Evaluation of potential factors affecting the measurement of cerebrovascular reactivity by near-infrared spectroscopy

1.Near-infrared (IR) spectroscopy is based on the relative transparency of skin, skull and brain to the light in the near-IR region (700–1100 ;nm) and on the oxygen-dependent tissue absorption changes of haemoglobin. 2.We evaluated the most relevant factors (reproducibility, venous return, age and sex) that might affect reliability of near-IR spectroscopy to test CO2 cerebrovascular reactivity. 3.Thirty-four healthy volunteers were enrolled in the study. The protocol consisted of a 3-min baseline, a 3-min hypercapnia (5% CO2 in air) and a 2-min recovery. Transcranial Doppler sonography measurements were simultaneously performed. The CO2 reactivity test was repeated on 27 subjects after 1 ;h to assess reproducibility. CO2 reactivity was also evaluated at different body positions (supine, 35° Trendelenburg and 35° reverse Trendelenburg), and over a gradual increase of the inspired CO2. 4.Changes in near-IR spectroscopy and transcranial Doppler sonography parameters were significantly correlated with variations of end-tidal CO2 (P< 0.005). A significant correlation between the reactivity indexes of near-IR spectroscopy parameters and flow velocity was also found (P< 0.01). A high reproducibility was also found for deoxyhaemoglobin (rI = 0.76), oxyhaemoglobin (rI = 0.68) and flow velocity (rI = 0.60) reactivity indexes. No significant differences between the reactivity indexes of different body positions were found (P> 0.05). The reactivity index of oxyhaemoglobin and deoxyhaemoglobin decreased (P< 0.05) and increased (P< 0.01) with age respectively. 5.We found that near-IR spectroscopy is a reliable and reproducible method for the evaluation of cerebrovascular reactivity and might be considered, after appropriate validation, for the assessment of patients with cerebrovascular disease.