Exploring The Translational Clinical Value of Cerebrovascular Reactivity Assessments by Diffuse Correlation Spectroscopy

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COWDRICK-DISSERTATION-2023.pdf (2.58 MB)
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Cowdrick, Kyle Robert
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Buckley, Erin M.
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Wallace H. Coulter Department of Biomedical Engineering
The joint Georgia Tech and Emory department was established in 1997
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https://hdl.handle.net/1853/75546
Abstract
Cerebrovascular reactivity (CVR), i.e., the ability of cerebral vasculature to dilate or constrict in response to vasoactive stimuli, is a biomarker of vascular health and CVR quantification is considered an unmet clinical need. However, the value of addressing this unmet need is not clear. This thesis focuses on enhancing the clinical value proposition of CVR assessments by exploring novel experimental approaches to quantify CVR and investigating CVR assessments in a previously unexplored pediatric patient population using an emerging optical neuromonitoring technology termed Diffuse Correlation Spectroscopy (DCS). DCS is an emerging low-cost, noninvasive, and portable optical tool that utilizes near-infrared light to assess cerebral hemodynamics (i.e., cerebral blood flow, cerebrovascular reactivity) at the microvascular length scale. The overall goal of this work is to explore and enhance the clinical value proposition DCS-mediated CVR assessments in pediatric patients. This work has two primary aims. In Aim #1, I hypothesize that CVR assessed with DCS using more tolerable experimental protocols will agree well with the gold standard hypercapnia challenge. In Aim #2, I hypothesize that children with SCD experience markedly reduced CVR when compared to healthy children in response to a breath hold challenge. The ultimate outcome of this work lends support to the clinical value of DCS-measured CVR assessed in a routine outpatient clinical workflow for a pediatric population with sickle cell disease.
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2023-07-24
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