A brief history of the development of transcranial tissue Doppler ultrasound

This article documents the early development of the first transcranial Doppler (TCD)-based ultrasound system for continuous monitoring of brain tissue pulsations (BTPs). Transcranial tissue Doppler (TCTD) uses a lightweight, wearable single-element ultrasound probe to track tissue motion perpendicular to the skin’s surface, providing tissue displacement estimates along a single beam line. Feasibility tests using an adapted TCD system confirmed that brain tissue motion data can be obtained from existing TCD hardware. Brain Tissue Velocimetry (Brain TV), a TCTD data acquisition system, was then developed to provide a lightweight and portable means of continuously recording TCTD data in real-time. Brain TV measurements are synchronized to a 3-lead electrocardiogram and can be recorded alongside other physiological measurements, such as blood pressure, heart rate and end-tidal carbon dioxide. We have shown that Brain TV is able to record BTPs from sample depths ranging from 22 to 80 mm below the probe’s surface and from multiple positions on the head. Studies in healthy volunteers, stroke patients and ultrasound phantom brain models demonstrate how TCTD might provide insights into the relationships between physiological measurements and brain tissue motion and show promise for rapid clinical assessment and continuous monitoring of BTPs.