Brain TV for emergency assessment of brain injury
Research type
Research Study
Full title
Brain TV (Tissue Velocimetry) for emergency assessment of acquired brain injury
IRAS ID
233655
Contact name
Emma Chung
Contact email
Sponsor organisation
University of Leicester
Clinicaltrials.gov Identifier
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Research Summary
This study uses a Doppler ultrasound technique called Brain Tissue Velocimetry (Brain TV), to investigate brain tissue motion over the cardiac cycle. Brain motion is highly sensitive to heart and brain biomechanics, but the impact of brain injury on brain tissue motion has yet to be explored. Preliminary Brain TV measurements from a small number of patients suggest that brain biomechanics may be disturbed in the presence of injury. This study will help to establish whether analysis of brain tissue motions provides clinically useful information for emergency diagnosis and monitoring of brain injury.This study comprises 3 parts:
1. Screening: Brain TV, ECG and Blood pressure (BP) recordings will be gathered from up to 250 patients with suspected Acquired Brain Injury (ABI) (due to stroke, cardiac arrest, or head injury). These measurements will be compared with recordings from subjects with no brain injury to determine the sensitivity and specificity of Brain TV in detecting abnormal brain biomechanics and to relate disruption of Brain TV waveforms to the severity of injury.2. Imaging: Patients referred for brain imaging (CT or MRI) will be asked to wear a headband during their scan to aid positioning of the ultrasound probe with respect to the location of brain injury. In patients receiving brain MRI as part of standard care, an additional cardiac-gated MRI scan will be performed to visualise brain motion over the cardiac cycle. This will add a further 20 mins to the standard MRI scan.
3. Follow-up: Patients admitted to hospital will receive daily Brain TV, ECG and BP monitoring for <1 hr per session (up to a maximum of 5 sessions per day) to explore trends in parameters over time. These time series data will enable us to explore the potential of Brain TV for patient monitoring.
Summary of Results
The aim of this study was to use ultrasound to investigate brain tissue motion in patients with suspected stroke or brain injury. Overall 154 patients were recruited to our study, in which 102 of these patients had had a diagnosis of stroke or a stroke mimic. Six of these patients also received a brain magnetic resonance imaging scan. The remaining patients had a head injury from other causes, including tumours.We found that we were able to measure the motion of the brain over the cardiac cycle using ultrasound. This showed that the strength of pulsations varied widely between patients. Although there were no obvious changes in the strength of brain tissue motion in the presence of brain injury, some changes in the pulsation waveform were noted which we plan to investigate in future research.
Data are still undergoing analysis but have so far resulted in the following publication and doctoral thesis:
Brain tissue motion in acute hemorrhagic stroke using amplified MRI (aMRI), Dr Ince et al. (2022) and Understanding the Impact of Large Vessel Occlusion on Brain Tissue Pulsatility, Dr Jennifer Nicholls, University of Leicester.
REC name
Wales REC 4
REC reference
19/WA/0028
Date of REC Opinion
10 Apr 2019
REC opinion
Further Information Favourable Opinion