Characterization of cerebral vascular response to EEG bursts using ICP pulse waveform template matching

Abstract

Neurovascular coupling is the relationship between the activity of the brain and the subsequent change in blood flow to the active region. The most common methods of detecting neurovascular coupling are cumbersome and noncontinuous. However, the integration of intracranial pressure (ICP) and electroencephalography (EEG) may serve as an indirect measure of neurovascular coupling. This study used data collected from burst-suppressed patients who received both ICP and depth EEG monitoring. An adaptive thresholding algorithm was used to detect the start and end of each EEG burst. The morphological clustering and analysis of ICP and pulse morphological template-matching algorithms were then applied to derive several metrics describing the shape of the ICP pulse waveform and track how it changed following an EEG burst. These changes were compared using a template obtained from patients undergoing CO2-induced vasodilation. All segments exhibited a significant period of vasodilation within 1–2 s after burst, and 4 of 5 had a significant period of vasoconstriction within 4–11 s of the EEG burst, suggesting that there might be a characteristic response of vasodilation and subsequent vasoconstriction after a spontaneous EEG burst. Furthermore, these findings demonstrate the potential of integrated EEG and ICP as an indirect measure of neurovascular coupling.