{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T07:42:48Z","timestamp":1768808568634,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health","award":["R01GM116177"],"award-info":[{"award-number":["R01GM116177"]}]},{"name":"National Institutes of Health","award":["R01HD0091067"],"award-info":[{"award-number":["R01HD0091067"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Objective: This pilot study aims to show the feasibility of noninvasive and real-time cerebral hemodynamic monitoring during carotid endarterectomy (CEA) via diffuse correlation spectroscopy (DCS) and near-infrared spectroscopy (NIRS). Methods: Cerebral blood flow index (CBFi) was measured unilaterally in seven patients and bilaterally in seventeen patients via DCS. In fourteen patients, hemoglobin oxygenation changes were measured bilaterally and simultaneously via NIRS. Cerebral autoregulation (CAR) and cerebrovascular resistance (CVR) were estimated using CBFi and arterial blood pressure data. Further, compensatory responses to the ipsilateral hemisphere were investigated at different contralateral stenosis levels. Results: Clamping of carotid arteries caused a sharp increase of CVR (~70%) and a marked decrease of ipsilateral CBFi (57%). From the initial drop, we observed partial recovery in CBFi, an increase of blood volume, and a reduction in CVR in the ipsilateral hemisphere. There were no significant changes in compensatory responses between different contralateral stenosis levels as CAR was intact in both hemispheres throughout the CEA phase. A comparison between hemispheric CBFi showed lower ipsilateral levels during the CEA and post-CEA phases (p &lt; 0.001, 0.03). Conclusion: DCS alone or combined with NIRS is a useful monitoring technique for real-time assessment of cerebral hemodynamic changes and allows individualized strategies to improve cerebral perfusion during CEA by identifying different hemodynamic metrics.<\/jats:p>","DOI":"10.3390\/brainsci12081025","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T21:41:37Z","timestamp":1659476497000},"page":"1025","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Intraoperative Cerebral Hemodynamic Monitoring during Carotid Endarterectomy via Diffuse Correlation Spectroscopy and Near-Infrared Spectroscopy"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1826-4659","authenticated-orcid":false,"given":"Kutlu","family":"Kaya","sequence":"first","affiliation":[{"name":"Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"},{"name":"Department of Physiology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3383-0724","authenticated-orcid":false,"given":"Alexander I.","family":"Zavriyev","sequence":"additional","affiliation":[{"name":"Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-7283","authenticated-orcid":false,"given":"Felipe","family":"Orihuela-Espina","sequence":"additional","affiliation":[{"name":"Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"},{"name":"School of Computer Science, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirela V.","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn M.","family":"LaMuraglia","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery in the General Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric T.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Angela","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Sunwoo","sequence":"additional","affiliation":[{"name":"Optics at Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/bja\/aem137","article-title":"Carotid Endarterectomy","volume":"99","author":"Howell","year":"2007","journal-title":"Br. J. Anaesth."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"279","DOI":"10.2174\/157340309789317887","article-title":"Cerebral Collateral Circulation in Carotid Artery Disease","volume":"5","author":"Romero","year":"2009","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1038\/jcbfm.2014.7","article-title":"Function of Circle of Willis","volume":"34","author":"Vrselja","year":"2014","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2577","DOI":"10.1016\/j.clinph.2005.06.026","article-title":"Electroencephalographic Background Desynchronization during Cerebral Blood Flow Reduction","volume":"116","author":"Cursi","year":"2005","journal-title":"Clin. Neurophysiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1097\/01.anes.0000281894.69422.ff","article-title":"Accuracy of Cerebral Monitoring in Detecting Cerebral Ischemia during Carotid Endarterectomy: A Comparison of Transcranial Doppler Sonography, Near-Infrared Spectroscopy, Stump Pressure, and Somatosensory Evoked Potentials","volume":"107","author":"Moritz","year":"2007","journal-title":"Anesthesiology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1017\/S0317167100003437","article-title":"Comparison of Monitoring Techniques for Intraoperative Cerebral Ischemia","volume":"31","author":"Rowed","year":"2004","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/00004691-199805000-00005","article-title":"Anesthetic Effects on Electrophysiologic Recordings","volume":"15","author":"Sloan","year":"1998","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1161\/01.STR.24.5.665","article-title":"Carotid Endarterectomy with Transcranial Doppler and Electroencephalographic Monitoring. A Prospective Study in 130 Operations","volume":"24","author":"Jansen","year":"1993","journal-title":"Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1053\/ejvs.2002.1823","article-title":"Stump Pressure and Transcranial Doppler for Predicting Shunting in Carotid Endarterectomy","volume":"25","author":"Belardi","year":"2003","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1161\/01.STR.21.3.415","article-title":"Detection of Middle Cerebral Artery Emboli during Carotid Endarterectomy Using Transcranial Doppler Ultrasonography","volume":"21","author":"Spencer","year":"1990","journal-title":"Stroke"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1088\/0967-3334\/31\/4\/002","article-title":"The Effects of Healthy Aging on Cerebral Hemodynamic Responses to Posture Change","volume":"31","author":"Edlow","year":"2010","journal-title":"Physiol. Meas."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.ejvs.2009.07.008","article-title":"The Value of Near-Infrared Spectroscopy Measured Cerebral Oximetry during Carotid Endarterectomy in Perioperative Stroke Prevention. A Review","volume":"38","author":"Pennekamp","year":"2009","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1088\/0031-9155\/33\/12\/008","article-title":"Estimation of Optical Pathlength through Tissue from Direct Time of Flight Measurement","volume":"33","author":"Delpy","year":"1988","journal-title":"Phys. Med. Biol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1212\/WNL.0b013e3181a2e846","article-title":"Near-Infrared Spectroscopy in Carotid Artery Stenting Predicts Cerebral Hyperperfusion Syndrome","volume":"72","author":"Matsumoto","year":"2009","journal-title":"Neurology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jclinane.2004.09.007","article-title":"A Clinical Evaluation of Near-Infrared Cerebral Oximetry in the Awake Patient to Monitor Cerebral Perfusion during Carotid Endarterectomy","volume":"17","author":"Rigamonti","year":"2005","journal-title":"J. Clin. Anesth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1097\/00000539-200012000-00006","article-title":"Comparing Doppler Ultrasonography and Cerebral Oximetry as Indicators for Shunting in Carotid Endarterectomy","volume":"91","author":"Grubhofer","year":"2000","journal-title":"Anesth. Analg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1097\/EJA.0b013e32832b89c2","article-title":"Regional Cerebral Saturation versus Transcranial Doppler during Carotid Endarterectomy under Regional Anaesthesia","volume":"26","author":"Pugliese","year":"2009","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_18","first-page":"156975","article-title":"Is Near-Infrared Spectroscopy a Reliable Method to Evaluate Clamping Ischemia during Carotid Surgery?","volume":"2012","author":"Pedrini","year":"2012","journal-title":"Stroke Res. Treat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.ejvs.2004.02.012","article-title":"Near Infrared Spectroscopy Monitoring during Carotid Endarterectomy: Which Threshold Value Is Critical?","volume":"27","author":"Mille","year":"2004","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.ejvs.2010.12.009","article-title":"The Role of Cerebral Oximetry in Combination with Awake Testing in Patients Undergoing Carotid Endarterectomy under Local Anaesthesia","volume":"41","author":"Ritter","year":"2011","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"076701","DOI":"10.1088\/0034-4885\/73\/7\/076701","article-title":"Diffuse Optics for Tissue Monitoring and Tomography","volume":"73","author":"Durduran","year":"2010","journal-title":"Rep. Prog. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1364\/JOSAA.14.000192","article-title":"Spatially Varying Dynamical Properties of Turbid Media Probed with Diffusing Temporal Light Correlation","volume":"14","author":"Boas","year":"1997","journal-title":"J. Opt. Soc. Am. A"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1364\/OL.29.001766","article-title":"Diffuse Optical Measurement of Blood Flow, Blood Oxygenation, and Metabolism in a Human Brain during Sensorimotor Cortex Activation","volume":"29","author":"Durduran","year":"2004","journal-title":"Opt. Lett."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3884","DOI":"10.1364\/OE.17.003884","article-title":"Transcranial Optical Monitoring of Cerebrovascular Hemodynamics in Acute Stroke Patients","volume":"17","author":"Durduran","year":"2009","journal-title":"Opt. Express"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"North American Symptomatic Carotid Endarterectomy Trial Collaborators (NASCET) (1991). Beneficial Effect of Carotid Endarterectomy in Symptomatic Patients with High-Grade Carotid Stenosis. N. Engl. J. Med., 325, 445\u2013453.","DOI":"10.1056\/NEJM199108153250701"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3993","DOI":"10.1364\/BOE.8.003993","article-title":"Combined Multi-Distance Frequency Domain and Diffuse Correlation Spectroscopy System with Simultaneous Data Acquisition and Real-Time Analysis","volume":"8","author":"Carp","year":"2017","journal-title":"Biomed. Opt. Express"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"015005","DOI":"10.1117\/1.NPh.1.1.015005","article-title":"Sensitivity of Near-Infrared Spectroscopy and Diffuse Correlation Spectroscopy to Brain Hemodynamics: Simulations and Experimental Findings during Hypercapnia","volume":"1","author":"Selb","year":"2014","journal-title":"Neurophotonics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"097003","DOI":"10.1117\/1.JBO.25.9.097003","article-title":"Diffuse Correlation Spectroscopy Measurements of Blood Flow Using 1064 Nm Light","volume":"25","author":"Carp","year":"2020","journal-title":"J. Biomed. Opt."},{"key":"ref_29","first-page":"788","article-title":"Tabulated Molar Extinction Coefficient for Hemoglobin in Water","volume":"401","author":"Prahl","year":"1999","journal-title":"Nature"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3915","DOI":"10.1021\/ac0101306","article-title":"Determination of Water Concentration in Brain Tissue by Raman Spectroscopy","volume":"73","author":"Wolthuis","year":"2001","journal-title":"Anal. Chem."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1161\/STROKEAHA.108.536094","article-title":"Cerebrovascular Reactivity Measured by Near-Infrared Spectroscopy","volume":"40","author":"Lee","year":"2009","journal-title":"Stroke"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2207","DOI":"10.2147\/JPR.S142582","article-title":"A Novel Cross-Correlation Methodology for Assessing Biophysical Responses Associated with Pain","volume":"11","author":"Sunwoo","year":"2018","journal-title":"J. Pain Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/s12028-010-9492-5","article-title":"Critical Thresholds for Transcranial Doppler Indices of Cerebral Autoregulation in Traumatic Brain Injury","volume":"14","author":"Sorrentino","year":"2011","journal-title":"Neurocrit. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.medengphy.2014.03.002","article-title":"Continuous Time-Domain Monitoring of Cerebral Autoregulation in Neurocritical Care","volume":"36","author":"Zweifel","year":"2014","journal-title":"Med. Eng. Phys."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3015","DOI":"10.1088\/0031-9155\/56\/10\/008","article-title":"Cerebral Monitoring during Carotid Endarterectomy Using Near-Infrared Diffuse Optical Spectroscopies and Electroencephalogram","volume":"56","author":"Shang","year":"2011","journal-title":"Phys. Med. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1161\/01.STR.30.12.2671","article-title":"Circle of Willis Collateral Flow Investigated by Magnetic Resonance Angiography","volume":"30","author":"Hartkamp","year":"1999","journal-title":"Stroke"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1159\/000368595","article-title":"Dynamic Cerebral Autoregulation Is Transiently Impaired for One Week after Large-Vessel Acute Ischemic Stroke","volume":"39","author":"Petersen","year":"2015","journal-title":"Cerebrovasc. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e01907","DOI":"10.1002\/brb3.1907","article-title":"Cerebral Autoregulation Is Heterogeneous in Different Stroke Mechanism of Ischemic Stroke Caused by Intracranial Atherosclerotic Stenosis","volume":"11","author":"Tian","year":"2020","journal-title":"Brain Behav."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3171\/jns.2007.106.1.142","article-title":"A Microsurgical Study of the Anatomy and Course of the Ophthalmic Artery and Its Possibly Dangerous Anastomoses","volume":"106","author":"Perrini","year":"2007","journal-title":"J. Neurosurg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/00000542-200309000-00015","article-title":"Effects of Sevoflurane, Propofol, and Adjunct Nitrous Oxide on Regional Cerebral Blood Flow, Oxygen Consumption, and Blood Volume in Humans","volume":"99","author":"Kaisti","year":"2003","journal-title":"Anesthesiology"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/8\/1025\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:01:06Z","timestamp":1760140866000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/8\/1025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,2]]},"references-count":40,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["brainsci12081025"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12081025","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,2]]}}}