University of California

Yama Akbari

Bernard H Choi

Robert H Wilson

Christian Crouzet

Bruce J Tromberg

Thomas E Milner

Electrophysiologic biomarkers for prognostication of neurological outcome are described herein. An inverse correlation was found between timing of a cortical spreading depolarization (SD) wave and neurological outcome as tested at 24 hours post-CPR. Additionally, a minor image of this SD was identified as a 'repolarization (RP) wave.' Quantifying features of SD and RP during cardiac arrest and cardiopulmonary resuscitation (CPR) provide important metrics for diagnosis and prognosis of neurological injury from hypoxia-ischemia and can serve as an early prognostication tool for predicting outcome at subsequent days after successful CPR. This discovery may also allow for novel therapeutic interventions to improve neurological recovery after hypoxia-ischemia insults.

Spreading depolarization and repolarization as biomarkers of neurological recovery after cardiac arrest

A multimodal optical imaging platform is used to obtain cerebral perfusion-metabolism mismatch metrics for rapid assessment of acute brain injury, ongoing (real-time) feedback to optimize cardiopulmonary resuscitation to improve neurological outcome, and rapid prognosis of recovery. Light of several wavelengths and types is delivered to the tissue, which is then absorbed and scattered by tissue components such as blood and cellular components. Some of this light scatters back to the surface, where it is captured by a detector. The resulting data are processed to obtain blood flow and oxygenation parameters, as well as tissue scattering. These parameters are then combined to calculate metabolism and flow-metabolism coupling/decoupling metrics, which are used to determine ischemic damage, ongoing need for optimal blood flow and oxygenation, and to predict cerebral recovery in patients with acute brain injury during and immediately after cardiac arrest, stroke, traumatic brain injury, etc.

Real-time methods to enable precision-guided CPR to improve neurological outcome and predict brain damage after ischemic injury and reperfusion

A portable device for quantitative measurement of tissue autoregulation and neurovascular coupling via portable measurement of blood flow, oxygenation, metabolism, and/or EEG signals and methods for using said device. The device may comprise a body and a plurality of legs pivotably attached to the body. The plurality of legs may comprise at least one reference electrode leg and at least one measurement electrode leg for electrical measurement, and an optical detection fiber leg and at least one optical source fiber leg for optical blood flow, oxygenation, and metabolism measurement. The present invention is additionally directed to a portable device for blood flow measurement and therapeutic photobiomodulation. The device may comprise a body and a plurality of legs. The plurality of legs may comprise at least one optical detection fiber leg and at least one optical source fiber leg, and at least one leg for therapeutic photobiomodulation.

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Irvine, CA, United States of America

Yama Akbari