· August 19: Bi-weekly Lecture Series with Ajay Rajaram
· September 9: BCH AI and Machine Learning Group Lightning Talk with Dr. Pienaar & Dr. Ou
Watch last week's ISMRM talks and posters from our researchers here
Bi-Weekly Lecture Series:
This Wednesday's Bi-Weekly Lecture Series will be presented by Ajay Rajaram.
Date: Wednesday, August 19 at 10:00 AM
Title: Optical neuromonitoring of cerebral perfusion and metabolism at the bedside
The human brain relies almost exclusively on oxidative metabolism, having very limited energy storage, and is therefore susceptible to injury due to impaired cerebral blood flow (CBF). This is particularly evident in premature infants as the underdeveloped vascular system in the immature brain can lead to poor CBF control. For example, cerebral autoregulation – the ability to maintain CBF despite changes in blood pressure – is known to be impaired in this age group. Periods of low CBF can impact energy metabolism, leading to cell death, tissue damage, and subsequent brain injury. NNeMo (Neonatal NeuroMonitor) is an optical brain monitor (designed and constructed in-house) that provides continuous and simultaneous measurements of CBF and energy metabolism. NNeMo utilizes diffuse correlation spectroscopy (DCS) to measure CBF by analyzing light scatter from red blood cells in the microvasculature. In addition, it employs broadband near infrared spectroscopy (B-NIRS) to quantify cerebral tissue saturation and the oxidation state of cytochrome c oxidase – a direct marker of cerebral energy metabolism.
The system’s ability to continuously monitor hemodynamics was first demonstrated in an animal model of neonatal hypoxia-ischemia. Currently, NNeMo is employed in three clinical studies. First, it is used to monitor the brains of premature infants (< 32 weeks gestational age and/or < 1500 g) immediately following birth and resuscitation. Changes in perfusion and metabolism are acquired for multiple 6-hour periods with the goal of identifying physiological precursors of intraventricular hemorrhaging. A second study monitors infants who have already experienced a bleed and have post-hemorrhagic ventricular dilatation. During ventricular taps – the surgical removal of cerebrospinal fluid – CBF and metabolism are analyzed to determine the immediate impact of the procedure with the goal of providing a better indication of when to perform a tap or how much fluid to remove (current protocol relies on head circumference). Finally, NNeMo has recently been translated to the cardiac operating room to monitor adults during surgery with cardiopulmonary bypass (CPB). The goal of this work is to determine the efficacy of CPB in adequately perfusing the brain and to identify intraoperative events that could be predictive of post-operative neurological complications. With greater insight into hemodynamic events that precede brain injury, NNeMo could aid clinicians in both the NICU and OR with patient management to help mitigate brain damage and minimize adverse cognitive outcome.
Ajay Rajaram is a senior PhD candidate in the Department of Medical Biophysics at Western University in London, Ontario, Canada and previously completed a Bachelor of Science in Medical Physics from McMaster University. His current research focuses on the development and clinical translation of an optical brain monitor for continuous measurement of cerebral perfusion and metabolism. Ajay has eight published peer-reviewed articles, and three in review, and has presented his work at over 40 clinical and technical conferences. He currently holds a Natural Sciences and Engineering Research Council (NSERC) Canadian Graduate Scholarship.
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How have we adapted to work from home?
Banu Ahtam made pogacas (poh-ah-chas), a breakfast and tea time Turkish pastry. Hers were filled with feta cheese and potato. Do you want to try to make these delicious treats at home? Read more here.