{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:58:19Z","timestamp":1790319499097,"version":"4.1.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Science Center, Poland","award":["UMO-2022\/45\/N\/ST7\/01980 (AK)"],"award-info":[{"award-number":["UMO-2022\/45\/N\/ST7\/01980 (AK)"]}]},{"DOI":"10.13039\/501100005982","name":"Politechnika Wroc\u0142awska","doi-asserted-by":"publisher","award":["Minigrants for doctoral students"],"award-info":[{"award-number":["Minigrants for doctoral students"]}],"id":[{"id":"10.13039\/501100005982","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Pulse shape index (PSI) is a novel artificial intelligence\u2013supported parameter that evaluates the pressure\u2013volume compensatory reserve of the craniospinal system through intracranial pressure (ICP) pulse waveform classification. This study assessed the agreement between PSI derived from invasive ICP monitoring (PSI\n                      <jats:sub>ICP<\/jats:sub>\n                      ) and noninvasive brain4care (B4C) sensor signal (PSI\n                      <jats:sub>B4C<\/jats:sub>\n                      ) and investigated the influence of cranial integrity, age, and internal jugular vein (IJV) compression on PSI values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Simultaneous ICP and B4C monitoring was performed in 47 adult patients ( age: 43\u00a0(30)  years) before and during IJV compression. Patients were grouped by cranial integrity: intact skull bone (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917), large skull fractures or craniotomies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917), and craniectomies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913). Pulse waveforms were automatically classified into four classes (from 1\u2009=\u2009normal to 4\u2009=\u2009pathological) by a neural network, and PSI was calculated as the weighted average of class numbers.\u00a0Values are presented as median (interquartile range).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Bland\u2013Altman analysis demonstrated good agreement between PSI\n                      <jats:sub>ICP<\/jats:sub>\n                      and PSI\n                      <jats:sub>B4C<\/jats:sub>\n                      , with approximately 6% outliers. PSI was significantly higher in patients who underwent craniectomy compared with those with intact skulls (PSI\n                      <jats:sub>ICP<\/jats:sub>\n                      :\u00a03.5 (0.8) vs. 2.0 (1.2) arbitrary units,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.002; PSI\n                      <jats:sub>B4C<\/jats:sub>\n                      :\u00a03.0 (0.4) vs. 2.0 (0.6) arbitrary units,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005) or those with craniotomies or large fractures (PSI\n                      <jats:sub>ICP<\/jats:sub>\n                      :\u00a03.5 (0.8) vs. 2.0 (2.1) arbitrary units,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05; PSI\n                      <jats:sub>B4C<\/jats:sub>\n                      :\u00a03.0 (0.4) vs. 2.0 (2.2) arbitrary units,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). IJV compression did not affect PSI. Both PSI\n                      <jats:sub>ICP<\/jats:sub>\n                      (r\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.02) and PSI\n                      <jats:sub>B4C<\/jats:sub>\n                      (r\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) correlated with age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study supports the B4C signal\u2019s capability to noninvasively reflect ICP waveform morphology via PSI, offering a promising monitoring alternative. PSI appears to be influenced by age and craniectomy but not by a slight, sudden ICP change induced by IJV compression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12028-025-02382-2","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:58:50Z","timestamp":1759334330000},"page":"282-293","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Invasive and Noninvasive Intracranial Pressure Pulse Waveform in Neurocritical Care Patients with Different Cranium Integrity"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2271-7737","authenticated-orcid":false,"given":"Magdalena","family":"Kasprowicz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Kazimierska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Hendler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Cardim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zofia","family":"Czosnyka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Czosnyka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wellingson","family":"Paiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Brasil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"issue":"2\u20134","key":"2382_CR1","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/BF01476419","volume":"126","author":"M Czosnyka","year":"1994","unstructured":"Czosnyka M, Price DJ, Williamson M. 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S.B. and M.C. are scientific advisors for brain4care. The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}},{"value":"The study protocol was approved by the local Ethics Committee and registered under the identifier NCT03144219 (ClinicalTrials.gov). All procedures adhered to relevant guidelines and regulations, and informed consent was obtained from legally authorized representatives or next of kin due to the severity of the patients\u2019 conditions.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval\/Informed Consent"}}]}}