New research identifies less invasive method for examining brain activity following traumatic brain injury
An interdisciplinary Johns Hopkins research team has published new research on a potential alternative and less-invasive approach to evaluate intracranial pressure (ICP) in patients with serious neurological conditions.
This research was published July 12 in the journal Computers in Biology and Medicine.
The current standard for ICP monitoring is highly invasive: It requires the placement of an external ventricular drain (EVD) or an intraparenchymal brain monitor (IPM) in the functional tissue in the brain consisting of neurons and glial cells by drilling through the skull.
EVD procedures carry a number of risks including catheter misplacement, infection, and hemorrhaging at 15.3 %, 5.8 %, and 12.1 %, respectively, according to recent research. EVD and IPM procedures also require surgical expertise and specialized equipment that is not consistently available in many settings thus underscoring the need for an alternative method in examining and monitoring ICP in patients.
The Johns Hopkins team, a group that included faculty and students from the School of Medicine and Whiting School of Engineering, hypothesized that severe forms of brain injury, and elevations in ICP in particular, are associated with pathological changes in systemic cardiocirculatory function due, for example, to dysregulation of the central autonomic nervous system. This hypothesis suggests that extracranial physiological waveforms can be studied to better understand brain activity and ICP severity.
In this study, the Johns Hopkins team set out to explore the relationship between the ICP waveform and the three physiological waveforms that are routinely captured in the ICU: invasive arterial blood pressure (ABP), photoplethysmography (PPG) and electrocardiography (ECG). ABP, PPG and ECG data were used to train deep learning algorithms, resulting in a level of accuracy in determining ICP that rivals or exceeds other methodologies.
Overall study findings suggest a completely new, noninvasive alternative to monitor ICP in patients.
