Nichtinvasive Messung von regionalen cerebralen Oxygenerierungsänderungen während Leao´s ´corticale depression und spontaner Depolarisation bei fokaler verebraler Ischämie mit der Nah-Infrarot-Spektroskopoie

Abstract

In this thesis the optical method of Near-Infrared-Spectroscopy (NIRS) is evaluated with regards to its capability of non-invasive detection of Leão´s cortical spreading depression (CSD) and spontaneous peri-infarct-depolarizations (PID). With the NIR-spectrometer NIRO 500 (Hamamatsu, Japan) regional cerebral oxy-genation (rCBO) changes were measured during CSD in 9, and during PID in 10 barbiturate anesthatized rats. The method if NIRS that relies on oxygen-dependent absorption changes of hemo-globin and cytochrome oxydase as well as the high penetrability of biologic tissues for light in the range between 700 and 1000 nm proved suitable to detect and to distinguish both CSD and PID experimentally. This distinction relies on the robust decrease of deoxy- and increase of oxyhemo-globin concentrations (i.e. a relative hyperoxemia) during CSD while PID is cha-racterized by an initial increase of deoxy- and decrease of oxyhemoglobin (relative hypooxemia). Despite the profound anatomical differences between gyrencephalic humans and lyssencephalic rats, the observed patterns of rCBO changes may guide the inter-pretation of future NIRS measurements in patients with migraines with aura (CSD) or stroke (PID). However, for concentration changes of oxydized cytochrome aa3 with its low con-centration compared to the hemoglobins, the pathophysiological interpretation of the data obtained with NIRO 500 is confounded by the limits of attenuation mea-surements at only four wavelengths. A validation of the cytochrome oxydase signal and an improved quantification of all concentration changes is highly desirable and may be achieved by employment of a continuous-wavelength device measuring the full spectral range of the near infrared. It would also allow to measure the mean optical pathlength in the highly scattering tissue and to correct for its physiologically occuring changes e.g. by measurements at the water absorption peak. Similar improvements would enhance the value of the method for further physiolo-gical and pathophysiological studies because NIRS provides the unique opportu-nity to obtain simultaneous data on blood oxygenation as well as the redox state of the mitochondrial cytochrome oxydase.