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Cross-spectral analysis of cerebral autoregulation after mild traumatic brain injury

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Abstract

Severe traumatic brain injury (TBI) disrupts cerebral autoregulation (CAR), which may increase the risk of secondary neuronal damage in victims with large fluctuations in blood pressure (BP). CAR is also impaired in mild TBI. Given that mild TBI accounts for up to 70% of cases, this issue needs to be addressed. Physiological and non-invasive methods are now required to study CAR without the sharp fluctuations in blood pressure that underlie CAR tests. The cross-spectral analysis of fluctuations between cerebral blood flow and blood pressure discussed in the article is truly non-invasive and physiological. Forty-eight victims with mild traumatic brain injury were studied. CAR was assessed using two methods. The cuff test was used as a control method to assess autoregulation (RoR). Non-invasive cross-spectral analysis with phase shift (PS) detection was performed. The RoR values were normal, but there were cases within the group with varying severity of symptoms of the acute period of mild TBI. For example, the RoR was significantly higher (p < 0.001) in 32 patients with regression of symptoms than in 16 with persistence of symptoms. Their RoR and PS indicated a violation of the CAR, which required correction of the treatment. It was found that in 1/3 of the patients with mild TBI, a different state of CAR required individual tactics. RoR and PS correlated well.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author.

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Authors and Affiliations

  1. Department of Neurosurgery and Neuropathology, National Centre for Neurosurgery, Astana, Republic of Kazakhstan

    Baglan Mustafayev

  2. Department of Neurorehabilitation, National Centre for Neurosurgery, Astana, Republic of Kazakhstan

    Alina Mustafayeva

  3. Department of Neurosurgery, Shymkent Regional Clinical Hospital, Shymkent, Republic of Kazakhstan

    Askar Bakhtiyarov

  4. Department of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan

    Kuanysh Nikatov

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  1. Baglan Mustafayev
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  2. Alina Mustafayeva
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  3. Askar Bakhtiyarov
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  4. Kuanysh Nikatov
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Contributions

Askar Bakhtiyarov designed the model and the computational framework and analysed the data. Kuanysh Nikatov carried out the implementation. Baglan Mustafayev wrote the manuscript with input from all authors. Baglan Mustafayev and Alina Mustafayeva conceived the study and were in charge of overall direction and planning.

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Correspondence to Baglan Mustafayev.

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The authors declare no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. A study was approved by the Ethics Commission of the National Center for Neurosurgery of the Republic of Kazakhstan, No. A-5651. All persons gave their written informed consent prior to their inclusion in the study.

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Mustafayev, B., Mustafayeva, A., Bakhtiyarov, A. et al. Cross-spectral analysis of cerebral autoregulation after mild traumatic brain injury. Neurosurg Rev 46, 263 (2023). https://doi.org/10.1007/s10143-023-02173-3

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