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. 2017:2017:8454527.
doi: 10.1155/2017/8454527. Epub 2017 Jan 31.

Detection of Impaired Cerebral Autoregulation Using Selected Correlation Analysis: A Validation Study

Martin A Proescholdt  1 , Rupert Faltermeier  1 , Sylvia Bele  1 , Alexander Brawanski  1
Affiliations

Detection of Impaired Cerebral Autoregulation Using Selected Correlation Analysis: A Validation Study

Martin A Proescholdt et al. Comput Math Methods Med. 2017.

Abstract

Multimodal brain monitoring has been utilized to optimize treatment of patients with critical neurological diseases. However, the amount of data requires an integrative tool set to unmask pathological events in a timely fashion. Recently we have introduced a mathematical model allowing the simulation of pathophysiological conditions such as reduced intracranial compliance and impaired autoregulation. Utilizing a mathematical tool set called selected correlation analysis (sca), correlation patterns, which indicate impaired autoregulation, can be detected in patient data sets (scp). In this study we compared the results of the sca with the pressure reactivity index (PRx), an established marker for impaired autoregulation. Mean PRx values were significantly higher in time segments identified as scp compared to segments showing no selected correlations (nsc). The sca based approach predicted cerebral autoregulation failure with a sensitivity of 78.8% and a specificity of 62.6%. Autoregulation failure, as detected by the results of both analysis methods, was significantly correlated with poor outcome. Sca of brain monitoring data detects impaired autoregulation with high sensitivity and sufficient specificity. Since the sca approach allows the simultaneous detection of both major pathological conditions, disturbed autoregulation and reduced compliance, it may become a useful analysis tool for brain multimodal monitoring data.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
PRx values in time segments with selected correlation positive (scp) indicating impaired autoregulation are significantly higher compared to no selected correlation (nsc) (mean: 0.026 versus 0.286; p = 0.001).
Figure 2
Figure 2
Outcome studies. (a) The percentage of time during the observational period in which patients showed scp, indicating a disturbed autoregulation, strongly correlates with outcome measured by GOS at the last follow-up (p = 0.0013; Spearman's rank correlation analysis). (b) Correspondingly, high PRx values implicating deteriorated cerebrovascular pressure reactivity were associated with poor outcome (ANOVA on ranks, p < 0.001).
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