Time-domain near-infrared spectroscopy in acute ischemic stroke patients

Abstract

Large vessel occlusion (LVO) stroke might cause different degrees of hemodynamic impairment that affects microcirculation and contributes to metabolic derangement. Time-domain near-infrared spectroscopy (TD-NIRS) estimates the oxygenation of microcirculation of cerebral outer layers. We measure hemoglobin species and tissue oxygen saturation ( ${\mathrm{StO}}_2$ ) of anterior circulation stroke patients, classified as LVO or lacunar, and assess the differences compared with controls and according to LVO recanalization status. Fiducial markers categorize the brain region below each TD-NIRS probe as ischemic or nonstroke areas. The study includes 47 consecutive acute ischemic stroke patients and 35 controls. The ischemic area has significantly higher deoxy-hemoglobin (HbR) and total hemoglobin (HbT) compared with controls in both recanalized and nonrecanalized patients but lower ${\mathrm{StO}}_2$ only in recanalized patients. Recanalized patients have significantly lower mean ${\mathrm{StO}}_2$ in the ipsilateral hemisphere compared with nonrecanalized patients. This is the first study to report TD-NIRS measurements in acute ischemic stroke patients. TD-NIRS is able to detect significant differences in hemoglobin species in LVO stroke compared with controls and according to recanalization status. This preliminary data might suggest that ${\mathrm{StO}}_2$ can serve as a surrogate functional marker of the metabolic activity of rescued brain tissue.

Keywords: acute ischemic stroke; large vessel occlusion; near-infrared spectroscopy; oximetry; revascularization.