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Paperdoi:10.1007/s00701-024-06002-4

A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients

Venue listed2024Added Nov 5, 2026

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Authors: Maria Roldan, Tomas Ysehak Abay, Christopher Uff, Panayiotis A. Kyriacou

Acta Neurochirurgica

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CC BY 4.0

TL;DR

In this research, a non-invasive intracranial pressure (nICP) optical sensor was developed and evaluated in a clinical pilot study. The technology relied on infrared light to probe brain tissue, using photodetectors to capture backscattered light modulated by vascular pulsations within the brain’s vascular tissue. The underlying hypothesis was that changes in extramural arterial pressure could affect the morphology of recorded optical signals (photoplethysmograms, or PPGs), and analysing these signals with a custom algorithm could enable the non-invasive calculation of intracranial pressure (nICP).

Abstract

Purpose

In this research, a non-invasive intracranial pressure (nICP) optical sensor was developed and evaluated in a clinical pilot study. The technology relied on infrared light to probe brain tissue, using photodetectors to capture backscattered light modulated by vascular pulsations within the brain’s vascular tissue. The underlying hypothesis was that changes in extramural arterial pressure could affect the morphology of recorded optical signals (photoplethysmograms, or PPGs), and analysing these signals with a custom algorithm could enable the non-invasive calculation of intracranial pressure (nICP).

Methods

This pilot study was the first to evaluate the nICP probe alongside invasive ICP monitoring as a gold standard. nICP monitoring occurred in 40 patients undergoing invasive ICP monitoring, with data randomly split for machine learning. Quality PPG signals were extracted and analysed for time-based features. The study employed Bland–Altman analysis and ROC curve calculations to assess nICP accuracy compared to invasive ICP data.

Results

Successful acquisition of cerebral PPG signals from traumatic brain injury (TBI) patients allowed for the development of a bagging tree model to estimate nICP non-invasively. The nICP estimation exhibited 95% limits of agreement of 3.8 mmHg with minimal bias and a correlation of 0.8254 with invasive ICP monitoring. ROC curve analysis showed strong diagnostic capability with 80% sensitivity and 89% specificity.

Conclusion

The clinical evaluation of this innovative optical nICP sensor revealed its ability to estimate ICP non-invasively with acceptable and clinically useful accuracy. This breakthrough opens the door to further technological refinement and larger-scale clinical studies in the future.

Trial registration

NCT05632302, 11th November 2022, retrospectively registered.

Verbatim from the publisher's DOI record (opens in a new tab) · Publisher licence: https://creativecommons.org/licenses/by/4.0

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Keywords

Kyriacou BibliographyBrain Monitoring Icp

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How Method works: Setup → Method → TargetSetup: Signals (PPG). Method: Method.SetupSignals: PPGSignalsPPGMethodMethod

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Roldan, M., Abay, T. Y., Uff, C., & Kyriacou, P. A. (2024). A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients. Acta Neurochirurgica. https://doi.org/10.1007/s00701-024-06002-4
Roldan, Maria, Tomas Ysehak Abay, Christopher Uff, and Panayiotis A. Kyriacou. 2024. "A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients." Acta Neurochirurgica. https://doi.org/10.1007/s00701-024-06002-4.
Roldan, M., Abay, T. Y., Uff, C. and Kyriacou, P. A. (2024) 'A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients', Acta Neurochirurgica. doi: 10.1007/s00701-024-06002-4.
Roldan, Maria, et al. "A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients." Acta Neurochirurgica, 2024. https://doi.org/10.1007/s00701-024-06002-4.
M. Roldan, T. Y. Abay, C. Uff, and P. A. Kyriacou, "A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients," Acta Neurochirurgica, 2024, doi: 10.1007/s00701-024-06002-4.
@article{roldan2024pilot,
  title         = {{A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients}},
  author        = {Roldan, Maria and Abay, Tomas Ysehak and Uff, Christopher and Kyriacou, Panayiotis A.},
  year          = {2024},
  journal       = {Acta Neurochirurgica},
  doi           = {10.1007/s00701-024-06002-4}
}

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