This invention relates to a system and method for non-invasively measuring blood volume oscillations inside the cranium of a human subject and using the measured oscillations to non-invasively determine intracranial pressure (IPC).
Conventional optical sensing systems, particularly those using near-infrared (NIR) light, have been used to monitor both blood volume oscillations and blood oxygen content by using one or more light sources and detector placed on the skin. All such measurements that seek to obtain information from within the cranium are subject to confounding of the reflected (or scattered) return light signal to the detector by the necessity of the light to transit the superficial region or superficial space above the cranium. In conventional functional near infrared spectroscopy (fNIRS) applications, the primary objective is to detect changes in oxygenation attributed to regional brain activity. Conventional systems and methods have been developed and proposed for removal of the superficial contribution to the cranial signal in such applications. However, such conventional systems and methods typically apply filtering techniques that are designed to remove cardiac-driven oscillations from the data in order to retrieve the slower activation-driven oxygen changes. For determination of blood volume oscillations within the cranium, such filtering may not be applied because the filtering would distort the shape and timing of the cranial blood volume waveforms, which may be required for other processing, such as non-invasively determining intra-cranial pressure (ICP) based on the impact of ICP on the pulse wave velocity inside the cranium. Therefore, such conventional systems and methods may be unable to accurately measure blood volume oscillations inside the cranium or non-invasively determine ICP.
Thus, there is a need for a non-invasive system and method to measure blood volume oscillations inside the cranium of a human subject that removes contributions of photon absorption and scattering in the superficial layer or superficial space from the detected light from inside the cranium which has passed through the superficial space, in order to accurately measure blood volume oscillations inside the cranium without significantly distorting wave shape or timing. There is also a need for such a system and method to measure blood volume oscillations inside the cranium of a human subject and use the measured blood volume oscillation to non-invasively measure ICP.
In one aspect, a system for non-invasively measuring blood volume oscillations inside a cranium of a human subject is featured. The system includes a first light source adapted to be placed on the skin above the cranium of the human subject configured to emit light which penetrates a superficial space outside the cranium. At least one detector is adapted to be placed on the skin above the cranium of the human subject spaced from the first light source by a first predetermined separation distance that causes the detector to detect light which reflects from the superficial space outside the cranium and output superficial output signals. A second light source is adapted be placed on the skin above the cranium configured to emit light which penetrates through the superficial space outside the cranium to inside the cranium. A detector is spaced from the second light source by a second predetermined separation distance that causes the detector to detect light which reflects from inside the cranium and output cranial output signals. A processing subsystem is coupled to the first light source, the second light source, and the detector. The processing subsystem is configured to alternately enable the first light source and the second light source and alternately enable the detector to detect the light which reflects from the superficial space outside the cranium and the light which reflects from inside the cranium to generate the superficial output signals and cranial output signals. The processing subsystem is responsive to the superficial output signals and the cranial output signals and is further configured to reduce contributions from the superficial space existing in the cranial output signals and generate corrected cranial output signals indicative of blood volume oscillations inside the cranium.
In one embodiment, the first light source, the second light source, and the detector may be adapted to be placed on skin above the cranium of the human subject with the first light source located between the second light source and the detector. The system may include a reference sensor adapted to be placed on the human subject and coupled to the processing subsystem. The reference sensor may be configured to provide reference signals to be used as a time reference for calculating a pulse transit time from one location on the human subject to the corrected cranial output signals. The first light source and the second light source may be adapted to be placed on a forehead of the cranium. The reference sensor may be adapted to be placed on one of: an ear, a temple, a finger, a hand, a forearm, a wrist, a chest, a back, a leg, a toe, or foot of the human subject. The reference sensor may be adapted to be placed on the human subject approximately the same distance from a heart of the human subject as the first light source and the second light source. The processing system may be configured to calculate a phase shift of the corrected cranial output signals compared to the reference signals and determine intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the reference signals. The processing system may be configured to calculate a difference or transfer function between the superficial output signals and the corrected cranial output signals and determine intracranial pressure from the difference or transfer function. The processing system may be configured to calculate a phase shift of the corrected cranial output signals compared to the superficial signals and determine intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the superficial signals. The processing system may be configured to calculate a time delay between the corrected cranial output signals and the superficial output signals and determine intracranial pressure of the human subject from the time delay.
In another aspect, a system for non-invasively measuring blood volume oscillations inside a cranium of a human subject is featured. The system includes a first sensor adapted to be placed on the skin above the cranium of the human subject including a first light source and a first light detector. The first light source is configured to emit light which penetrates a superficial space outside the cranium. The first detector is spaced from the first light source by a first predetermined separation distance that causes the first detector to detect light which reflects from the superficial space outside the cranium and output superficial output signals. A second sensor is adapted to be placed on the skin above the cranium of the human subject proximate the first sensor. The second sensor includes a second light source and a second light detector. The second light source is configured to emit light which penetrates through the superficial space outside the cranium to inside the cranium. The second detector is placed proximate the first detector and spaced from the second light source by a second predetermined separation distance that causes the second detector to detect light which reflects from inside the cranium and output cranial output signals. A processing subsystem is coupled to the first sensor and the second sensor. The processing subsystem is configured to alternately enable the first light source and the second light source and alternately enable the first detector to detect the light which reflects from the superficial space outside the cranium and alternately enable the second detector to detect the light which reflects from inside the cranium to generate the superficial output signals and cranial output signals. The processing subsystem is responsive to the superficial output signals and the cranial output signals and is further configured to reduce contributions from the superficial space existing in the cranial output signals and generate corrected cranial output signals indicative of blood volume oscillations inside the cranium.
In one embodiment, the first sensor and the second sensor may be adapted to be placed with the first light source located between the second light source and the first and second detectors. The first sensor and the second sensor may be configured to share the first detector or the second detector. The system may include a third sensor adapted to be placed on the human subject configured to provide reference signals to be used as a time reference for calculating a pulse transit time from one location on the human subject to the corrected cranial output signals. The first sensor and the second sensor may be adapted to be placed on a forehead of the cranium. The third sensor may be adapted to be placed on one of: an ear, a temple, a finger, a hand, a forearm, a wrist, a chest, a back, a leg, a toe, or foot of the human subject. The third sensor may be adapted to be placed on the human subject approximately the same distance from a heart of the human subject as the first sensor and/or the second sensor. The processing system may be configured to calculate a phase shift of the corrected cranial output signals compared to the reference signals and determine intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the reference signals. The processing system may be configured to calculate a difference or transfer function between the superficial output signals and corrected cranial output signals and determine intracranial pressure from the difference or the transfer function. The processing system may be configured to calculate a phase shift of the corrected cranial output signals compared to the superficial output signals and determine intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the superficial output signals. The processing system may be configured to calculate a time delay between the corrected cranial output signals and the superficial output signals and determine intracranial pressure of the human subject from the time delay.
In another aspect, a method for non-invasively measuring blood volume oscillations inside a cranium of a human subject is featured. The method includes alternately emitting light which penetrates a superficial space outside the cranium of the human subject, alternately detecting the light which reflects from the superficial space outside the cranium of the human subject and outputting superficial output signals, alternately emitting light which penetrates inside the cranium of the human subject, and alternately detecting the light which reflects from inside the cranium of the human subject and outputting cranial output signals. The method also includes responding to the superficial output signals and the cranial output signals and reducing contributions from the superficial space existing in the cranial output signals and generating corrected cranial output signals indicative of blood volume oscillations inside the cranium.
In one embodiment, the method may include providing reference signals to be used as a time reference for calculating a pulse transit time from one location on the human subject to the corrected cranial output signals. The method may include calculating a phase shift of the corrected cranial output signals compared to the reference signals and determining intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the reference signals. The method may include calculating a difference or transfer function between the superficial output signals and corrected cranial output signals and determining intracranial pressure from the difference or transfer function. The method may include calculating a phase shift of the corrected cranial output signals compared to the superficial output signals and determining intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the superficial output signals. The method may include calculating a time delay between the corrected cranial output signals and the superficial output signals and determining intracranial pressure of the human subject from the time delay. The method may include measuring the approximate difference in the arterial length from the heart to the cranial signal source and the arterial length from the heart to the location of the reference sensor placed on a location of the human subject and using this difference in length to determine the correspondence between the determined pulse transit time and the pulse wave velocity.
The subject invention, however, in other embodiments, need not achieve all these objectives and the claims hereof should not be limited to structures or methods capable of achieving these objectives.
Other objects, features and advantages will occur to those skilled in the art from the following description of a preferred embodiment and the accompanying drawings, in which:
Aside from the preferred embodiment or embodiments disclosed below, this invention is capable of other embodiments and of being practiced or being carried out in various ways. Thus, it is to be understood that the invention is not limited in its application to the details of construction and the arrangements of components set forth in the following description or illustrated in the drawings. If only one embodiment is described herein, the claims hereof are not to be limited to that embodiment. Moreover, the claims hereof are not to be read restrictively unless there is clear and convincing evidence manifesting a certain exclusion, restriction, or disclaimer.
There is shown in
System 10,
System 10,
System 10,
Processing subsystem 40 is configured to alternately enable first light source 16 to emit light 18 which penetrates superficial space 20 outside cranium 12 and second light source 30 to emit light 32 which penetrates through the superficial space outside the cranium to inside cranium 46 and alternately enable detector 22 to detect light 18 which reflects from superficial space 20 outside the cranium emitted by first light source 16 to generate the superficial output signals and detect light 32 emitted by second light source 30 which reflects from inside cranium 46 to generate the cranial output signals.
Processing subsystem 40 is responsive to the superficial output signals and the cranial output signals and is further configured to reduce contributions from the superficial space existing in the cranial output signals and generate corrected cranial output signals indicative of blood volume oscillations inside the cranium. Processing subsystem 40 may reduce the superficial contribution in the cranial signal by subtraction of normalized signals, linear regression where the superficial signal is used as a regressor and the unprocessed cranial signal as the regressed, Kalman filtering, other mathematical and statistical techniques known in the art, and physics-based photon propagation models. Preferably, processing by processing subsystem 40 may avoid filtering of frequency components of the signals in the region of about 0.5 Hz to about 2.0 Hz which contains the cardiac signal in order to preserve important wave shape and timing characteristics of the blood volume oscillation in the corrected cranial output signal. In some examples, the correction in the corrected cranial output signals by processing subsystem 40 may be null. As disclosed herein, such uncorrected cranial output signals are still referred to as corrected cranial output signals and the systems and methods discussed below may be utilized but may be less accurate.
The result is system 10 for non-invasively measured blood volume oscillations inside the cranium and has effectively reduced the contributions in the light detected by detector 22 from inside the cranium which has passed through superficial space 20 due to the blood volume oscillations in the superficial space. Thus, system 10 non-invasively, accurately, and effectively measures blood volume oscillations inside the cranium of a human subject. The measured blood volume oscillations may be used to non-invasively, accurately, and effectively measure ICP, as discussed below.
In one design, first light source 16,
In one design, first light source 16 and/or second light source 30 may include at least one near-infrared (NIR) light source. In other examples, first light source 16 and/or second light source 30 may include at least one light emitting diode (LED).
As known by those skilled in the art, pulse transit time is the time it takes for a blood pressure pulse to travel from one location of human subject 14 to another location of human subject 14 in the vasculature of a human subject. If the length along the vascular tree between the two locations on human subject 14 is known, then the pulse wave velocity (PWV) can be calculated from one location on human subject 14 to another location of human subject 14 and used to determine ICP inside the cranium of human subject 14, as discussed below. A differential pulse transit time may also be defined as the time difference between arrival of the cardiac pulse at one location on human subject 14, e.g., any of the locations shown in
In one design, system 10 may also include reference sensor 50,
In one example, reference sensor 50 may include at least one NIR sensor. In another examples, reference sensor 50 may include at least one electrocardiogram (ECG) sensor, at least one plethysmograph sensor, at least one pressure sensor. or similar type sensors.
For example, to non-invasively determine ICP, processing subsystem 40,
In another example, processing subsystem 40 may calculate a difference or transfer function between the superficial output signals and the corrected cranial output signals and determine ICP from the difference. In this example, the superficial output signal indicates pulse transit time from the heart along a vascular pathway including the exterior carotid artery and the corrected cranial output signals indicate pulse transit time along a vascular pathway including the interior carotid artery and through the cranium where it is influenced by changes in ICP.
In another example, processing subsystem 40 may calculate a phase shift of the corrected cranial output signals compared to the superficial output signals and determine ICP of human subject 14 from a phase shift of the corrected cranial output signals compared to the superficial output signals.
In one design, processing system 40 may calculate a time delay between the corrected cranial output signals and the superficial output signals and determine intracranial pressure of the human subject from the time delay. There are multiple ways to calculate the time delay or time shift between the corrected cranial output signals and the superficial output signals, e.g., locating a major feature of the superficial output signals and the corrected cranial output signals and calculating a time delay or time shift between the major features. The major features of the superficial output signals and the corrected cranial output signals may include a peak of a waveform of the superficial output signals and a peak of a waveform of the corrected cranial output signals, a trough of a waveform of the superficial output signals and a trough of a waveform corrected cranial output signals, or similar major features of the superficial output signals and the corrected cranial output signals, as known by those skilled in the art.
In another embodiment, system 100,
System 100 also includes second sensor 112 adapted to be placed on skin 17 above cranium 12 of human subject 14. Preferably second sensor 112 is adapted to be placed proximate to first sensor 102. Second sensor 112 includes second light source 120 and second detector 122. Second light source 120 is configured to emit light 124 which penetrates through superficial space 20 outside cranium 12 to inside cranium 46. Second detector 122 is preferably placed proximate first detector 106 as shown in
Processing subsystem 40,
In one design, first sensor 102,
In one example, first sensor 102 and/or second sensor 112 may include at least one NIR sensor. In one example, first light source 104 and/or second light source 122 may include at least one light emitting diode (LED).
In one embodiment, first sensor 102 and second sensor 112 may be configured to share first detector 106 or second detector 122, e.g., similar as discussed above with reference to
System 100,
In one example, first sensor 102,
Processing subsystem 40,
Similar as discussed above with reference to
In another embodiment, processing subsystem 40,
In one design, processing system 40 may calculate a time delay between the corrected cranial output signals and the superficial output signals and determine intracranial pressure of the human subject from the time delay, similar as discussed above.
In one embodiment, the method for non-invasively measuring blood volume oscillations inside the cranium of a human subject may include alternately emitting light which penetrates a superficial space outside the cranium, step 300,
In one example, the method may also include providing reference signals to be used as a time reference for calculating a pulse transmit time from one location of a human subject to the corrected cranial output signals.
The method may include calculating a phase shift in the corrected cranial output signals compared to the reference signals and determining intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the reference signals.
The method may include calculating a difference or transfer function between the superficial output signals and corrected cranial output signals and determining intracranial pressure from the difference or transfer function.
The method may include calculating a phase shift of the corrected cranial output signals compared to the superficial output signals and determining intracranial pressure of the human subject from the phase shift of the corrected cranial output signals compared to the superficial output signals.
The method may include calculating a magnitude of the superficial output signals and the corrected cranial output signals and determining intracranial pressure of the human subject from a difference in magnitude of the superficial output signals and the corrected cranial output signals.
In one design, the method may include calculating a time delay between the corrected cranial output signals and the superficial output signals and determining intracranial pressure of the human subject from the time delay.
In an alternate embodiment, system 10, 100, and the method thereof discussed above with reference to one or more of
System 10 and the method thereof and/or system 100 and the method thereof discussed above with reference to one or more of
For example, similar as disclosed in the '849 patent application, in one example, ICP may be determined by determining the magnitude and phase of the spectral components of the first (superficial output signals), second (corrected cranial output signals), and third signals (reference signals) from each of first sensor, second sensor, and third sensor and comparing the magnitude or the phase of the spectral components of first sensor to the magnitude or the phase of the spectral components of third sensor and the magnitude or the phase of the spectral components of second sensor to the magnitude or the phase of the spectral components of third sensor and combining the compared values.
ICP may also be determined by combining the signals from the first sensor with the signals from the second sensor and combining the result with the signals from the third sensor. ICP may also be determined determining a first time lag between a peak of a signal from the first output signals (superficial output signals) to a peak of a signal from the third output signals (reference output signals) and a second time lag between a peak of a signal from the second output signals (corrected cranial output signals) to a peak of a signal from the third output signals (reference signals) and calculating the intracranial pressure based on the difference between the first time lag and the second time lag. ICP may also be determined by determining a time lag between a peak of a signal from the first output signals (superficial output signals) and a peak of signal from the second output signals (corrected cranial output signals) and calculating the intracranial pressure based on the time lag. ICP may also be determined by determining a first lag time between a peak of a signal from the first output signals (superficial output signals) to a peak of a signal from the third output signals (reference signals), a second time lag between a peak of a signal from the second output signals (corrected cranial output signals) to a peak of a signal from the third output signals (reference signals), and a third time lag between the peak of a signal from the first output signals (superficial output signals) to a peak of a signal from the second output signals (corrected cranial output signals) and calculating the intracranial pressure based on differences of the first, second, and third time lags.
Processing subsystem 40 shown in
System 10, 100, and the method thereof shown in one or more of
System 10, 100 and the method thereof may also calculate the phase shift of different frequencies included in the first output signals (superficial output signals) and the second output signals (corrected cranial output signals) and determine intracranial pressure of the human subject from the phase shift at the different frequencies of the first output signals (superficial output signals) and the second output signals (corrected cranial output signals). System 10, 100 may also calculate a difference between the first output signals (superficial output signals) and second output signals (corrected cranial output signals) and determine the intracranial pressure from the difference.
For enablement purposes only, the following code portions are provided which can be executed on one or more processors, a computing device, a computer, a smart device, or similar type device to carry out the primary steps and/or functions of the system and method for non-invasively measuring blood volume oscillations inside a cranium of a human subject discussed above with reference to one or more of
% Acquire Cerebral signal
% Acquire Superficial signal
% Basic Data Conditioning of acquired signals
% Identify Frequency Components of interest
% Use Superficial signal to remove External Contribution from Cerebral Signal
% This is just an example,
% several methods can be used to remove the external contribution from the cerebral signal
% Calculate Arrival Delay (or Pulse Transit Time: PTT) between Cerebral Signal and Reference Signal
PTT=PhaseDiff\(2*π*f); % f is frequency associated to physiological parameter of interest
ICP=UseCalculatedPTTtoRetrievelCPfromLookUpTable; % Look Up Table previously built based on empirical data
In this example, the exemplary code above executed by processing subsystem 40, of system 10, 100 and method thereof for non-invasively measuring blood volume oscillations inside a cranium of a human subject discussed above with reference to one or more of
Although specific features of the invention are shown in some drawings and not in others, this is for convenience only as each feature may be combined with any or all of the other features in accordance with the invention. The words “including”, “comprising”, “having”, and “with” as used herein are to be interpreted broadly and comprehensively and are not limited to any physical interconnection. Moreover, any embodiments disclosed in the subject application are not to be taken as the only possible embodiments.
In addition, any amendment presented during the prosecution of the patent application for this patent is not a disclaimer of any claim element presented in the application as filed: those skilled in the art cannot reasonably be expected to draft a claim that would literally encompass all possible equivalents, many equivalents will be unforeseeable at the time of the amendment and are beyond a fair interpretation of what is to be surrendered (if anything), the rationale underlying the amendment may bear no more than a tangential relation to many equivalents, and/or there are many other reasons the applicant cannot be expected to describe certain insubstantial substitutes for any claim element amended.
Other embodiments will occur to those skilled in the art and are within the following claims.
This application claims benefit of and priority to U.S. Provisional Application Ser. No. 62/973,021 filed Sep. 12, 2019, under 35 U.S.C. §§ 119, 120, 363, 365, and 37 C.F.R. § 1.55 and § 1.78, which is incorporated herein by this reference.
This invention was made with U.S. Government support under Contract No. W81XWH-17-C-0006, awarded by the US Army. The Government has certain rights in the invention.
Number | Date | Country | |
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62973021 | Sep 2019 | US |