Elsevier

Journal of Neuroscience Methods

Volume 303, 1 June 2018, Pages 114-125
Journal of Neuroscience Methods

In vivo assessment of the human cerebral microcirculation and its glycocalyx: A technical report

https://doi.org/10.1016/j.jneumeth.2018.03.009Get rights and content
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open access

Highlights

  • The cerebrovascular glycocalyx might be a blood-brain barrier regulator.

  • The cerebrovascular glycocalyx has only sparsely been reported on.

  • We assessed the human cerebrovascular glycocalyx intraoperatively.

  • Sidestream dark field imaging is a suitable technique to perform this assessment.

  • A sterile slipcover required for cerebral assessment affects the results.

Abstract

Introduction

The cerebral microcirculation and its glycocalyx, a matrix coating the luminal endothelium, are key regulators of capillary permeability and cerebral blood flow. Microvascular abnormalities are described in several neurological disorders. However, assessment of the cerebral microcirculation and glycocalyx has mainly been performed ex vivo.

New method

Here, the technical feasibility of in vivo assessment of the human cerebral microcirculation and its glycocalyx using sidestream dark field (SDF) imaging is discussed. Intraoperative assessment requires the application of a sterile drape covering the camera (slipcover). First, sublingual measurements with and without slipcover were performed in a healthy control to assess the impact of this slipcover. Subsequently, using SDF imaging, the sublingual (reference), cortical, and hippocampal microcirculation and glycocalyx were evaluated in patients who underwent resective brain surgery as treatment for drug-resistant temporal lobe epilepsy. Finally, vessel density, and the perfused boundary region (PBR), a validated gauge of glycocalyx health, were calculated using GlycoCheck© software.

Results

The addition of a slipcover affects vessel density and PBR values in a control subject. The cerebral measurements in five patients were more difficult to obtain than the sublingual ones. This was probably at least partly due to the introduction of a sterile slipcover. Results on vessel density and PBR showed similar patterns at all three measurement sites.

Comparison with existing methods

This is the first report on in vivo assessment of the human cerebrovascular glycocalyx. Assessment of the glycocalyx is an additional application of in vivo imaging of the cerebral microcirculation using SDF technique. This method enables functional analysis of the microcirculation and glycocalyx, however the addition of a sterile slipcover affects the measurements.

Conclusions

SDF imaging is a safe, quick, and straightforward technique to evaluate the functional cerebral microcirculation and glycocalyx. Because of their eminent role in cerebral homeostasis, this method may significantly add to research on the role of vascular pathophysiology underling various neurological disorders.

Keywords

Glycocalyx
Microcirculation
Blood-brain barrier
Cerebrovascular disease
Epilepsy

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