Changes in cerebral blood flow after acetazolamide: an experimental study comparing near-infrared spectroscopy and SPECT

Eur J Neurol. 2009 Apr;16(4):461-7. doi: 10.1111/j.1468-1331.2008.02398.x.

Abstract

Background and purpose: It is important to find a reliable and bedside method, which can estimate the cerebral blood flow (CBF) of patients in clinical settings. Estimation of CBF by calculating a blood flow index (BFI) using continuous wave near-infrared spectroscopy (CW-NIRS) and indocyanine green (ICG) as an i.v. tracer has been proposed to be a feasible and promising method. To validate if the BFI method can detect relative changes in CBF we compared data with the established method (133)Xenon single photon emission computer tomography ((133)Xe-SPECT).

Methods: Ten healthy subjects were investigated before and after a bolus of acetazolamide. NIRS data were obtained using a multi source detector separation configuration in order to assess a corrected BFI (BFI(corr)) value, which attempts to eliminate contamination of skin blood flow.

Results: Data obtained showed no significant correlation between CBF changes measured by (133)Xe-SPECT and BFI(corr) (0.133, P = 0.732). After acetazolamide, a 49% increase in CBF was detected using the (133)Xe-SPECT method, whereas no changes in any ICG variables were observed after acetazolamide.

Conclusion: The study shows that it is not possible to obtain reliable BFI data, which reflect changes in CBF after acetazolamide infusion, using the CW-NIRS and ICG method.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetazolamide / pharmacology*
  • Adolescent
  • Adult
  • Arterioles / drug effects
  • Brain / blood supply
  • Brain / diagnostic imaging
  • Brain / drug effects
  • Carbonic Anhydrase Inhibitors / pharmacology*
  • Cerebrovascular Circulation / drug effects*
  • Female
  • Humans
  • Indocyanine Green
  • Injections, Intravenous
  • Male
  • Regional Blood Flow / drug effects
  • Skin / blood supply
  • Skin / diagnostic imaging
  • Skin / drug effects
  • Spectroscopy, Near-Infrared*
  • Tomography, Emission-Computed, Single-Photon*
  • Xenon Radioisotopes
  • Young Adult

Substances

  • Carbonic Anhydrase Inhibitors
  • Xenon Radioisotopes
  • Indocyanine Green
  • Acetazolamide