Assessing Information Transfer and Modification in Plateau Waves of Intracranial Pressure

Plateau waves (PW) of Intracranial Pressure occur mostly in patients with Traumatic Brain Injury (TBI) and preserved cerebral autoregulation. This cerebral vascular phenomenon is associated with an intense systemic stress response that can be evidenced by Heart Rate Variability (HRV), as a mirror of the autonomic nervous system dysfunction. The Network Physiology framework allows the multivariate and simultaneous analysis of the information processed in multiple interacting dynamical systems. In this study, we used the multiscale representation of Transfer Entropy (TE) within the network of interactions among slow waves and respiratory waves of Mean Arterial Pressure (MAP) and Intracranial Pressure (ICP), with the RR intervals. The decomposition into redundant and synergistic contributions, is obtained using a Vector AutoRegressive Fractionally Integrated (VARFI) framework for Gaussian processes. This recent method allows to assess directed interactions and to quantify the information flow accounting for the coexistence of short-term dynamics and long-range correlations. The results indicate that PWs are an extremely critical phenomenon with high persistence where the information transfer from MAP to RR is reduced. Moreover, the prevalence of synergistic interactions between MAP and ICP is observed, specially in the range of slow waves. The used approach enhanced the description of HRV during PW and was able to highlight the dependence of the information transfer on the balance between short-term and long-range correlations in this complex stress situation.