J Korean Neurol Assoc.  2017 Feb;35(1):8-15. 10.17340/jkna.2017.1.2.

Application of Near-Infrared Spectroscopy in Neurological Disorders: Especially in Orthostatic Intolerance

• Kim YH
• Paik SH
• V ZP
• Seok HY
• Jeon NJ
• Kim BM
• Kim BJ

• KMID: 2370961
• DOI: http://doi.org/10.17340/jkna.2017.1.2

Abstract

Near-infrared spectroscopy (NIRS), a noninvasive optical method, utilizes the characteristic absorption spectra of hemoglobin in the near-infrared range to provide information on cerebral hemodynamic changes in various clinical situations. NIRS monitoring have been used mainly to detect reduced perfusion of the brain during orthostatic stress for three common forms of orthostatic intolerance (OI); orthostatic hypotension, neurally mediated syncope, and postural orthostatic tachycardia syndrome. Autonomic function testing is an important diagnostic test to assess their autonomic nervous systems for patients with symptom of OI. However, these techniques cannot measure dynamic changes in cerebral blood flow. There are many experimentations about study of NIRS to reveal the pathophysiology of patients with OI. Research using NIRS in other neurologic diseases (stroke, epilepsy and migraine) are ongoing. NIRS have been experimentally used in all stages of stroke and may complement the established diagnostic and monitoring tools. NIRS also provide pathophysiological approach during rehabilitation and secondary prevention of stroke. The hemodynamic response to seizure has long been a topic for discussion in association with the neuronal damage resulting from convulsion. One critical issue when unpredictable events are to be detected is how continuous NIRS data are analyzed. Besides, NIRS studies targeting pathophysiological aspects of migraine may contribute to a deeper understanding of mechanisms relating to aura of migraine. NIRS monitoring may play an important role to trend regional hemodynamic distribution of flow in real time and also highlights the pathophysiology and management of not only patients with OI symptoms but also those with various neurologic diseases.

Keyword

Orthostatic intolerance; Spectroscopy; Near-Infrared; Clinical neurology

MeSH Terms

Absorption
Autonomic Nervous System
Brain
Cerebrovascular Circulation
Complement System Proteins
Diagnostic Tests, Routine
Epilepsy
Hemodynamics
Humans
Hypotension, Orthostatic
Methods
Migraine Disorders
Nervous System Diseases*
Neurons
Orthostatic Intolerance*
Perfusion
Postural Orthostatic Tachycardia Syndrome
Rehabilitation
Secondary Prevention
Seizures
Spectroscopy, Near-Infrared*
Spectrum Analysis
Stroke
Syncope
Complement System Proteins