CN116344034A - Cognitive function evaluation system based on blood pressure and cerebral blood oxygen monitoring - Google Patents
Cognitive function evaluation system based on blood pressure and cerebral blood oxygen monitoring Download PDFInfo
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Abstract
The invention discloses a cognitive function evaluation system based on blood pressure and cerebral blood oxygen monitoring, which comprises an acquisition module, a calculation module and an evaluation result calculation module, wherein: the acquisition module is used for synchronously acquiring forehead lobe cerebral blood oxygen data and continuous arterial blood pressure data at the left side and the right side; the calculation module is used for calculating a cerebral blood oxygen saturation average value, a forehead leaf cerebral blood oxygen coupling strength value at the left side and the right side and a cerebral blood oxygen and blood pressure coupling strength value in the acquisition period; the evaluation result calculation module is used for evaluating the cognitive function of the subject according to the calculated brain blood oxygen saturation average value, the forehead lobe brain blood oxygen coupling strength value at the left side and the right side and the brain blood oxygen and blood pressure coupling strength value; when the average value of the cerebral oxygen saturation of the forehead lobe on the dominant side is more than 60 percent, judging that cognition is normal; when the average value of the blood oxygen saturation of the forehead lobe brain at the dominant side is more than or equal to 56% and less than or equal to 60%, judging that the cognitive disorder is possible to be mild; when the mean value of the cerebral oxygen saturation of the prefrontal lobe is <56%, it is judged that the cognitive disorder may be severe.
Description
The present application is a divisional application of the invention patent application with the application number of 202210562941.9, the application date of 2022, the month of 05 and the application date of 23, and the invention name of a cognitive function assessment method and system.
Technical Field
The invention relates to the field of biological signal detection, in particular to a cognitive function evaluation system based on blood pressure and cerebral blood oxygen monitoring.
Background
With the aging of population worldwide, the prevalence of alzheimer's disease gradually increases, severely affecting the quality of life of the elderly. The course of the Alzheimer's disease is irreversible, but often the decline of the cognitive function occurs for a long time before the Alzheimer's disease occurs, if the cognitive function can be detected early, the cognitive function can be estimated, and the cognitive dysfunction can be found early, so that the development of the cognitive dysfunction can be prevented and intervened early, the development of the cognitive dysfunction can be delayed and even reversed, and the incidence rate of the Alzheimer's disease can be effectively reduced. At present, the cognitive function evaluation is mainly based on a scale, the evaluation is long in time consumption and high in subjectivity, and depends on professional evaluation staff, so that inconvenience is brought to cognitive disorder screening of a pension institution and communities lacking professional evaluation staff, and therefore, an evaluation system which is simple and easy to operate and objectively and quantitatively is very needed for evaluation and screening.
Therefore, the cognitive function evaluation method and system provided by the invention can evaluate the cognitive function more conveniently and accurately, discover cognitive disorder early, and have wide application prospects in the field of health monitoring.
Disclosure of Invention
The invention is realized by adopting the following technical scheme:
the cognitive function evaluation system comprises an acquisition module, a calculation module and an evaluation result calculation module, wherein: the acquisition module is used for synchronously acquiring forehead lobe cerebral blood oxygen data and continuous arterial blood pressure data at the left side and the right side; the calculation module is used for calculating a cerebral blood oxygen saturation average value, a forehead leaf cerebral blood oxygen coupling strength value at the left side and the right side and a cerebral blood oxygen and blood pressure coupling strength value in the acquisition period; the evaluation result calculation module is used for evaluating the cognitive function of the subject according to the calculated brain blood oxygen saturation average value, the forehead lobe brain blood oxygen coupling strength value at the left side and the right side and the brain blood oxygen and blood pressure coupling strength value.
The cognitive function assessment system, wherein: the acquisition module comprises: an arterial blood pressure acquisition module, a cerebral blood oxygen acquisition module and a blood pressure-cerebral oxygen synchronous triggering module.
The cognitive function assessment system, wherein: the blood pressure-cerebral oxygen synchronous triggering module controls the arterial blood pressure acquisition module and the cerebral blood oxygen acquisition module to synchronously acquire forehead lobe cerebral blood oxygen data and continuous arterial blood pressure data on the left side and the right side.
The cognitive function assessment system, wherein: the calculation module comprises a blood oxygen saturation calculation module, a coupling strength calculation module and a blood flow parameter calculation module.
The cognitive function assessment system, wherein: the blood oxygen saturation calculation module performs the average calculation of the brain blood oxygen saturation as follows:
wherein R is mean Is the average value of cerebral blood oxygen saturation, N is the sampling point number in the measurement time period, f is the sampling rate, R i Is the blood oxygen saturation value of the ith sampling point.
Said cognitionThe function evaluation system comprises a coupling strength calculation module, a blood oxygen coupling strength calculation module and a blood oxygen coupling strength calculation module, wherein the coupling strength calculation module is used for calculating the blood oxygen coupling strength values of the forehead lobes on the left side and the right side as follows: according to the cerebral oxygenated hemoglobin concentration change data of the forehead leaves at the left and right sides of the brain in a resting state within a 10min acquisition period, calculating the effect connection strength of the forehead leaves at the left and right sides within a frequency range of 0.05-0.15Hz, specifically, marking the cerebral blood oxygen signals of the forehead leaves at the left and right sides as i and j respectively, firstly extracting the phase information of the cerebral oxygenated hemoglobin concentration change signals within the frequency range of 0.05-0.15Hz through wavelet change, constructing a coupling phase oscillation model of the cerebral oxygenated hemoglobin concentration change signals of the two channels on the basis, constructing a likelihood function based on Bayesian reasoning, calculating the stable points of a negative log likelihood function through recursive operation to infer the coupling coefficient of the phase coupling model of the two channels, and then the coupling strength E of the i to j channels ij The method comprises the following steps:
wherein,,
and->
The coupling coefficients of the phase coupling models for the i and j channels, respectively.
The cognitive function assessment system, wherein: the coupling strength calculation module calculates the coupling strength value of cerebral blood oxygen and blood pressure as follows: according to the concentration change of cerebral oxyhemoglobin of the dominant side forehead lobe of a subject in a resting state within a 10min acquisition period and arterial blood pressure change data, calculating the coupling strength of the blood pressure of a frequency band of 0.6-2Hz and the cerebral oxygen of the dominant side forehead lobe in a frequency band of 0.02-0.07Hz, specifically, marking the cerebral blood oxygen signals of the arterial blood pressure signal and the dominant side forehead lobe as x and y respectively, firstly extracting the phase information of the blood pressure signal in the frequency band of 0.6-2Hz and the cerebral oxyhemoglobin concentration change signal in the frequency band of 0.02-0.07Hz through wavelet change, constructing a coupling phase oscillation model based on the coupling phase oscillation model, and constructing a similar structure based on Bayesian reasoningHowever, by deducing the coupling coefficient of the phase coupling model by calculating the stable point of the negative log likelihood function by recursive operation, the coupling strength E of the x-to-y channel xy The method comprises the following steps:
wherein,,
and->
Coupling coefficients of the phase coupling models for the x and y channels, respectively.
The cognitive function assessment system, wherein: the evaluation result calculation module evaluates the cognitive function through the average value of the cerebral blood oxygen saturation: when the average value of the cerebral oxygen saturation of the forehead lobe on the dominant side is more than 60 percent, judging that cognition is normal; when the average value of the blood oxygen saturation of the forehead lobe brain at the dominant side is more than or equal to 56% and less than or equal to 60%, judging that the cognitive disorder is possible to be mild; judging that the cognitive disorder is possibly serious when the average value of the cerebral oxygen saturation of the forehead lobe on the dominant side is less than 56%;
the evaluation result calculation module evaluates the cognitive function through the forehead lobe cerebral blood oxygen coupling strength values at the left side and the right side: the forehead lobe cerebral blood oxygen coupling strength values at the left side and the right side are tested and recorded regularly every month, and when the forehead lobe cerebral blood oxygen coupling strength values at the left side and the right side of the continuous 3 times of testing are continuously reduced by more than 20%, cognitive disorder is judged to be possible to occur; or when the coupling strength value of the last test is reduced by more than 50% compared with the test result before 6 months, testing once every week for 3 weeks continuously, and judging that cognitive dysfunction is likely to occur if the test results of 3 times are reduced by more than 50% compared with the test result before 6 months;
the evaluation result calculation module evaluates the cognitive function through the coupling strength value of cerebral blood oxygen and blood pressure: the coupling strength value of the cerebral blood oxygen and the blood pressure is tested and recorded regularly every month, and when the coupling strength value of the cerebral blood oxygen and the blood pressure which are tested continuously for 3 times is continuously increased by more than 15%, the cognitive disorder is judged to be possibly occurred; or when the coupling strength value of the last test is increased by more than 30% compared with the test result before 6 months, the last test is continuously tested once every week for 3 weeks, and if the test results of the 3 times are all increased by more than 30% compared with the test result before 6 months, the cognitive dysfunction is judged to be possibly generated.
The cognitive function assessment system, wherein:
the acquisition module is also used for detecting middle cerebral artery blood flow of a subject in a resting state through temporal windows on two sides of the head by utilizing transcranial Doppler ultrasound, and the detection depth is 50-60mm; acquiring blood flow velocity of middle cerebral artery at both sides;
the calculation module is also used for calculating the mean value of the PI values of the middle cerebral artery pulsation indexes, and the calculation mode is as follows:
wherein: v (V) SL 、V SR Peak flow rate of middle artery blood flow in systolic phase, V DL 、V DR The flow velocity of middle artery blood flow at end diastole is respectively the flow velocity of middle artery blood flow at the left side and the right side, V L 、V R Average flow rates of middle artery blood flow on the left and right sides respectively;
the evaluation result calculation module is further used for evaluating the cognitive function of the subject according to the calculated average value of the PI value: when the PI mean value is less than 1, judging that cognition is normal; when the PI mean value is more than or equal to 1 and less than or equal to 1.2, judging that the cognitive impairment is possible to be mild; when PI mean >1.2, it is judged that the cognitive impairment is likely to be severe.
The cognitive function assessment system, wherein:
the calculation module also comprises a frequency domain correlation value C for calculating the blood flow velocity of the dominant side middle cerebral artery and the blood oxygen saturation signal VR The calculation mode is as follows: assuming that the blood flow velocity and the blood oxygen saturation signals of the dominant side middle cerebral artery are x (n) and y (n) respectively, obtaining a power spectrum density function through Fourier transformation, extracting a power spectrum of the power spectrum in a frequency band of 0.02-0.07Hz, and S xx (f) And S is yy (f) Self-power spectra of x (n) and y (n), respectively, S xy (f) Cross-power spectrum of x (n) and y (n), frequency domain correlation between two signalsThe sex values are:
C VR ＝|S xy (f)| 2 /S xx (f)S yy (f)
the evaluation result calculation module judges as follows: when C VR Judging that cognition is normal when the cognition is more than or equal to 0.4; when C VR <0.4, it is judged that cognitive impairment is likely.
The cognitive function assessment system, wherein: assuming that the result of evaluating the cognitive function by the blood oxygen saturation mean is a, a=0 when the result is cognition normal, a=1 when the result is mild cognitive impairment, a=2 when the result is severe cognitive impairment; assuming that the result of evaluating the cognitive function by the left and right forehead lobe cerebral blood oxygen coupling intensity values is B, b=0 when the result is that cognition is normal, and b=1 when the result is that cognition disorder may exist; assuming that the result of evaluating the cognitive function by the blood pressure and cerebral blood oxygen coupling strength values is C, c=0 when the result is cognition normal, c=1 when the result is that cognitive impairment may exist; assuming that the result of evaluating the cognitive function by the mid-brain arterial pulsatility PI mean is D, d=0 when the result is cognition normal, d=1 when the result is mild cognitive impairment, and d=2 when the result is severe cognitive impairment; assuming that the result of evaluating the cognitive function by the frequency domain correlation value of the middle cerebral artery blood flow velocity and the blood oxygen saturation signal is E, e=0 when the result is cognition normal, e=1 when the result is cognition disorder;
establishing a comprehensive evaluation system model according to the parameters, and determining weights W1, W2, W3, W4 and W5 of each parameter in an evaluation system by utilizing a multiple linear regression analysis method to obtain a calculation formula of a comprehensive evaluation result P, wherein the calculation formula is as follows:
P＝W1*A+W2*B+W3*C+W4*D+W5*E
wherein W1, W2, W3, W4 and W5 are all values between 0 and 1, W1 and W4 are all larger than 0.5, and W2, W3 and W5 are all smaller than 0.5.
And comparing the P with threshold values P1 and P2, and determining the comprehensive evaluation results as cognitive normal, mild cognitive impairment and severe cognitive impairment.
The cognitive function assessment system, wherein:
P＝0.9*(A+D)+0.33*B+0.36*C+0.32*E
when P is less than or equal to 1, judging that the final result is cognition normal; 1<P is less than or equal to 2, judging that the final result is mild cognitive impairment; and when P is more than 2, judging the final result as the heavy cognitive dysfunction.
A cognitive function assessment method, the cognitive function assessment method comprising: step 1, synchronously collecting forehead lobe cerebral blood oxygen data and continuous arterial blood pressure data on the left side and the right side; step 2, calculating a cerebral blood oxygen saturation average value, a forehead leaf cerebral blood oxygen coupling strength value at the left side and the right side and a cerebral blood oxygen and blood pressure coupling strength value in an acquisition period; and 3, estimating the cognitive function of the subject according to the brain blood oxygen saturation average value obtained by calculation in the step 2, the forehead lobe brain blood oxygen coupling intensity values at the left side and the right side and the brain blood oxygen and blood pressure coupling intensity value.
The cognitive function assessment method comprises the following steps: in the process of synchronously measuring continuous arterial blood pressure and cerebral blood oxygen of forehead leaves at the left and right sides of a subject, the measurement state of the subject is a sitting state and a resting state, the continuous measurement time is not less than 10 minutes, and the sampling frequency is not less than 10Hz.
The cognitive function evaluation method, wherein the average value calculation method of the cerebral blood oxygen saturation in the step 2 is as follows: and calculating the average value of the blood oxygen saturation values of the prefrontal lobe of the brain of the subject in the resting state for 3min in the acquisition period.
16. The cognitive function assessment method according to claim 13, wherein: the method for calculating the average value of the cerebral blood oxygen saturation in the step 2 comprises the following steps:
wherein R is mean Is the average value of cerebral blood oxygen saturation, N is the sampling point number in the measurement time period, f is the sampling rate, R i Is the blood oxygen saturation value of the ith sampling point.
The cognitive function assessment method comprises the following steps: the calculation method of the forehead lobe cerebral blood oxygen coupling strength value at the left side and the right side in the step 2 comprises the following steps: according to forehead on left and right sides of brain of a subject in a resting state for 10min collection periodCalculating the effect connection strength of forehead leaves at the left and right sides in a frequency range of 0.05-0.15Hz, specifically, marking brain blood oxygen signals of the forehead leaves at the left and right sides as i and j respectively, extracting phase information of the brain oxygenated hemoglobin concentration change signals in the frequency range of 0.05-0.15Hz through wavelet change, constructing a coupling phase oscillation model of the brain oxygenated hemoglobin concentration change signals of the two channels on the basis, constructing likelihood functions based on Bayesian reasoning, calculating stable points of the negative log likelihood functions through recursive operation to infer coupling coefficients of the phase coupling models of the two channels, and then coupling strength E of the i to j channels ij The method comprises the following steps:
wherein,,
and->
The coupling coefficients of the phase coupling models for the i and j channels, respectively.
The cognitive function assessment method comprises the following steps: the method for calculating the coupling strength value of cerebral blood oxygen and blood pressure in the step 2 comprises the following steps: according to the brain oxyhemoglobin concentration change of the dominant side forehead lobe and arterial blood pressure change data of a subject in a resting state within a 10min acquisition period, calculating the blood pressure of a frequency band of 0.6-2Hz and the coupling strength of the brain oxygen of the dominant side forehead lobe in the frequency band of 0.02-0.07Hz, specifically, marking the brain blood oxygen signals of the arterial blood pressure signal and the dominant side forehead lobe as x and y respectively, firstly extracting the phase information of the blood pressure signal in the frequency band of 0.6-2Hz and the brain oxyhemoglobin concentration change signal in the frequency band of 0.02-0.07Hz through wavelet change, constructing a coupling phase oscillation model on the basis, constructing a likelihood function based on Bayes reasoning, calculating the stable point of a negative log likelihood function through recursive operation to infer the coupling coefficient of the phase coupling model, and then the coupling strength E of the x to y channel xy The method comprises the following steps:
wherein,,
and->
Coupling coefficients of the phase coupling models for the x and y channels, respectively.
The cognitive function assessment method comprises the following steps: in step 3: the process of assessing cognitive function by brain blood oxygen saturation mean values is: when the average value of the cerebral oxygen saturation of the forehead lobe on the dominant side is more than 60 percent, judging that cognition is normal; when the average value of the blood oxygen saturation of the forehead lobe brain at the dominant side is more than or equal to 56% and less than or equal to 60%, judging that the cognitive disorder is possible to be mild; judging that the cognitive disorder is possibly serious when the average value of the cerebral oxygen saturation of the forehead lobe on the dominant side is less than 56%;
the process of evaluating cognitive function through the forehead lobe cerebral blood oxygen coupling intensity values on the left side and the right side is as follows: the forehead lobe cerebral blood oxygen coupling strength values at the left side and the right side are tested and recorded regularly every month, and when the forehead lobe cerebral blood oxygen coupling strength values at the left side and the right side of the continuous 3 times of testing are continuously reduced by more than 20%, cognitive disorder is judged to be possible to occur; or when the coupling strength value of the last test is reduced by more than 50% compared with the test result before 6 months, testing once every week for 3 weeks continuously, and judging that cognitive dysfunction is likely to occur if the test results of 3 times are reduced by more than 50% compared with the test result before 6 months;
the process of assessing cognitive function by coupling strength values of cerebral blood oxygen and blood pressure is: the coupling strength value of the cerebral blood oxygen and the blood pressure is tested and recorded regularly every month, and when the coupling strength value of the cerebral blood oxygen and the blood pressure which are tested continuously for 3 times is continuously increased by more than 15%, the cognitive disorder is judged to be possibly occurred; or when the coupling strength value of the last test is increased by more than 30% compared with the test result before 6 months, the last test is continuously tested once every week for 3 weeks, and if the test results of the 3 times are all increased by more than 30% compared with the test result before 6 months, the cognitive dysfunction is judged to be possibly generated.
The cognitive function assessment method comprises the following steps:
step 1 also comprises detecting middle cerebral artery blood flow of the subject in resting state by using transcranial Doppler ultrasound through temporal windows on two sides of the head, wherein the detection depth is 50-60mm; acquiring blood flow velocity of middle cerebral artery at both sides;
step 2 further comprises: the average value of the arterial pulse index PI values of the two sides of the brain is calculated, and the calculation method is as follows:
wherein: v (V) SL 、V SR Peak flow rate of middle artery blood flow in systolic phase, V DL 、V DR The flow velocity of middle artery blood flow at end diastole is respectively the flow velocity of middle artery blood flow at the left side and the right side, V L 、V R Average flow rates of middle artery blood flow on the left and right sides respectively;
step 3 further comprises: evaluating the cognitive function of the subject according to the mean value of the PI values calculated in step 2: when the PI mean value is less than 1, judging that cognition is normal; when the PI mean value is more than or equal to 1 and less than or equal to 1.2, judging that the cognitive impairment is possible to be mild; when PI mean >1.2, it is judged that the cognitive impairment is likely to be severe.
The cognitive function assessment method comprises the following steps:
step 2 further comprises: calculating the frequency domain correlation value C of the blood flow velocity of the middle cerebral artery at the dominant side and the blood oxygen saturation signal VR The calculation method comprises the following steps: assuming that the blood flow velocity and the blood oxygen saturation signals of the dominant side middle cerebral artery are x (n) and y (n) respectively, obtaining a power spectrum density function through Fourier transformation, extracting a power spectrum of the power spectrum in a frequency band of 0.02-0.07Hz, and S xx (f) And S is yy (f) Self-power spectra of x (n) and y (n), respectively, S xy (f) For the cross-power spectrum of x (n) and y (n), the frequency domain correlation value between the two signals is:
C VR ＝|S xy (f)| 2 /S xx (f)S yy (f)
step 3 further comprises: when C VR Judging that cognition is normal when the cognition is more than or equal to 0.4; when C VR <0.4, it is judged that cognitive impairment is likely.
The cognitive function assessment method comprises the following steps: assuming that the result of evaluating the cognitive function by the blood oxygen saturation mean is a, a=0 when the result is cognition normal, a=1 when the result is mild cognitive impairment, a=2 when the result is severe cognitive impairment; assuming that the result of evaluating the cognitive function by the left and right forehead lobe cerebral blood oxygen coupling intensity values is B, b=0 when the result is that cognition is normal, and b=1 when the result is that cognition disorder may exist; assuming that the result of evaluating the cognitive function by the blood pressure and cerebral blood oxygen coupling strength values is C, c=0 when the result is cognition normal, c=1 when the result is that cognitive impairment may exist; assuming that the result of evaluating the cognitive function by the mid-brain arterial pulsatility PI mean is D, d=0 when the result is cognition normal, d=1 when the result is mild cognitive impairment, and d=2 when the result is severe cognitive impairment; assuming that the result of evaluating the cognitive function by the frequency domain correlation value of the middle cerebral artery blood flow velocity and the blood oxygen saturation signal is E, e=0 when the result is cognition normal, e=1 when the result is cognition disorder;
establishing a comprehensive evaluation system model according to the parameters, and determining weights W1, W2, W3, W4 and W5 of each parameter in an evaluation system by utilizing a multiple linear regression analysis method to obtain a calculation formula of a comprehensive evaluation result P, wherein the calculation formula is as follows:
P＝W1*A+W2*B+W3*C+W4*D+W5*E
wherein W1, W2, W3, W4 and W5 are all values between 0 and 1, W1 and W4 are all larger than 0.5, and W2, W3 and W5 are all smaller than 0.5.
And comparing the P with threshold values P1 and P2, and determining the comprehensive evaluation results as cognitive normal, mild cognitive impairment and severe cognitive impairment.
The cognitive function assessment method comprises the following steps:
P＝0.9*(A+D)+0.33*B+0.36*C+0.32*E
when P is less than or equal to 1, judging that the final result is cognition normal; 1<P is less than or equal to 2, judging that the final result is mild cognitive impairment; and when P is more than 2, judging the final result as the heavy cognitive dysfunction.
Drawings
FIG. 1 is a flow chart of a cognitive function assessment method;
FIG. 2 is a schematic diagram of a cerebral blood oxygen collection site;
fig. 3 is a schematic structural diagram of a cognitive function assessment system.
Detailed Description
The following describes embodiments of the present invention in detail with reference to fig. 1-3.
As shown in fig. 1, a specific embodiment of the present invention provides a cognitive function assessment method, which includes: step 1, synchronously collecting forehead lobe cerebral blood oxygen data and continuous arterial blood pressure data; step 2, calculating an average value of cerebral blood oxygen saturation, the coupling strength of cerebral blood oxygen of forehead lobes on the left side and the right side and the coupling strength of cerebral blood oxygen and blood pressure in an acquisition period; and 3, estimating the cognitive function of the subject according to the brain blood oxygen saturation average value obtained by calculation in the step 2, the forehead lobe brain blood oxygen coupling strength at the left side and the right side and the brain blood oxygen and blood pressure coupling strength value. The specific steps are as follows:
step 1, synchronously measuring continuous arterial blood pressure of a subject and cerebral blood oxygen data of forehead leaves at the left and right sides of the brain, wherein the cerebral blood oxygen data comprises oxyhemoglobin concentration change, deoxyhemoglobin concentration change, total hemoglobin concentration change and cerebral blood oxygen saturation.
According to one embodiment, in the process of synchronously measuring arterial blood pressure and cerebral blood oxygen of forehead leaves at the left and right sides of a subject, the measurement state of the subject is a sitting state and a resting state, the continuous measurement time is not less than 10 minutes, and the sampling frequency is not less than 10Hz. The location of cerebral blood oxygen collection is shown in figure 2. The two cerebral blood oxygen detection sensors 2A and 2B are respectively fixed at the forehead leaf to-be-tested parts on the left side and the right side of the subject, the fixed positions are bilaterally symmetrical and flush up and down relative to the facial midline 2C of the subject, and the blood oxygen sensor central connecting line 2D is positioned 1.5cm above the eyebrows and avoids the facial midline 2C.
And 2, calculating an average value of cerebral blood oxygen saturation, the coupling strength of the cerebral blood oxygen of the forehead lobes on the left side and the right side and the coupling strength of the cerebral blood oxygen and the blood pressure in the acquisition period.
According to one embodiment, the method for calculating the average value of the cerebral blood oxygen saturation comprises the following steps:
wherein R is mean Is the average value of cerebral blood oxygen saturation, N is the sampling point number in the measurement time period, f is the sampling rate, R i Is the blood oxygen saturation value of the ith sampling point.
The calculation method of the forehead lobe cerebral blood oxygen coupling strength at the left side and the right side comprises the following steps: according to the brain oxyhemoglobin concentration change data of forehead leaves at the left and right sides of the brain in a resting state of a subject within a 10min acquisition period, calculating to obtain the effect connection strength of the forehead leaves at the left and right sides within a frequency band of 0.05-0.15Hz by using a Bayesian inference (DBI) method, wherein the method specifically comprises the following steps: the cerebral blood oxygen signals of the left and right forehead leaves are respectively marked as i and j, firstly, the phase information of the cerebral oxygenated hemoglobin concentration change signal in the frequency range of 0.05-0.15Hz is extracted through wavelet change, on the basis, a coupling phase oscillation model of the cerebral oxygenated hemoglobin concentration change signals of the two channels is constructed, likelihood functions are constructed based on DBI, the stable points of the negative log likelihood functions are calculated through recursive operation to infer the coupling coefficients of the two-channel phase coupling model, and the coupling intensity E of the i channel to the j channel is obtained ij The method comprises the following steps:
wherein phi is i (t) and phi j (t) coupled phase oscillation models for the i and j channels respectively,
and->
The coupling coefficients of the phase coupling models for the i and j channels, respectively.
The method for calculating the coupling strength of cerebral blood oxygen and blood pressure comprises the following steps: and calculating to obtain 0 by using a Bayesian inference method according to the concentration change of the oxyhemoglobin of the prefrontal lobe brain and the arterial blood pressure change data of the dominant side brain in the resting state of the subject within a 10-min acquisition period.The coupling strength of the blood pressure of the 6-2Hz frequency band and the dominant side forehead lobe brain oxygen in the 0.02-0.07Hz frequency band is specifically as follows: the arterial blood pressure signal and the cerebral blood oxygen signal of the dominant side forehead lobe are respectively marked as x and y, firstly, the phase information of the blood pressure signal in the frequency range of 0.6-2Hz and the cerebral oxygenated hemoglobin concentration change signal in the frequency range of 0.02-0.07Hz is extracted through wavelet change, and a coupled phase oscillation model is constructed on the basis. Constructing likelihood function based on DBI, calculating stable point of negative log likelihood function by recursion operation to infer coupling coefficient of phase coupling model, coupling strength E of x-to-y channel xy The method comprises the following steps:
wherein phi is x (t) and phi y (t) a coupled phase oscillation model for the x and y channels respectively,
and->
Coupling coefficients of the phase coupling models for the x and y channels, respectively.
In the above calculation method, the dominant side is defined as: if the subject is right handy, the left brain is dominant; if the subject is left handicapped, the right brain is dominant. If a subject has a brain injury or dysplasia on one side, the brain on the undamaged side is the dominant side.
In addition to the above embodiments, the present invention can also calculate the coupling strength of cerebral blood oxygen and blood pressure of the forehead lobes on the left and right sides by using the grange causality analysis method or the transfer function analysis method.
And 3, estimating the cognitive function of the subject according to the brain blood oxygen saturation average value obtained by calculation in the step 2, the forehead lobe brain blood oxygen coupling strength at the left side and the right side and the brain blood oxygen and blood pressure coupling strength value.
Specifically, the process of assessing cognitive function by brain blood oxygen saturation averages is: when the average value of the cerebral oxygen saturation of the forehead lobe on the dominant side is more than 60 percent, judging that cognition is normal; when the average value of the blood oxygen saturation of the forehead lobe brain at the dominant side is more than or equal to 56% and less than or equal to 60%, judging that the cognitive disorder is possible to be mild; when the mean value of the cerebral oxygen saturation of the prefrontal lobe is <56%, it is judged that the cognitive disorder may be severe.
The process of evaluating cognitive function by the forehead lobe cerebral blood oxygen coupling intensity on the left and right sides is as follows: the forehead lobe cerebral blood oxygen coupling strength values at the left side and the right side are tested and recorded regularly every month, and when the forehead lobe cerebral blood oxygen coupling strength values at the left side and the right side of the continuous 3 times of testing are continuously reduced by more than 20%, cognitive disorder is judged to be possible to occur; or when the coupling strength value of the last test is reduced by more than 50% compared with the test result before 6 months, the last test is continuously tested once every 3 weeks, and if the test results of the 3 times are reduced by more than 50% compared with the test result before 6 months, the cognitive dysfunction is judged to be possibly generated.
The process of assessing cognitive function by the coupling strength of cerebral blood oxygen and blood pressure is: the coupling strength value of the cerebral blood oxygen and the blood pressure is tested and recorded regularly every month, and when the coupling strength value of the cerebral blood oxygen and the blood pressure which are tested continuously for 3 times is continuously increased by more than 15%, the cognitive disorder is judged to be possibly occurred; or when the coupling strength value of the last test is increased by more than 30% compared with the test result before 6 months, the last test is continuously tested once every week for 3 weeks, and if the test results of the 3 times are all increased by more than 30% compared with the test result before 6 months, the cognitive dysfunction is judged to be possibly generated.
According to a specific embodiment, any one of the above three methods may be used to perform the cognitive function assessment, or the cognitive function may be comprehensively determined according to the results of the three methods assessment. Specifically, the method for comprehensively judging the result by using the three methods is as follows: assuming that the result of evaluating the cognitive function by the blood oxygen saturation mean is a, a=0 when the result is cognition normal, a=1 when the result is mild cognitive impairment, a=2 when the result is severe cognitive impairment; assuming that the result of evaluating the cognitive function by the left and right forehead lobe cerebral blood oxygen coupling intensities is B, b=0 when the result is that cognition is normal, and b=1 when the result is that cognition disorder may exist; assuming that the result of evaluating cognitive function by blood pressure and cerebral blood oxygen coupling strength is C, c=0 when the result is cognition normal, and c=1 when the result is that cognitive dysfunction may exist. The calculation method of the comprehensive evaluation result P comprises the following steps:
P＝A+0.5*B+0.8*C
when P is less than or equal to 1, judging that the final result is cognition normal; when 1< P <2.5, judging that the final result is mild cognitive impairment; and when P is more than or equal to 2.5, judging that the final result is the heavy cognitive dysfunction.
According to another embodiment, the method for comprehensively judging the cognitive function by using the results evaluated by the three methods comprises the following steps: if the results of the two or more methods are consistent, the result is taken as the final evaluation result. According to a specific embodiment, if the cognitive impairment is considered to exist according to the coupling strength of the cerebral blood oxygen of the forehead lobes on the left and right sides and the coupling strength of the cerebral blood oxygen and the blood pressure, the degree of the cognitive impairment is judged by combining the evaluation result of the cerebral blood oxygen saturation, if the evaluation result of the cerebral blood oxygen saturation is the heavy cognitive impairment, the heavy cognitive impairment is judged, and otherwise, the mild cognitive impairment is judged. If the evaluation result of the cerebral blood oxygen saturation is mild or severe cognitive impairment, and the result of any one of the other two methods is cognitive impairment, the evaluation result of the cerebral blood oxygen saturation is taken as the final evaluation result. If the evaluation result of cerebral blood oxygen saturation is mild or severe cognitive impairment, and the evaluation result of the other two methods is no cognitive impairment, the result is not judged to be cognitive impairment, but the higher risk of cognitive impairment is considered, and the change of the result needs to be continuously monitored.
The invention also provides another embodiment, which further carries out cognitive function assessment based on the result of monitoring the blood flow of the middle cerebral artery, specifically: detecting middle cerebral artery blood flow of a subject in a resting state through temporal windows on two sides of the head by using transcranial Doppler ultrasound, wherein the detection depth is 50-60mm; and obtaining blood flow velocity of middle cerebral artery at both sides.
Calculating the mean value PI of the pulse index PI value of the middle cerebral artery blood flow at two sides mean The calculation method comprises the following steps:
wherein: v (V) SL 、V SR Peak flow rate of middle artery blood flow in systolic phase, V DL 、V DR The flow velocity of middle artery blood flow at end diastole is respectively the flow velocity of middle artery blood flow at the left side and the right side, V L 、V R The average flow rates of middle artery blood flow on the left and right sides, respectively.
When the PI mean value is less than 1, judging that cognition is normal; when the PI mean value is more than or equal to 1 and less than or equal to 1.2, judging that the cognitive impairment is possible to be mild; when PI mean >1.2, it is judged that the cognitive impairment is likely to be severe.
Calculating the frequency domain correlation value C of the blood flow velocity of the middle cerebral artery at the dominant side and the blood oxygen saturation signal VR The calculation method comprises the following steps: assuming that the blood flow velocity and the blood oxygen saturation signals of the dominant side middle cerebral artery are x (n) and y (n) respectively, obtaining a power spectrum density function through Fourier transformation, extracting a power spectrum of the power spectrum in a frequency band of 0.02-0.07Hz, and S xx (f) And S is yy (f) Self-power spectra of x (n) and y (n), respectively, S xy (f) For the cross-power spectrum of x (n) and y (n), the frequency domain correlation value between the two signals is:
C VR ＝|S xy (f)| 2 /S xx (f)S yy (f)
when C VR Judging that cognition is normal when the cognition is more than or equal to 0.4; when C VR <0.4, it is judged that cognitive impairment is likely.
The cognitive function evaluation can be carried out independently according to the method, or the result of the evaluation method and the result of the evaluation by blood pressure and cerebral blood oxygen are comprehensively carried out, and the specific combination method is as follows: assuming that the result of evaluating the cognitive function by the blood oxygen saturation mean is a, a=0 when the result is cognition normal, a=1 when the result is mild cognitive impairment, a=2 when the result is severe cognitive impairment; assuming that the result of evaluating the cognitive function by the left and right forehead lobe cerebral blood oxygen coupling intensities is B, b=0 when the result is that cognition is normal, and b=1 when the result is that cognition disorder may exist; assuming that the result of evaluating cognitive function by blood pressure and cerebral blood oxygen coupling strength is C, c=0 when the result is cognition normal, c=1 when the result is that cognitive dysfunction may exist; assuming that the result of evaluating the cognitive function by the mid-brain arterial pulsatility PI mean is D, d=0 when the result is cognition normal, d=1 when the result is mild cognitive impairment, and d=2 when the result is severe cognitive impairment; assuming that the result of evaluating the cognitive function by the frequency domain correlation value of the dominant side middle cerebral artery blood flow velocity and the blood oxygen saturation signal is E, e=0 when the result is cognitive normal, and e=1 when the result is cognitive dysfunction. Establishing a comprehensive evaluation system model according to the parameters, and determining weights W1, W2, W3, W4 and W5 of each parameter in an evaluation system by utilizing a multiple linear regression analysis method to obtain a calculation formula of a comprehensive evaluation result P, wherein the calculation formula is as follows:
P＝W1*A+W2*B+W3*C+W4*D+W5*E
wherein W1, W2, W3, W4 and W5 are all values between 0 and 1, W1 and W4 are all larger than 0.5, and W2, W3 and W5 are all smaller than 0.5.
And comparing the P with threshold values P1 and P2, and determining the comprehensive evaluation results as cognitive normal, mild cognitive impairment and severe cognitive impairment.
According to one embodiment: p=0.9 (a+d) +0.33×b+0.36×c+0.32×e
When P is less than or equal to 1, judging that the final result is cognition normal; 1<P is less than or equal to 2, judging that the final result is mild cognitive impairment; and when P is more than 2, judging the final result as the heavy cognitive dysfunction.
After the related parameters of the arterial blood flow in the brain are increased, the cognitive function of the subject can be reflected more comprehensively and accurately. Through verification, the accuracy of the results of the comprehensive evaluation of five parameters, namely the brain blood oxygen saturation mean value, the blood oxygen coupling strength at two sides, the blood oxygen and blood pressure coupling strength, the middle cerebral artery blood flow pulsation index and the blood flow velocity and blood oxygen saturation frequency domain coherence, is obviously improved compared with the results of the evaluation of the brain blood oxygen saturation mean value, the blood oxygen coupling strength at two sides and the blood oxygen and blood pressure coupling strength.
As shown in fig. 3, the present invention provides a cognitive function assessment system, comprising: an arterial blood pressure acquisition module 3A, a cerebral blood oxygen acquisition module 3B, a blood pressure-cerebral oxygen synchronous triggering module 3C, a cerebral arterial blood flow detection module 3D, an evaluation calculation module 3E and a result reporting module 3F.
According to one embodiment, the arterial blood pressure acquisition module 3A is a device for continuously measuring arterial blood pressure data of a human body by using photoplethysmography, and includes an infrared light source 3A1, an optical signal detection probe 3A2, a probe holder 3A3 and a data processing and transmitting module 3A4. The probe holder 3A3 is used for fixing the blood pressure detecting component (the infrared light source 3A1 and the optical signal detecting probe 3 A2) on the part of the human body to be detected, which can be the finger tip or the inner side of the wrist, and the data processing and transmitting module 3A4 calculates the blood pressure data through the signal detected by the optical signal detecting probe 3A2 and transmits the blood pressure data to the evaluation and calculation module 3E of the system.
The cerebral blood oxygen acquisition module 3B acquires the hemoglobin concentration change data of the cerebral cortex tissue by utilizing a near infrared spectrum technology, and comprises at least 2 acquisition sensors 3B1, optical fibers 3B2 and a data processing and transmitting module 3B3. Each sensor 3B1 consists of a near infrared light source 3B11 and two probes 3B12 and 3B13, and the distance between the light source 3B11 and the two probes 3B12 and 3B13 is 2cm and 3cm respectively; each sensor 3B1 is connected to a data processing transmission module 3B3 through an optical fiber 3B2, and the data processing transmission module 3B3 is used to calculate hemoglobin concentration variation data and transmit it to an evaluation calculation module 3E of the system.
The arterial blood pressure acquisition module 3A and the cerebral blood oxygen acquisition module 3B are simultaneously connected to the blood pressure-cerebral oxygen synchronous triggering module 3C, and an instruction for starting acquisition is simultaneously sent to the arterial blood pressure acquisition module 3A and the cerebral blood oxygen acquisition module 3B through the blood pressure-cerebral oxygen synchronous triggering module 3C, so that synchronous acquisition of blood pressure data and cerebral blood oxygen data is realized.
The cerebral arterial blood flow detection module 3D includes an ultrasonic probe 3D1 and a data processing transmission module 3D2 for detecting cerebral arterial blood flow related parameters and transmitting them to an evaluation calculation module 3E of the system.
The evaluation calculation module 3E includes a data preprocessing module 3E1, a blood oxygen saturation calculation module 3E2, a coupling strength calculation module 3E3, a blood flow parameter calculation module 3E4, and an evaluation result calculation module 3E5. The data preprocessing module 3E1 is configured to preprocess the collected brain hemoglobin concentration signal, the blood oxygen saturation calculating module 3E2 is configured to calculate a blood oxygen saturation mean value in the collection period, the coupling strength calculating module 3E3 is configured to calculate a left and right forehead lobe brain blood oxygen coupling strength and a brain blood oxygen and blood pressure coupling strength, the blood flow parameter calculating module 3E4 is configured to calculate a frequency domain coherence value of a middle cerebral artery blood flow speed and a forehead She Xie oxygen saturation, and the evaluation result calculating module 3E5 is configured to calculate a final cognitive function evaluation result according to the calculated blood oxygen saturation, the left and right forehead lobe brain blood oxygen coupling strength, the brain blood oxygen and blood pressure coupling strength value, the middle cerebral artery blood flow speed and the forehead She Xie oxygen saturation frequency domain coherence value. Wherein, preprocessing module 3D1 contains the preprocessing model of hemoglobin concentration variation signal, and model processing procedure includes: 1) Removing a noise channel according to the collected original light intensity data, wherein the standard of the noise channel is that the light intensity data is more than 1000 or less than 0.5, or the mean value/standard deviation is less than 2; 2) Converting the light intensity data into an optical density time sequence, filtering heartbeat, respiratory components and low-frequency system noise by adopting a fourth-order 0.01-0.2Hz band-pass filter, and removing motion artifacts; 3) The optical density data are converted into delta oxy-Hb data, and the principal component analysis method is used for eliminating the system physiological signals in the delta oxy-Hb time sequence, so that the neural induced hemodynamic response is reserved.
The result reporting module 3F is configured to give an evaluation result and report. The assessment report includes: subject name, gender, age, test time, dominant side frontal lobe brain blood oxygen saturation value change curve of test period, dominant side frontal lobe brain blood oxygen saturation mean value of the test, history test record curve of effect connection strength between left and right frontal lobes, history test record curve of blood pressure-brain oxygen coupling strength, pulsation coefficient mean value of middle artery at both sides of the test, frequency domain coherence value of dominant side middle artery blood flow velocity and forehead She Xie oxygen saturation, and final result of cognitive function evaluation.
Finally, it should be noted that: the above examples are only specific embodiments of the present invention, and are not intended to limit the scope of the present invention, but it should be understood by those skilled in the art that the present invention is not limited thereto, and that the present invention is described in detail with reference to the foregoing examples: any person skilled in the art may modify or easily conceive of changes to the technical solutions described in the foregoing embodiments or make equivalent substitutions for some technical features thereof within the technical scope of the present disclosure, and these modifications, changes or substitutions should not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present disclosure, and should be covered in the protection scope of the present disclosure. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.
According to the invention, the cognitive function evaluation can be carried out through the detection of physiological information such as blood pressure, cerebral blood oxygen, cerebral blood flow and the like, the evaluation method is simple and easy to operate, the result is objective and quantitative, and the method does not depend on professionals, can be used as an effective means for large-scale screening of cognitive disorders in communities and aged enterprises, and has important significance for realizing early discovery and early intervention of the cognitive disorders.
Claims (3)
1. The utility model provides a cognitive function evaluation system based on blood pressure and brain blood oxygen monitoring, includes collection module, calculation module and evaluation result calculation module, its characterized in that: the acquisition module is used for synchronously acquiring forehead lobe cerebral blood oxygen data and continuous arterial blood pressure data at the left side and the right side; the calculation module is used for calculating a cerebral blood oxygen saturation average value, a forehead leaf cerebral blood oxygen coupling strength value at the left side and the right side and a cerebral blood oxygen and blood pressure coupling strength value in the acquisition period; the evaluation result calculation module is used for evaluating the cognitive function of the subject according to the calculated brain blood oxygen saturation average value, the forehead lobe brain blood oxygen coupling strength value at the left side and the right side and the brain blood oxygen and blood pressure coupling strength value; the evaluation result calculation module evaluates the cognitive function through the average value of the cerebral blood oxygen saturation: when the average value of the cerebral oxygen saturation of the forehead lobe on the dominant side is more than 60 percent, judging that cognition is normal; when the average value of the blood oxygen saturation of the forehead lobe brain at the dominant side is more than or equal to 56% and less than or equal to 60%, judging that the cognitive disorder is possible to be mild; when the mean value of the cerebral oxygen saturation of the prefrontal lobe is <56%, it is judged that the cognitive disorder may be severe.
2. The cognitive function assessment system based on blood pressure and cerebral blood oxygen monitoring of claim 1, wherein: the acquisition module comprises: an arterial blood pressure acquisition module and a cerebral blood oxygen acquisition module.
3. The cognitive function assessment system based on blood pressure and cerebral blood oxygen monitoring of claim 1, wherein: the acquisition module is also used for detecting middle cerebral artery blood flow of a subject in a resting state through temporal windows on two sides of the head by utilizing transcranial Doppler ultrasound, and the detection depth is 50-60mm; and obtaining blood flow velocity of middle cerebral artery at both sides.
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| CN112206140B (en) * | 2020-09-03 | 2022-04-15 | 国家康复辅具研究中心 | Pneumatic circulation training system of heart brain coupling direction |
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