Assessment of non-invasive ICP during CSF infusion test: an approach with transcranial Doppler.

BACKGROUND: This study aimed to compare four non-invasive intracranial pressure (nICP) methods in a prospective cohort of hydrocephalus patients whose cerebrospinal fluid dynamics was investigated using infusion tests involving controllable test-rise of ICP. METHOD: Cerebral blood flow velocity (FV), ICP and non-invasive arterial blood pressure (ABP) were recorded in 53 patients diagnosed for hydrocephalus. Non-invasive ICP methods were based on: (1) interaction between FV and ABP using black-box model (nICP_BB); (2) diastolic FV (nICP_FVd); (3) critical closing pressure (nICP_CrCP); (4) transcranial Doppler-derived pulsatility index (nICP_PI). Correlation between rise in ICP (∆ICP) and ∆nICP and averaged correlations for changes in time between ICP and nICP during infusion test were investigated. RESULTS: From baseline to plateau, all nICP estimators increased significantly. Correlations between ∆ICP and ∆nICP were better represented by nICP_PI and nICP_BB: 0.45 and 0.30 (p < 0.05). nICP_FVd and nICP_CrCP presented non-significant correlations: -0.17 (p = 0.21), 0.21 (p = 0.13). For changes in ICP during individual infusion test nICP_PI, nICP_BB and nICP_FVd presented similar correlations with ICP: 0.39 ± 0.40, 0.39 ± 0.43 and 0.35 ± 0.41 respectively. However, nICP_CrCP presented a weaker correlation (R = 0.29 ± 0.24). CONCLUSIONS: Out of the four methods, nICP_PI was the one with best performance for predicting changes in ∆ICP during infusion test, followed by nICP_BB. Unreliable correlations were shown by nICP_FVd and nICP_CrCP. Changes of ICP observed during the test were expressed by nICP values with only moderate correlations.

Non-extensive entropy and the extraction of BOLD spatial information in event-related functional MRI.

Functional magnetic resonance imaging (fMRI) data analysis has been carried out recently in the framework of information theory, by means of the Shannon entropy. As a natural extension, a method based on the generalized Tsallis entropy was developed to the analysis event-related (ER-fMRI), where a brief stimulus is presented, followed by a long period of rest. The new technique aims for spatial localization neuronal activity due to a specific task. This method does not require a priori hypothesis of the hemodynamic response function (HRF) shape and the linear relation between BOLD responses with the presented task. Numerical simulations were performed so as to determine the optimal values of the Tsallis q parameter and the number of levels, L. In order to avoid undesirable divergences of the Tsallis entropy, only positive q values were studied. Results from simulated data (with L = 3) indicated that, for q = 0.8, the active brain areas are detected with the highest performance. Moreover, the method was tested for an in vivo experiment and demonstrated the ability to discriminate active brain regions that selectively responded to a bilateral motor task.