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Validating the use of spatially resolved spectroscopy to demonstrate improvement of cerebral blood flow following external counterpulsation treatment in patients with mild cognitive impairment or Alzheimer’s disease
Author(s) -
Helfgott Jonathan S.
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.046319
Subject(s) - randomization , cerebral blood flow , medicine , oxygenation , perfusion , cardiology , nuclear medicine , anesthesia , randomized controlled trial
Background There is a strong correlation between Alzheimer’s Disease (AD) and poor cerebral blood flow (CBF). Renew TM NCP‐5 is an FDA‐cleared, external counterpulsation ECP device, which chronically improves coronary and peripheral vascular hemodynamics, and may provide the same benefit for cerebral perfusion and cognitive function. Accurate measurements of CBF, such as arterial spin labelling MRI, can be extremely costly, and alternative solutions may be less accurate. The moorVMS‐NIRS uses the established spatially resolved spectroscopy technique to measure tissue oxygen saturation (SO2) and relative concentrations of oxygenated haemoglobin (oxyHb) and deoxygenated haemoglobin (deoxyHb) in human tissue Method A subset analysis of patients enrolled in the Renew TM NCP‐5‐1001 research protocol (NCT03721705), will be monitored with the VMS‐NIRS device over the course of two 60 minute treatments, first during randomization then during week 24, which mark the start and end of their treatment regimen, respectively. The moorVMS‐NIRS measures oxygenation using a probe which is placed in contact with the skin over patients’ temples. Each probe consists of a detector head which contains two identical photodiodes and emitter head which contains near infrared LEDs emitting light at approximately 750 nm and 850 nm. To ensure replicable measurements from randomization to week 24. A BraiNet cap is used to mark the probe location. Result Individual patient data will be analyzed using both the individual patient as their own control (at randomization versus week 24) as well as a therapeutic efficacy comparison between patients randomized to the treatment group versus sham therapy. Acute and chronic changes will be monitored as continuous measurements will be taken during each treatment session. Arterial spin labeling MRI will be measured within 3 weeks of randomization and again within 3 days of the week 24 visit. Conclusion MRI results may be able to corroborate and further validate the use of the moorVMS‐NIRS device as an accurate, cost‐effective measurement to detect changes in levels of brain oxygenation for future trials.