The Theoretical and Translational Advancement of Diffuse Correlation Spectroscopy Measurements of Blood Flow
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Sathialingam, Eashani
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Abstract
The Theoretical and Translational Advancement of Diffuse Correlation Spectroscopy Measurements of Blood Flow
Eashani Sathialingam
146 pages
Directed by Dr. Erin M. Buckley
Cerebral blood flow is an important biomarker of brain health and function. Numerous conditions, such as ischemic stroke and subarachnoid hemorrhage, are associated with compromised cerebral blood flow that, if left untreated, can lead to neuronal death and ultimately to significant adverse outcomes. To optimize clinical management after a brain injury, there is an unmet need for noninvasive modalities that can monitor cerebral perfusion for improved patient-centered care that prevents further brain injury. Diffuse correlation spectroscopy (DCS) is an emerging low-cost (<$50k) optical modality that can provide measurements of microvascular cerebral blood flow in a non-invasive and portable manner.
DCS measures an index of blood flow (BFI, cm2/s). while BFI has been correlated in vivo with measurements of blood flow made with other perfusion modalities, the dependence of BFI on red blood cell properties (i.e., flow velocity, vessel size, hematocrit, and morphology) is less understood. The first aim of this dissertation focuses on the theoretical advancement of DCS by designing a novel microfluidic tissue-simulating phantom to explore the contribution of flow velocity, vessel size, and hematocrit on the measured DCS blood flow index, which to date has not been well defined. Understanding these influences will improve the accuracy of the DCS blood flow index and expand the clinical applications of DCS.
The second aim of this dissertation explores the translational potential of DCS measurements of microvascular cerebral perfusion in patients with subarachnoid hemorrhage (SAH). I demonstrate the clinical utility of these measurements by monitoring the CBF response to a commonly used vasodilatory treatment for SAH. The results demonstrate that a lack of CBF response to this treatment is associated with development of a secondary stroke. Thus, the blood flow response to this treatment could be used as a novel early biomarker of poor outcome, alerting clinicians that alternative interventions are merited.
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2022-06-22
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Dissertation