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Neurovascular Complexity Index: A Potential Quantitative Measure for Assessment of Traumatic Brain Injury
Author(s) -
Howard Jeffrey T,
Janak Jud C,
Bukhman Vladislav,
Robertson Claudia,
Frolov Iurii,
Nawn Corinne D,
Schiller Alicia M,
Convertino Victor A
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.1087.6
Subject(s) - traumatic brain injury , medicine , logistic regression , neurovascular bundle , cerebral blood flow , odds ratio , receiver operating characteristic , surgery , psychiatry
Multimodal monitoring of brain physiology following a traumatic brain injury (TBI) shows promise as a strategy to improve management and outcomes of TBI patients. Valid and reliable measures of different aspects of brain physiology following a TBI could prove critical to accurately capturing these changes. Using a case‐control study design, we evaluated a new proprietary algorithm of cerebral blood flow variability (CBFV) called the neurovascular complexity index (NCI). Baseline NCI data from 169 healthy control participants were compared to 51 TBI patients. Unadjusted and age‐sex adjusted logistic regression models were used to assess the association between NCI and TBI. TBI patients exhibited significantly greater variability in NCI scores than healthy controls (F=131.88; p<0.0001). Compared to the continuous measure of NCI, the threshold of ± 1.96 standard deviations from the mean for the healthy control group measure (5.888.10) had superior ability to identify TBI patients based on the Receiver Operator Characteristic Area Under the Curve (0.84 vs. 0.61; p=0.0007), and greater sensitivity (74.5 vs. 51.0; p=0.0013). Individuals with NCI scores outside the 5.88–8.10 range had a 29‐fold increase in the odds of TBI in multivariate logistic regression models adjusted for age, sex and end tidal CO 2 (OR=29.44; 95% CI 5.98–144.87; p<0.0001). Advancement in multimodal monitoring of TBI patients is important in reducing the potential risk of secondary injury. This study reports results for a new non‐invasive quantifiable assessment of TBI based on a measure of CBFV showing potential for continuous monitoring and early identification of brain‐injured patients to better inform individualized management. Support or Funding Information US Army MRMC Combat Casualty Care Research Program