud van Kaam, Guus Leijte, Judith van den Brule, Peter Pickkers, Marcel Aries, Natasha Maurits, Jan Willem Elting (2021), Near-infrared spectroscopy derived Dynamic Cerebral Autoregulation in Experimental Human Endotoxemia, Frontiers in Neurology.