Advanced Near-Infrared Spectroscopy Enhances Screening for Sickle Cell Disease Progression

Recent research led by Carnegie Mellon University and the University of Pittsburgh has introduced a promising new approach to monitoring sickle cell disease (SCD) progression using near-infrared spectroscopy (NIRS). This optical technology assesses microvascular blood flow and oxygenation in a noninvasive manner, offering valuable insights into the disease's impact on the brain, especially as patients age.

Sickle cell disease disrupts normal oxygen transport in the body, increasing the risk of small blood vessel complications in the brain. These issues can impair blood flow and contribute to cognitive difficulties such as memory and thinking problems, which affect patients’ quality of life. A key indicator of cerebral small vessel disease, common in aging individuals with SCD, is cerebral autoregulation—the brain’s ability to maintain stable blood flow despite fluctuations in blood pressure.

Traditionally, cerebral autoregulation is assessed using methods that measure pressure and flow in larger vessels, such as transcranial Doppler ultrasound or blood pressure cuffs. However, these techniques have limitations, notably poor accuracy in adults and inability to measure oxygenation levels directly, especially in small vessels.

The innovative study employed NIRS to monitor cerebral autoregulation dynamically by tracking blood and oxygen changes in tiny vessels during controlled breathing. This approach provided detailed measurements of blood flow transit times and microvascular responses, distinctions not achievable with conventional methods. The findings suggest NIRS is a reliable and practical screening tool for cerebral small vessel disease in adults with SCD.

This research has significant implications, especially in resource-limited settings. In Nigeria, researchers are conducting clinical trials combining NIRS with affordable medication like erythropoietin, which enhances hemoglobin levels. Early results show increased oxygenation in patients, indicating positive therapeutic responses.

"Unlike previous studies focused on larger vessels or static conditions, our study emphasized real-time blood pressure responses in small vessels using NIRS, which enhances its clinical utility," explained lead researcher Sossena Wood. The technique’s ability to measure microvascular blood flow and oxygenation during breathing exercises offers a new perspective on disease monitoring.

These advancements support the potential of NIRS as a point-of-care device, facilitating early detection of cerebral involvement in SCD. The ongoing research aims to improve understanding of the disease’s pathology and assist clinicians in making timely interventions, ultimately improving patients’ quality of life.

For further details, see the full study published in the Journal of Applied Physiology: DOI: 10.1152/japplphysiol.00426.2023.