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Complexity analysis of the cerebrospinal fluid pulse waveform during infusion studies

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Abstract

Purpose

Nonlinear dynamics has enhanced the diagnostic abilities of some physiological signals. Recent studies have shown that the complexity of the intracranial pressure waveform decreases during periods of intracranial hypertension in paediatric patients with acute brain injury. We wanted to assess changes in the complexity of the cerebrospinal fluid (CSF) pressure signal over the large range covered during the study of CSF circulation with infusion studies.

Methods

We performed 37 infusion studies in patients with hydrocephalus of various types and origin (median age 71 years; interquartile range 60–77 years). After 5 min of baseline measurement, infusion was started at a rate of 1.5 ml/min until a plateau was reached. Once the infusion finished, CSF pressure was recorded until it returned to baseline. We analysed CSF pressure signals using the Lempel–Ziv (LZ) complexity measure. To characterise more accurately the behaviour of LZ complexity, the study was segmented into four periods: basal, early infusion, plateau and recovery.

Results

The LZ complexity of the CSF pressure decreased in the plateau of the infusion study compared to the basal complexity (p = 0.0018). This indicates loss of complexity of the CSF pulse waveform with intracranial hypertension. We also noted that the level of complexity begins to increase when the infusion is interrupted and CSF pressure drops towards the initial values.

Conclusions

The LZ complexity decreases when CSF pressure reaches the range of intracranial hypertension during infusion studies. This finding provides further evidence of a phenomenon of decomplexification in the pulsatile component of the pressure signal during intracranial hypertension.

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Acknowledgements

This study has been partially supported by the Consejería de Sanidad, Junta de Castilla y León (project code SOCIO126/LE04/09).

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of León, León, Spain

    David Santamarta, Milton Martínez-Madrigal, Javier Fernández & Jose García-Cosamalón

  2. Biomedical Engineering Group, E.T.S. Ingenieros de Telecomunicación, University of Valladolid, Valladolid, Spain

    Roberto Hornero & Daniel Abásolo

  3. Servicio de Neurocirugía, Hospital de León, Altos de Nava s/n, 24080, León, Spain

    David Santamarta

Authors
  1. David Santamarta
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  2. Roberto Hornero
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  3. Daniel Abásolo
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  4. Milton Martínez-Madrigal
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  5. Javier Fernández
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  6. Jose García-Cosamalón
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Correspondence to David Santamarta.

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Santamarta, D., Hornero, R., Abásolo, D. et al. Complexity analysis of the cerebrospinal fluid pulse waveform during infusion studies. Childs Nerv Syst 26, 1683–1689 (2010). https://doi.org/10.1007/s00381-010-1244-5

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  • DOI: https://doi.org/10.1007/s00381-010-1244-5

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