Measurement of cranial optical path length as a function of age using phase resolved near infrared spectroscopy

[Cerebral near-infrared spectroscopy (NIRS) in paediatric anaesthesia]

Cerebral oximetry allows continuous real-time and non-invasive monitoring of cerebral oxygen saturation (cSO(2)), by measuring oxyhaemoglobin and deoxyhaemoglobin near infrared light absorption, similarly to pulse oximetry. cSO(2) measurement predominantly reflects brain venous compartment, and is correlated with jugular venous saturation. As jugular venous saturation, cSO(2) must therefore be interpreted as a measure of balance between transport and consumption of O(2) in the brain. Cerebral oximetry should be used as a trend monitoring, because its accuracy is insufficient to be considered as reliable measure of absolute value of ScO(2). In adult, correction of intraoperative cerebral desaturation reduces hospital stay, heavy morbidity and mortality, and serious postoperative neurocognitive impairment after cardiac and major abdominal surgery. In children, the occurrence of intra- and postoperative cerebral desaturations during congenital heart surgery is associated with increased neurological morbi-mortality. Cerebral oximetry could be a useful monitoring during anaesthesia of (ex) preterm neonates, due to the risk of impaired cerebral blood flow autoregulation in these patients.

Functional near-infrared spectroscopy for the assessment of overt reading

Functional near-infrared spectroscopy (fNIRS) has become increasingly established as a promising technique for monitoring functional brain activity. To our knowledge, no study has yet used fNIRS to investigate overt reading of irregular words and nonwords with a full coverage of the cerebral regions involved in reading processes. The aim of our study was to design and validate a protocol using fNIRS for the assessment of overt reading. Twelve healthy French-speaking adults underwent one session of fNIRS recording while performing an overt reading of 13 blocks of irregular words and nonwords. Reading blocks were separated by baseline periods during which participants were instructed to fixate a cross. Sources (n = 55) and detectors (n = 16) were placed bilaterally over frontal, temporal, parietal, and occipital regions. Two wavelengths were used: 690 nm, more sensitive to deoxyhemoglobin (HbR) concentration changes, and 830 nm, more sensitive to oxyhemoglobin (HbO) concentration changes. For all participants, total hemoglobin (HbT) concentrations (HbO + HbR) were significantly higher than baseline for both irregular word and nonword reading in the inferior frontal gyri, the middle and superior temporal gyri, and the occipital cortices bilaterally. In the temporal gyri, although the difference was not significant, [HbT] values were higher in the left hemisphere. In the bilateral inferior frontal gyri, higher [HbT] values were found in nonword than in irregular word reading. This activation could be related to the grapheme-to-phoneme conversion characterizing the phonological pathway of reading. Our findings confirm that fNIRS is an appropriate technique to assess the neural correlates of overt reading.

Number-space interactions in the human parietal cortex: Enlightening the SNARC effect with functional near-infrared spectroscopy

Interactions between numbers and space have become a major issue in cognitive neuroscience, because they suggest that numerical representations might be deeply rooted in cortical networks that also subserve spatial cognition. The spatial-numerical association of response codes (SNARC) is the most robust and widely replicated demonstration of the link between numbers and space: in magnitude comparison or parity judgments, participants' reaction times to small numbers are faster with left than right effectors, whereas the converse is found for large numbers. However, despite the massive body of research on number-space interactions, the nature of the SNARC effect remains controversial and no study to date has identified its hemodynamic correlates. Using functional near-infrared spectroscopy, we found a hemodynamic signature of the SNARC effect in the bilateral intraparietal sulcus, a core region for numerical magnitude representation, and left angular gyrus (ANG), a region implicated in verbal number processing. Activation of intraparietal sulcus was also modulated by numerical distance. Our findings point to number semantics as cognitive locus of number-space interactions, thereby revealing the intrinsic spatial nature of numerical magnitude representation. Moreover, the involvement of left ANG is consistent with the mediating role of verbal/cultural factors in shaping interactions between numbers and space.

Effects of aging on cerebral oxygenation during working-memory performance: a functional near-infrared spectroscopy study

Working memory is sensitive to aging-related decline. Evidence exists that aging is accompanied by a reorganization of the working-memory circuitry, but the underlying neurocognitive mechanisms are unclear. In this study, we examined aging-related changes in prefrontal activation during working-memory performance using functional Near-Infrared Spectroscopy (fNIRS), a noninvasive neuroimaging technique. Seventeen healthy young (21–32 years) and 17 healthy older adults (64–81 years) performed a verbal working-memory task (n-back). Oxygenated and deoxygenated hemoglobin concentration changes were registered by two fNIRS channels located over the left and right prefrontal cortex. Increased working-memory load resulted in worse performance compared to the control condition in older adults, but not in young participants. In both young and older adults, prefrontal activation increased with rising working-memory load. Young adults showed slight right-hemispheric dominance at low levels of working-memory load, while no hemispheric differences were apparent in older adults. Analysis of the time-activation curve during the high working-memory load condition revealed a continuous increase of the hemodynamic response in the young. In contrast to that, a quadratic pattern of activation was found in the older participants. Based on these results it could be hypothesized that young adults were better able to keep the prefrontal cortex recruited over a prolonged period of time. To conclude, already at low levels of working-memory load do older adults recruit both hemispheres, possibly in an attempt to compensate for the observed aging-related decline in performance. Also, our study shows that aging effects on the time course of the hemodynamic response must be taken into account in the interpretation of the results of neuroimaging studies that rely on blood oxygen levels, such as fMRI.

A fNIRS investigation of switching and inhibition during the modified Stroop task in younger and older adults

Brain imaging studies have reported age-related differences in brain activation for attentional control functions, such as inhibition and task-switching. However, age-related differences in brain activation patterns in more than one attentional control task have rarely been studied in the same group of participants. In this study, younger and older adults completed a modified Stroop task with interference and switching conditions, using functional near infra-red spectroscopy. While interference did not reveal any significant activation of the prefrontal cortex in younger adults, switching produced an increased activation bilaterally in both the anterior dorsolateral prefrontal cortex (DLPFC) and the anterior ventrolateral prefrontal cortex (VLPFC). In older adults, an isolated right and left anterior DLPFC activation was observed even in the non-executive conditions of the Stroop task (color denomination) and the interference condition revealed activation mostly in the posterior left DLPFC and bilateral VLPFC with a small right anterior DLPFC component. Specific to older adults, switching induced an increased activation spread out bilaterally over the prefrontal cortex in the bilateral anterior DLPFC, the posterior left DLPFC and bilateral VLPFC. These results suggest that for both older and younger adults, inhibition and switching are associated with distinct patterns of prefrontal activation and that age-related differences exist in these patterns such that prefrontal activation seems to be more spread out at different sites in older adults.

A fast neuronal signal-sensitive continuous-wave near-infrared imaging system

We have developed a continuous-wave near-infrared imaging system to measure fast neuronal signals. We used a simultaneous sampling method with a separate high-speed analog-to-digital converter for each input channel, which provides a much larger point sample in a digital lock-in algorithm, higher temporal resolution, and lower crosstalk among detected channels. Without any analog filter, digital lock-in detection with a large point sample suppresses noise excellently, making the system less complex and offering better flexibility. In addition, using a custom-made collimator, more photons can reach the brain tissue due to the smaller divergence angle. Performance analysis shows high detection sensitivity (on the order of 0.1 pW) and high temporal resolution (~50 Hz, 48 channels). Simulation experiments show that intensity changes on the order of 0.01% can be resolved by our instrument when averaging over approximately 500 stimuli. In vivo experiments over the motor cortex show that our instrument can detect fast neuronal signals in the human brain.

Dietary nitrate improves muscle but not cerebral oxygenation status during exercise in hypoxia

Exercise tolerance is impaired in hypoxia, and it has recently been shown that dietary nitrate supplementation can reduce the oxygen (O2) cost of muscle contractions. Therefore, we investigated the effect of dietary nitrate supplementation on arterial, muscle, and cerebral oxygenation status, symptoms of acute mountain sickness (AMS), and exercise tolerance at simulated 5,000 m altitude. Fifteen young, healthy volunteers participated in three experimental sessions according to a crossover study design. From 6 days prior to each session, subjects received either beetroot (BR) juice delivering 0.07 mmol nitrate/kg body wt/day or a control drink (CON). One session was in normoxia with CON (NORCON); the two other sessions were in hypoxia (11% O2), with either CON (HYPCON) or BR (HYPBR). Subjects first cycled for 20 min at 45% of peak O2 consumption (VO2peak; EX45%) and thereafter, performed a maximal incremental exercise test (EXmax). Whole-body VO2, arterial O2 saturation (%SpO2) via pulsoximetry, and tissue oxygenation index of both muscle (TOIM) and cerebral (TOIC) tissue by near-infrared spectroscopy were measured. Hypoxia per se substantially reduced VO2peak, %SpO2, TOIM, and TOIC (NORCON vs. HYPCON, P < 0.05). Compared with HYPCON, VO2 at rest and during EX45% was lower in HYPBR ( P < 0.05), whereas %SpO2 was higher ( P < 0.05). TOIM was ∼4-5% higher in HYPBR than in HYPCON both at rest and during EX45% and EXmax ( P < 0.05). TOIC as well as the incidence of AMS symptoms were similar between HYPCON and HYPBR at any time. Hypoxia reduced time to exhaustion in EXmax by 36% ( P < 0.05), but this ergolytic effect was partly negated by BR (+5%, P < 0.05). Short-term dietary nitrate supplementation improves arterial and muscle oxygenation status but not cerebral oxygenation status during exercise in severe hypoxia. This is associated with improved exercise tolerance against the background of a similar incidence of AMS.

High-density diffuse optical tomography of term infant visual cortex in the nursery

Advancements in antenatal and neonatal medicine over the last few decades have led to significant improvement in the survival rates of sick newborn infants. However, this improvement in survival has not been matched by a reduction in neurodevelopmental morbidities with increasing recognition of the diverse cognitive and behavioral challenges that preterm infants face in childhood. Conventional neuroimaging modalities, such as cranial ultrasound and magnetic resonance imaging, provide an important definition of neuroanatomy with recognition of brain injury. However, they fail to define the functional integrity of the immature brain, particularly during this critical developmental period. Diffuse optical tomography methods have established success in imaging adult brain function; however, few studies exist to demonstrate their feasibility in the neonatal population. We demonstrate the feasibility of using recently developed high-density diffuse optical tomography (HD-DOT) to map functional activation of the visual cortex in healthy term-born infants. The functional images show high contrast-to-noise ratio obtained in seven neonates. These results illustrate the potential for HD-DOT and provide a foundation for investigations of brain function in more vulnerable newborns, such as preterm infants.

Multi-channel NIRS of the primary motor cortex to discriminate hand from foot activity

The poor spatial resolution of near-infrared spectroscopy (NIRS) makes it difficult to distinguish two closely located cortical areas from each other. Here, a combination of multi-channel NIRS and a centre of gravity (CoG) approach (widely accepted in the field of transcranial magnetic stimulation; TMS) was used to discriminate between closely located cortical areas activated during hand and foot movements. Similarly, the possibility of separating the more anteriorly represented discrete movements from rhythmic movements was studied. Thirteen healthy right-handed subjects performed rhythmic or discrete ('task') hand or foot ('extremity') tapping. Hemodynamic responses were measured using an 8-channel NIRS setup. For oxyhemoglobin (OHb) and deoxyhemoglobin (HHb), a CoG was determined for each condition using the mean hemodynamic responses and the coordinates of the channels. Significant hemodynamic responses were found for hand and foot movements. Based on the HHb responses, the NIRS-CoG of hand movements was located 0.6 cm more laterally compared to the NIRS-CoG of foot movements. For OHb responses no difference in NIRS-CoG was found for 'extremity' nor for 'task'. This is the first NIRS study showing hemodynamic responses for isolated foot movements. Furthermore, HHb responses have the potential to be used in multi-channel NIRS experiments requiring differential activation of motor cortex areas linked to either hand or foot movements.

Time course of the haemodynamic response to visual stimulation in migraine, measured using near-infrared spectroscopy

Background: In patients with migraine, an abnormally large haemodynamic response to epileptogenic visual stimulation has previously been observed, consistent with the hypothesis of a cortical hyperexcitability. Ophthalmic filters have been used in the treatment of migraine, and they reduce the haemodynamic response.

Methods: The present study used near-infrared spectroscopy (NIRS) to characterise the haemodynamic response to a range of visual stimuli in 20 patients with migraine (15 with aura and 5 without) and paired controls in order to assess the effect of ophthalmic treatment. In an initial study, the response to three stimuli (chequerboard, and two gratings of different spatial frequency) was measured. In a second study, using the mid-spatial frequency grating as stimulus, the response was compared when precision spectral filters (PSF), grey filters or filters of control colour were worn as ophthalmic lenses.

Results: In the first study the time course of the response differed between the groups. The difference was most distinct for the grating with mid-spatial frequency. In the second study the PSF broadened (normalised) the haemodynamic response in migraineurs relative to controls, consistent with fMRI BOLD findings and suggesting a physiological mechanism for their reported efficacy. In neither study were there differences in the amplitude of the response between migraine and control groups or indeed between filters.

Conclusion: The time course of the functional response as measured by NIRS may be an effective tool to track therapy with PSF and explore the mechanisms of visual stress in migraine.

Noninvasive evaluation of skeletal muscle mitochondrial capacity with near-infrared spectroscopy: correcting for blood volume changes

Near-infrared spectroscopy (NIRS) is a well-known method used to measure muscle oxygenation and hemodynamics in vivo. The application of arterial occlusions allows for the assessment of muscle oxygen consumption (mVo(2)) using NIRS. The aim of this study was to measure skeletal muscle mitochondrial capacity using blood volume-corrected NIRS signals that represent oxygenated hemoglobin/myoglobin (O(2)Hb) and deoxygenated hemoglobin/myoglobin (HHb). We also assessed the reliability and reproducibility of NIRS measurements of resting oxygen consumption and mitochondrial capacity. Twenty-four subjects, including four with chronic spinal cord injury, were tested using either the vastus lateralis or gastrocnemius muscles. Ten healthy, able-bodied subjects were tested on two occasions within a period of 7 days to assess the reliability and reproducibility. NIRS signals were corrected for blood volume changes using three different methods. Resting oxygen consumption had a mean coefficient of variation (CV) of 2.4% (range 1-32%). The recovery of oxygen consumption (mVo(2)) after electrical stimulation at 4 Hz was fit to an exponential curve, which represents mitochondrial capacity. The time constant for the recovery of mVo(2) was reproducible with a mean CV of 10% (range 1-22%) only when correcting for blood volume changes. We also examined the effects of adipose tissue thickness on measurements of mVo(2). We found the mVo(2) measurements using absolute units to be influenced by adipose tissue thickness (ATT), and this relationship was removed when an ischemic calibration was performed, supporting its use to compare mVo(2) between individuals of varying ATT. In conclusion, in vivo oxidative capacity can be assessed using blood volume-corrected NIRS signals with a high degree of reliability and reproducibility.

Changes in diffusion path length with old age in diffuse optical tomography

Diffuse, optical near infrared imaging is increasingly being used in various neurocognitive contexts where changes in optical signals are interpreted through activation maps. Statistical population comparison of different age or clinical groups rely on the relative homogeneous distribution of measurements across subjects in order to infer changes in brain function. In the context of an increasing use of diffuse optical imaging with older adult populations, changes in tissue properties and anatomy with age adds additional confounds. Few studies investigated these changes with age. Duncan et al. measured the so-called diffusion path length factor (DPF) in a large population but did not explore beyond the age of 51 after which physiological and anatomical changes are expected to occur [Pediatr. Res. 39(5), 889-894 (1996)]. With increasing interest in studying the geriatric population with optical imaging, we studied changes in tissue properties in young and old subjects using both magnetic resonance imaging (MRI)-guided Monte-Carlo simulations and time-domain diffuse optical imaging. Our results, measured in the frontal cortex, show changes in DPF that are smaller than previously measured by Duncan et al. in a younger population. The origin of these changes are studied using simulations and experimental measures.

Validation of diffuse correlation spectroscopic measurement of cerebral blood flow using phase-encoded velocity mapping magnetic resonance imaging

Diffuse correlation spectroscopy (DCS) is a novel optical technique that appears to be an excellent tool for assessing cerebral blood flow in a continuous and non-invasive manner at the bedside. We present new clinical validation of the DCS methodology by demonstrating strong agreement between DCS indices of relative cerebral blood flow and indices based on phase-encoded velocity mapping magnetic resonance imaging (VENC MRI) of relative blood flow in the jugular veins and superior vena cava. Data were acquired from 46 children with single ventricle cardiac lesions during a hypercapnia intervention. Significant increases in cerebral blood flow, measured both by DCS and by VENC MRI, as well as significant increases in oxyhemoglobin concentration, and total hemoglobin concentration, were observed during hypercapnia. Comparison of blood flow changes measured by VENC MRI in the jugular veins and by DCS revealed a strong linear relationship, R=0.88, p<0.001, slope=0.91±0.07. Similar correlations were observed between DCS and VENC MRI in the superior vena cava, R=0.77, slope=0.99±0.12, p<0.001. The relationship between VENC MRI in the aorta and DCS, a negative control, was weakly correlated, R=0.46, slope=1.77±0.45, p<0.001.

Head-up tilt and hyperventilation produce similar changes in cerebral oxygenation and blood volume: an observational comparison study using frequency-domain near-infrared spectroscopy

PURPOSE

During anesthesia, maneuvers which cause the least disturbance of cerebral oxygenation with the greatest decrease in intracranial pressure would be most beneficial to patients with intracranial hypertension. Both head-up tilt (HUT) and hyperventilation are used to decrease brain bulk, and both may be associated with decreases in cerebral oxygenation. In this observational study, our null hypothesis was that the impact of HUT and hyperventilation on cerebral tissue oxygen saturation (SctO2) and cerebral blood volume (CBV) are comparable.

METHODS

Surgical patients without neurological disease were anesthetized with propofol-remifentanil. Before the start of surgery, frequency-domain near-infrared spectroscopy was used to measure SctO2 and CBV at the supine position, at the 30° head-up and head-down positions, as well as during hypoventilation and hyperventilation.

RESULTS

Thirty-three patients were studied. Both HUT and hyperventilation induced small decreases in SctO2 [3.5 (2.6)%; P < 0.001 and 3.0 (1.8)%; P < 0.001, respectively] and in CBV [0.05 (0.07) mL x 100 g(-1); P < 0.001 and 0.06 (0.05) mL x 100 g(-1); P < 0.001, respectively]. There were no differences between HUT to 30° and hyperventilation to an end-tidal carbon dioxide (ETCO2) of 25 mmHg (from 45 mmHg) in both SctO2 (P = 0.3) and CBV (P = 0.4).

DISCUSSION

The small but statistically significant decreases in both SctO2 and CBV caused by HUT and hyperventilation are comparable. There was no correlation between the decreases in SctO2 and CBV and the decreases in blood pressure and cardiac output during head-up and head-down tilts. However, the decreases in both SctO2 and CBV correlate with the decreases in ETCO2 during ventilation adjustment.

Cerebral near-infrared spectroscopy as a measure of nociceptive evoked activity in critically ill infants

Signs of pain may be subtle or absent in a critically ill infant. The complex nature of pain may further obscure its identification and measurement. Because the use of monitoring and neuroimaging techniques has become more common in pain research, an understanding of these specialized technologies is important. Near-infrared spectroscopy (NIRS) is a noninvasive technique for monitoring tissue hemodynamics and oxygenation. There are indications that NIRS is capable of detecting the cerebral hemodynamic changes associated with sensory stimuli, including pain, in infants. These developments suggest that NIRS may play an important role in research focusing on pain perception in critically ill infants. The present review briefly describes the cortical responses to noxious stimuli, which parallel cerebral hemodynamic responses to various stimuli. This is followed by an overview of NIRS technology including a summary of the literature on functional studies that have used NIRS in infants. Current NIRS techniques have well-recognized limitations that must be considered carefully during the measurement and interpretation of the signals. Nonetheless, until more advanced NIRS techniques emerge, the current devices have strengths that should be exploited.

Specific functional asymmetries of the human visual cortex revealed by functional near-infrared spectroscopy

Based on multiple invasive reports and neuroimaging studies, it is well established that the cytoarchitecture of the visual cortex is related to its functional organization, namely, its retinotopy. The present study aimed to further investigate retinotopic mapping as well as specific vertical and horizontal functional asymmetries within the human visual cortex using functional near-infrared spectroscopy (fNIRS). Black and white wedge checkerboard stimuli were randomly presented to the four visual field (VF) quadrants of eight healthy adults in order to quantify and compare the localization and the amplitude of hemodynamic cortical responses to each VF quadrant. Results showed the expected activation in the contralateral hemisphere, with respect to the side of the stimulated quadrant. We also measured significantly stronger activations in the upper visual cortex when low hemifield stimuli were presented compared to activations in the lower visual cortex when upper hemifield stimuli were shown, especially when the stimulation was presented in the right visual field. These findings confirm the vertical asymmetry of the visual cortex previously reported by neuroimaging and behavioral studies. More importantly, the present work confirms the reliability of the fNIRS technique for functional mapping of the human brain.

The activity of the primary motor cortex ipsilateral to the exercising hand decreases during repetitive handgrip exercise

The brain function controlling muscle force production is not yet fully understood. The purpose of this study was to examine bilateral primary motor cortex (M1) oxygenation during static-handgrip exercises performed with the right hand (60% maximal voluntary contraction; 10 s exercise/75 s rest; five sets). Twelve healthy, right-handed male subjects participated in this study. Near-infrared spectroscopy probes were positioned over the bilateral M1 to measure cortical oxygenation during handgrip exercises. The maximum values of the changes in concentrations of oxyhemoglobin (HbO(2)) and deoxyhemoglobin (Hb) across the trials (i) did not change significantly during the contralateral M1 activation (p > 0.05), whereas (ii) in the case of the ipsilateral M1 activation a significant (p < 0.05) decrease in HbO(2) and a significant (p < 0.01) decrease in Hb could be measured. The activation in ipsilateral M1 at the fifth trial was significantly decreased compared with that in the first trial (HbO(2): p < 0.001; Hb: p < 0.001). The present results suggest that the ipsilateral M1 is recruited during the motor task in compensation for the contralateral M1 and the habituation to motor task might alter the efficiency for interaction of the ipsilateral M1 to the contralateral M1. The interhemispheric interaction might change due to habituation to motor task.

Functional near infrared spectroscopy study of age-related difference in cortical activation patterns during cycling with speed feedback

Functional decline of lower-limb affects the ability of locomotion and the age-related brain differences have been elucidated among the elderly. Cycling exercise is a common training program for restoring motor function in the deconditioned elderly or stroke patients. The provision of speed feedback has been commonly suggested to clinical therapists for facilitating learning of controlled cycling performance and maintaining motivation in training programs with elderly participants. However, the cortical control of pedaling movements and the effect of external feedback remain poorly understanding. This study investigated the regional cortical activities detected by functional near infrared spectroscopy (fNIRS) in 12 healthy young and 13 healthy elderly subjects under conditions of cycling without-(free cycling) and with feedback (target cycling). The elderly exhibited predominant activation of the sensorimotor cortex during free cycling similar to young subjects but with poorer cycling performance. The cycling performance improved in both groups, and the elderly showed increased brain activities of the supplementary motor area and premotor cortex under target cycling condition. These findings demonstrated age-related changes in the cortical control in processing external feedback and pedaling movements. Use of fNIRS to evaluate brain activation patterns after training may facilitate brain-based design of tailored therapeutic rehabilitation strategies.

Correlation of functional and resting state connectivity of cerebral oxy-, deoxy-, and total hemoglobin concentration changes measured by near-infrared spectrophotometry

The aim is to study cerebral vascular functional connectivity during motor tasks and resting state using multichannel frequency-domain near-infrared spectrophotometry. Maps of 5.7 × 10.8 cm size displaying changes in cerebral oxyhemoglobin (O(2)Hb), deoxyhemoglobin (HHb), and total hemoglobin (tHb) concentrations were measured in the motor cortex in 12 subjects (mean age of 28.8±12.7 yrs) during resting state and during two palm squeezing tasks with different timing. For each condition, phase plane plots, cross correlation functions, and connectivity indices were generated for O(2)Hb, HHb, and tHb. The amplitude of the concentration changes in O(2)Hb and HHb depends on the age of the subject. We found large regions of connectivity, which were similar for resting state and task conditions. This means the spatial relationships during resting state, when changes in O(2)Hb, HHb, and tHb corresponded to spontaneous oscillations, were correlated to the spatial patterns during the activation tasks, when changes in O(2)Hb, HHb, and tHb concentration were related to the alternation of stimulation and rest. Thus, the vascular functional connectivity was also present during resting state. The findings suggest that the vascular response to functional activation may be a nonlinear synchronization phenomenon and that resting state processes are more important than previously expected.

TMS: a navigator for NIRS of the primary motor cortex?

Near-infrared spectroscopy (NIRS) is a non-invasive optical imaging technique, which is increasingly used to measure hemodynamic responses in the motor cortex. The location at which the NIRS optodes are placed on the skull is a major factor in measuring the hemodynamic responses optimally. In this study, the validity of using transcranial magnetic stimulation (TMS) in combination with a 3D motion analysis system to relocate the TMS derived position was tested. In addition, the main goal was to quantify the advantage of using TMS to locate the optimal position in relation to the most commonly used EEG C3 position. Markers were placed on the TMS coil and on the head of the subject. In eleven subjects, a TMS measurement was performed to determine the individual motor-evoked potential center-of-gravity (MEP-CoG). This procedure was repeated in nine subjects to test the validity. Subsequently, hemodynamic responses were measured at the MEP-CoG position and at the C3 position during a thumb abduction and adduction task. On average, the MEP-CoG location was located 19.2mm away from the C3 position. The reproducibility study on the MEP-CoG relocation procedure revealed no systematic relocations. No differences in early and delayed hemodynamic responses were found between the C3 and MEP-CoG position. These results indicate that using TMS for NIRS optodes positioning on the motor cortex does not result in higher hemodynamic response amplitudes. This could be explained if NIRS and TMS assess slightly different functions.

Prefrontal Brain Activation During Emotional Processing: A Functional Near Infrared Spectroscopy Study (fNIRS)

The limbic system and especially the amygdala have been identified as key structures in emotion induction and regulation. Recently research has additionally focused on the influence of prefrontal areas on emotion processing in the limbic system and the amygdala. Results from fMRI studies indicate that the prefrontal cortex (PFC) is involved not only in emotion induction but also in emotion regulation. However, studies using fNIRS only report prefrontal brain activation during emotion induction. So far it lacks the attempt to compare emotion induction and emotion regulation with regard to prefrontal activation measured with fNIRS, to exclude the possibility that the reported prefrontal brain activation in fNIRS studies are mainly caused by automatic emotion regulation processes. Therefore this work tried to distinguish emotion induction from regulation via fNIRS of the prefrontal cortex. 20 healthy women viewed neutral pictures as a baseline condition, fearful pictures as induction condition and reappraised fearful pictures as regulation condition in randomized order. As predicted, the view-fearful condition led to higher arousal ratings than the view-neutral condition with the reappraise-fearful condition in between. For the fNIRS results the induction condition showed an activation of the bilateral PFC compared to the baseline condition (viewing neutral). The regulation condition showed an activation only of the left PFC compared to the baseline condition, although the direct comparison between induction and regulation condition revealed no significant difference in brain activation. Therefore our study underscores the results of previous fNIRS studies showing prefrontal brain activation during emotion induction and rejects the hypothesis that this prefrontal brain activation might only be a result of automatic emotion regulation processes.

Intra- and extra-cranial effects of transient blood pressure changes on brain near-infrared spectroscopy (NIRS) measurements

Brain near-infrared spectroscopy (NIRS) is an emerging neurophysiological tool that combines straightforward activity localization with cost-economy, portability and patient compatibility. NIRS is proving its empirical utility across specific cognitive and emotional paradigms. However, a potential limitation is that it is not only sensitive to haemodynamic changes taking place in the cortex, and task-related cardiovascular responses expressed in the perfusion of extracranial layers may be confounding. Existing literature reports correlations between brain NIRS and systemic blood pressure, yet it falls short of establishing whether in normal participants the blood pressure changes encountered in experimental settings can have confounding effects. Here, we tested this hypothesis by performing two experimental manipulations while recording from superficial occipital cortex, encompassing striate and extrastriate regions. Visual stimulation with reversing chequerboards evoked cortical haemodynamic responses. Simultaneously and independently, transient systemic blood pressure changes were generated through rapid arm-raising. Shallow-penetration NIRS recordings, probing only extra-cerebral tissues, highlighted close haemodynamic coupling with blood pressure. A different coupling pattern was observed in deep-penetration recordings directed at haemodynamic signals from visual cortex. In absence of blood-pressure changes, NIRS signals tracked differences in visual stimulus duration. However when blood pressure was actively manipulated, this effect was absent and replaced by a very large pressure-related response. Our observations demonstrate that blood pressure fluctuations can exert confounding effects on brain NIRS, through expression in extracranial tissues and within the brain itself. We highlight the necessity for continuous blood pressure monitoring alongside brain NIRS, and for further research on methods to correct for physiological confounds.

Biophysical model estimation of neurovascular parameters in a rat model of healthy aging

Neuronal, vascular and metabolic factors result in a deterioration of the cerebral hemodynamic response with age. The interpretation of neuroimaging studies in the context of aging is rendered difficult due to the challenge in untangling the composite effect of these modifications. In this work we integrate multimodal optical imaging in biophysical models to investigate vascular and metabolic changes occurring in aging. Multispectral intrinsic optical imaging of an animal model of healthy aging, the LOU/c rat, is used in combination with somatosensory stimulation to study the modifications of the hemodynamic response with increasing age. Results are fitted with three macroscopic biophysical models to extract parameters, providing a phenomenological description of vascular and metabolic changes. Our results show that 1) biophysical parameters are estimable from multimodal data and 2) parameter estimates in this population change with aging.

Cortical hemodynamic responses to intravenous thiamine propyldisulphide administration detected by multichannel near infrared spectroscopy (NIRS) system

Intravenous injection of thiamine propyldisulphide (TPD), which induces sensation of a garlic-like odor, has been used as a representative subjective olfactory test in Japan. However, cortical loci activated by TPD still remain unclear. We recorded cerebral hemodynamic responses (changes in Oxy-Hb concentrations) induced by TPD administration using whole-head multi-channel near infrared spectroscopy (NIRS) system based on 3D-MRIs. TPD as an odorant and saline as a control were injected from the cephalic vein in the left forearm in ten male normosmic (five young and five elderly) subjects and five dysosmic elderly patients. The all normosmic, but not dysosmic, subjects felt the garlic-like odor in the all TPD trials. There was no significant difference in hemodynamic responses between the young and elderly normosmic subjects. However, TPD injection induced significantly larger hemodynamic responses in the bilateral operculums, bilateral dorsolateral prefrontal cortices (PFC) and anteromedial PFC in the normosmic subjects, compared with saline injection. Onset latencies of these hemodynamic responses were significantly correlated with onset latencies of subjective odor sensation in the normosmic subjects. Comparison of hemodynamic responses between the normosmic and dysosmic subjects indicated a significant difference in the bilateral operculums. The results demonstrated that Oxy-Hb increases in the bilateral operculums reflected olfactory sensation induced by TPD injection. Consideration of a route for intravenous TPD to reach the olfactory mucosa suggests that these hemodynamic responses might be attributed to food-related retronasal olfactory responses to TPD.

Dorsolateral prefrontal cortical oxygenation during REM sleep in humans

Previous neuroimaging studies that examined cerebral blood flow during rapid eye movement (REM) sleep have reported inconsistent findings regarding the activity of the dorsolateral prefrontal cortex (DLPFC). Although most previous positron emission tomography (PET) studies failed to detect DLPFC activation during REM sleep, several studies have observed DLPFC activation, possibly reflecting transient prefrontal activities related to REM. More recently, an event-related functional magnetic resonance imaging (fMRI) study observed REM-locked activation of the DLPFC during REM sleep. The present study investigated hemodynamic changes of the DLPFC throughout the REM sleep period in 25 subjects using near-infrared spectroscopy. Continuous monitoring of changes in the hemoglobin (Hb) concentration and tissue oxygenation index (TOI, proportion of oxygenated-Hb to total-Hb) in the bilateral DLPFC was conducted every 0.5s, simultaneously with polysomnographic recordings. Eight of the 25 subjects showed REM sleep, and all indicated a clear increase in both the oxygenated-Hb concentration and TOI from baseline at the occurrence of first REM, relative to prior stage 2 sleep. The results indicate that the appearance of the first REM that occurred just after onset of the REM sleep closely coincides with the activation of the DLPFC, which could play a role in cognitive activities during REM sleep in humans.

Does cerebral oxygenation affect cognitive function during exercise?

This study tested whether cerebral oxygenation affects cognitive function during exercise. We measured reaction times (RT) of 12 participants while they performed a modified version of the Eriksen flanker task, at rest and while cycling. In the exercise condition, participants performed the cognitive task at rest and while cycling at three workloads [40, 60, and 80% of peak oxygen uptake ([Formula: see text])]. In the control condition, the workload was fixed at 20 W. RT was divided into premotor and motor components based on surface electromyographic recordings. The premotor component of RT (premotor time) was used to evaluate the effects of acute exercise on cognitive function. Cerebral oxygenation was monitored during the cognitive task over the right frontal cortex using near-infrared spectroscopy. In the exercise condition, we found that premotor time significantly decreased during exercise at 60% peak [Formula: see text] relative to rest. However, this improvement was not observed during exercise at 80% peak [Formula: see text]. In the control condition, premotor time did not change during exercise. Cerebral oxygenation during exercise at 60% peak [Formula: see text] was not significantly different from that at rest, while cerebral oxygenation substantially decreased during exercise at 80% peak [Formula: see text]. The present results suggest that an improvement in cognitive function occurs during moderate exercise, independent of cerebral oxygenation.

Near-infrared spectroscopy: a report from the McDonnell infant methodology consortium

Near-infrared spectroscopy (NIRS) is a new and increasingly widespread brain imaging technique, particularly suitable for young infants. The laboratories of the McDonnell Consortium have contributed to the technological development and research applications of this technique for nearly a decade. The present paper provides a general introduction to the technique as well as a detailed report of the methodological innovations developed by the Consortium. The basic principles of NIRS and some of the existing developmental studies are reviewed. Issues concerning technological improvements, parameter optimization, possible experimental designs and data analysis techniques are discussed and illustrated by novel empirical data.

A hemodynamic correlate of lateralized visual short-term memories

Neuroimaging studies attempting to isolate the neural substrate of visual short-term memory in humans have concentrated on the behavior of neurons populating the posterior part of the parietal cortex as a possible source of visual short-term memory capacity limits. Using a standard change-detection task, fMRI studies have shown that maintenance of bilaterally encoded objects elicited bilateral increases of hemodynamic activation in the intra-parietal and intra-occipital sulci (IPS-IOS) proportional to the number of objects retained in visual short-term memory. We used a spatially cued variant of the change-detection task to record hemodynamic responses to unilaterally encoded objects using functional near-infrared spectroscopy (fNIRS). Electrophysiological studies that employed this task have shown that maintenance of unilaterally encoded objects elicited posterior unilateral (contralateral) increase in event-related negativity proportional to the number of objects retained in visual short-term memory. We therefore examined whether contralateral increases in oxy-hemoglobin concentration correlated with the number of retained objects. Contrary to the idea that bilateral increases in BOLD responses and unilateral increases in event-related negativity may be different reflections of the same underlying neural/functional processing, memory-related increases in oxy-hemoglobin concentration were found bilaterally even when objects had to be encoded unilaterally. The present findings suggest that EEG and fMRI/fNIRS techniques reveal distinct neural signatures of the mechanisms supporting visual short-term memory.

Bayesian filtering of human brain hemodynamic activity elicited by visual short-term maintenance recorded through functional near-infrared spectroscopy (fNIRS)

Functional near-infrared spectroscopy (fNIRS) is a neuroimaging technique that measures changes in oxy-hemoglobin (ΔHbO) and deoxy-hemoglobin (ΔHbR) concentration associated with brain activity. The signal acquired with fNIRS is naturally affected by disturbances engendering from ongoing physiological activity (e.g., cardiac, respiratory, Mayer wave) and random measurement noise. Despite its several drawbacks, the so-called conventional averaging (CA) is still widely used to estimate the hemodynamic response function (HRF) from noisy signal. One such drawback is related to the number of trials necessary to derive stable HRF functions adopting the CA approach, which must be substantial (N >> 50). In this work, a pre-processing procedure to remove artifacts followed by the application of a non-parametric Bayesian approach is proposed that capitalizes on a priori available knowledge about HRF and noise. Results with the proposed Bayesian approach were compared with CA and with a straightforward band-pass filtering approach. On simulated data, a five times lower estimation error on HRF was obtained with respect to that obtained by CA, and 2.5 times lower than that obtained by band pass filtering. On real data, the improvement achieved by the present method was attested by an increase in the contrast to noise ratio (CNR) and by a reduced variability in single trial estimation. An application of the present Bayesian approach is illustrated that was optimized to monitor changes in hemodynamic activity reflecting variations in visual short-term memory load in humans, which are notoriously hard to detect using functional magnetic resonance imaging (fMRI). In particular, statistical analyses of HRFs recorded during a memory task established with high reliability the crucial role of the intraparietal sulcus and the intra-occipital sulcus in posterior areas of the human brain in visual short-term memory maintenance.

Brain specificity of diffuse optical imaging: improvements from superficial signal regression and tomography

Functional near infrared spectroscopy (fNIRS) is a portable monitor of cerebral hemodynamics with wide clinical potential. However, in fNIRS, the vascular signal from the brain is often obscured by vascular signals present in the scalp and skull. In this paper, we evaluate two methods for improving in vivo data from adult human subjects through the use of high-density diffuse optical tomography (DOT). First, we test whether we can extend superficial regression methods (which utilize the multiple source–detector pair separations) from sparse optode arrays to application with DOT imaging arrays. In order to accomplish this goal, we modify the method to remove physiological artifacts from deeper sampling channels using an average of shallow measurements. Second, DOT provides three-dimensional image reconstructions and should explicitly separate different tissue layers. We test whether DOT's depth-sectioning can completely remove superficial physiological artifacts. Herein, we assess improvements in signal quality and reproducibility due to these methods using a well-characterized visual paradigm and our high-density DOT system. Both approaches remove noise from the data, resulting in cleaner imaging and more consistent hemodynamic responses. Additionally, the two methods act synergistically, with greater improvements when the approaches are used together.

Noninvasive measurement of cerebral blood flow and blood oxygenation using near-infrared and diffuse correlation spectroscopies in critically brain-injured adults

BACKGROUND

This study assesses the utility of a hybrid optical instrument for noninvasive transcranial monitoring in the neurointensive care unit. The instrument is based on diffuse correlation spectroscopy (DCS) for measurement of cerebral blood flow (CBF), and near-infrared spectroscopy (NIRS) for measurement of oxy- and deoxy-hemoglobin concentration. DCS/NIRS measurements of CBF and oxygenation from frontal lobes are compared with concurrent xenon-enhanced computed tomography (XeCT) in patients during induced blood pressure changes and carbon dioxide arterial partial pressure variation.

METHODS

Seven neurocritical care patients were included in the study. Relative CBF measured by DCS (rCBF(DCS)), and changes in oxy-hemoglobin (DeltaHbO(2)), deoxy-hemoglobin (DeltaHb), and total hemoglobin concentration (DeltaTHC), measured by NIRS, were continuously monitored throughout XeCT during a baseline scan and a scan after intervention. CBF from XeCT regions-of-interest (ROIs) under the optical probes were used to calculate relative XeCT CBF (rCBF(XeCT)) and were then compared to rCBF(DCS). Spearman's rank coefficients were employed to test for associations between rCBF(DCS) and rCBF(XeCT), as well as between rCBF from both modalities and NIRS parameters.

RESULTS

rCBF(DCS) and rCBF(XeCT) showed good correlation (r (s) = 0.73, P = 0.010) across the patient cohort. Moderate correlations between rCBF(DCS) and DeltaHbO(2)/DeltaTHC were also observed. Both NIRS and DCS distinguished the effects of xenon inhalation on CBF, which varied among the patients.

CONCLUSIONS

DCS measurements of CBF and NIRS measurements of tissue blood oxygenation were successfully obtained in neurocritical care patients. The potential for DCS to provide continuous, noninvasive bedside monitoring for the purpose of CBF management and individualized care is demonstrated.

Cerebral hemodynamic responses induced by specific acupuncture sensations during needling at trigger points: a near-infrared spectroscopic study

Acupuncture stimulation at specific points, or trigger points (TPs), elicits sensations called "de-qi". De-qi sensations relate to the clinical efficacy of the treatment. However, it is neither clear whether de-qi sensations are associated with TPs, nor clear whether acupuncture effects on brain activity are associated with TPs or de-qi. We recorded cerebral hemodynamic responses during acupuncture stimulation at TPs and non-TPs by functional near-infrared spectroscopy. The acupuncture needle was inserted into both TPs and non-TPs within the right extensor muscle in the forearm. Typical acupuncture needle manipulation was conducted eight times for 15 s. The subjects pressed a button if they felt a de-qi sensation. We investigated how hemodynamic responses related to de-qi sensations induced at TPs and non-TPs. We observed that acupuncture stimulations producing de-qi sensations significantly decreased the Oxy-Hb concentration in the supplementary motor area (SMA), pre-supplementary motor area, and anterior dorsomedial prefrontal cortex regardless of the point stimulated. The hemodynamic responses were statistically analyzed using a general linear model and a boxcar function approximating the hemodynamic response. We observed that hemodynamic responses best fit the boxcar function when an onset delay was introduced into the analyses, and that the latency of de-qi sensations correlated with the onset delay of the best-fit function applied to the SMA. Our findings suggest that de-qi sensations favorably predict acupuncture effects on cerebral hemodynamics regardless of the type of site stimulated. Also, the effect of acupuncture stimulation in producing de-qi sensation was partly mediated by the central nervous system including the SMA.

Significant correlation between autonomic nervous activity and cerebral hemodynamics during thermotherapy on the neck

Although local thermotherapy reduces mental stress and neck stiffness, its physiological mechanisms are still not fully understood. We speculated that local thermotherapy exerts its effect, in addition to its direct peripheral effects, through the central nervous system that is involved in controlling stress responses. In the present study, we investigated the effects of a heat- and steam-generating (HSG) sheet on cerebral hemodynamics and autonomic nervous activity using near-infrared spectroscopy (NIRS) and the electrocardiograms (ECGs). Thirteen healthy young female subjects participated in this study. HSG or simple (control) sheets were repeatedly applied to the neck for 120 s with 180 s intervals of rest between applications. During the experiment, brain hemodynamic responses (changes in Oxy-Hb, Deoxy-Hb, and Total-Hb) and autonomic nervous activity based on heart rate variability (HRV) were monitored. Subjective perception of neck stiffness and fatigue was significantly improved after application of the HSG sheet. NIRS findings indicated that the application of HSG sheets decreased Oxy-Hb concentration in the anterior-dorsal region of the medial prefrontal cortex (adMPFC), while increasing parasympathetic nervous activity and decreasing sympathetic nervous activity. Furthermore, changes in Oxy-Hb in the adMPFC were significantly and negatively correlated with those in parasympathetic nervous activity during application of the HSG sheet. These findings suggest that application of the HSG sheet to the neck region induced mental relaxation and ameliorated neck stiffness by modifying activity of the adMPFC.

Cerebral oxygenation decreases but does not impair performance during self-paced, strenuous exercise

AIM

The reduction in cerebral oxygenation (Cox) is associated with the cessation of exercise during constant work rate and incremental tests to exhaustion. Yet in exercises of this nature, ecological validity is limited due to work rate being either fully or partly dictated by the protocol, and it is unknown whether cerebral deoxygenation also occurs during self-paced exercise. Here, we investigated the cerebral haemodynamics during a 5-km running time trial in trained runners.

METHODS

Rating of perceived exertion (RPE) and surface electromyogram (EMG) of lower limb muscles were recorded every 0.5 km. Changes in Cox (prefrontal lobe) were monitored via near-infrared spectroscopy through concentration changes in oxy- and deoxyhaemoglobin (Delta[O(2)Hb], Delta[HHb]). Changes in total Hb were calculated (Delta[THb] = Delta[O(2)Hb] + Delta[HHb]) and used as an index of change in regional blood volume.

RESULTS

During the trial, RPE increased from 6.6 +/- 0.6 to 19.1 +/- 0.7 indicating maximal exertion. Cox rose from baseline to 2.5 km ( upward arrowDelta[O(2)Hb], upward arrowDelta[HHb], upward arrowDelta[THb]), remained constant between 2.5 and 4.5 km, and fell from 4.5 to 5 km ( downward arrowDelta[O(2)Hb], upward arrowDelta[HHb], <-->Delta[THb]). Interestingly, the drop in Cox at the end of the trial coincided with a final end spurt in treadmill speed and concomitant increase in skeletal muscle recruitment (as revealed by higher lower limb EMG).

CONCLUSION

Results confirm the large tolerance for change in Cox during exercise at sea level, yet further indicate that, in conditions of self-selected work rate, cerebral deoxygenation remains within a range that does not hinder strenuous exercise performance.

Influence of cerebral and muscle oxygenation on repeated-sprint ability

The study examined the influence of cerebral (prefrontal cortex) and muscle (vastus lateralis) oxygenation on the ability to perform repeated, cycling sprints. Thirteen team-sport athletes performed ten, 10-s sprints (with 30 s of rest) under normoxic (F(I)O(2) 0.21) and acute hypoxic (F(I)O(2) 0.13) conditions in a randomised, single-blind fashion and crossover design. Mechanical work was calculated and arterial O(2) saturation (S(p)O(2)) was estimated via pulse oximetry for every sprint. Cerebral and muscle oxy-(O(2)Hb), deoxy-(HHb), and total haemoglobin (THb) were monitored continuously by near-infrared spectroscopy. Compared with normoxia, hypoxia induced larger decrements in S(p)O(2) and work (11.6 and 7.6%, respectively; P < 0.05). In the muscle, we observed a fairly constant level of deoxygenation across sprints, with no effect of the condition. In normoxia, regional cerebral oxygenation increased during the first two sprints and slightly fluctuated thereafter. In contrast, this initial cerebral hyper-oxygenation was attenuated in hypoxia. Changes in [O(2)Hb] and [HHb] occurred earlier and were larger in hypoxia compared with normoxia (P < 0.05), while regional blood volume (Delta[THb]) remained unaffected by the condition. Changes in cerebral [HHb] and mechanical work were strongly correlated in normoxia and hypoxia (R(2) = 0.81 and R(2) = 0.85, respectively; P < 0.05), although the slope of this relationship differed (normoxia, -351.3 +/- 183.3 vs. hypoxia, -442.4 +/- 227.2; P < 0.05). The results of this NIRS study show that O(2) availability influences prefrontal cortex, but not muscle, oxygenation during repeated, short sprints. By using a hypoxia paradigm, the study suggests that cerebral oxygenation contributes to the impairment of repeated-sprint ability.

Neonatal hemodynamic response to visual cortex activity: high-density near-infrared spectroscopy study

The neurodevelopmental outcome of neonatal intensive care unit (NICU) infants is a major clinical concern with many infants displaying neurobehavioral deficits in childhood. Functional neuroimaging may provide early recognition of neural deficits in high-risk infants. Near-infrared spectroscopy (NIRS) has the advantage of providing functional neuroimaging in infants at the bedside. However, limitations in traditional NIRS have included contamination from superficial vascular dynamics in the scalp. Furthermore, controversy exists over the nature of normal vascular, responses in infants. To address these issues, we extend the use of novel high-density NIRS arrays with multiple source-detector distances and a superficial signal regression technique to infants. Evaluations of healthy term-born infants within the first three days of life are performed without sedation using a visual stimulus. We find that the regression technique significantly improves brain activation signal quality. Furthermore, in six out of eight infants, both oxy- and total hemoglobin increases while deoxyhemoglobin decreases, suggesting that, at term, the neurovascular coupling in the visual cortex is similar to that found in healthy adults. These results demonstrate the feasibility of using high-density NIRS arrays in infants to improve signal quality through superficial signal regression, and provide a foundation for further development of high-density NIRS as a clinical tool.

The effects of healthy aging on cerebral hemodynamic responses to posture change

Aging is associated with an increased incidence of orthostatic hypotension, impairment of the baroreceptor reflex and lower baseline cerebral blood flow. The effect of aging on cerebrovascular autoregulation, however, remains to be fully elucidated. We used a novel optical instrument to assess microvascular cerebral hemodynamics in the frontal lobe cortex of 60 healthy subjects ranging from ages 20-78. Diffuse correlation spectroscopy (DCS) and near-infrared spectroscopy (NIRS) were used to measure relative cerebral blood flow (rCBF), total hemoglobin concentration (THC), oxyhemoglobin concentration (HbO(2)) and deoxyhemoglobin concentration (Hb). Cerebral hemodynamics were monitored for 5 min at each of the following postures: head-of-bed 30 degrees , supine, standing and supine. Supine-to-standing posture change caused significant declines in rCBF, THC and HbO(2), and an increase in Hb, across the age continuum (p < 0.01). Healthy aging did not alter postural changes in frontal cortical rCBF (p = 0.23) and was associated with a smaller magnitude of decline in HbO(2) (p < 0.05) during supine-to-standing posture change. We conclude that healthy aging does not alter postural changes in frontal cortical perfusion.

Reaction time to peripheral visual stimuli during exercise under hypoxia

The purpose of this study was to test the hypothesis that decrease in cerebral oxygenation compromises an individual's ability to respond to peripheral visual stimuli during exercise. We measured the simple reaction time (RT) to peripheral visual stimuli at rest and during and after cycling at three different workloads [40%, 60%, and 80% peak oxygen uptake (VO2)] under either normoxia [inspired fraction of oxygen (FIO2)=0.21] or normobaric hypoxia (FIO2=0.16). Peripheral visual stimuli were presented at 10 degrees to either the right or the left of the midpoint of the eyes. Cerebral oxygenation was monitored during the RT measurement over the right frontal cortex with near-infrared spectroscopy. We used the premotor component of RT (premotor time) to assess effects of exercise on the central process. The premotor time was significantly longer during exercise at 80% peak VO2 (normoxia: 214.2+/-33.0 ms, hypoxia: 221.5+/-30.1 ms) relative to that at rest (normoxia: 201.0+/-27.2 ms, hypoxia: 202.9+/-29.7 ms) (P<0.01). Under normoxia, cerebral oxygenation gradually increased up to 60% peak VO2 and then decreased to the resting level at 80% peak VO2. Under hypoxia, cerebral oxygenation progressively decreased as exercise workload increased. We found a strong correlation between increase in premotor time and decrease in cerebral oxygenation (r2=0.89, P<0.01), suggesting that increase in premotor time during exercise is associated with decrease in cerebral oxygenation. Accordingly, exercise at high altitude may compromise visual perceptual performance.

Basic principles and concepts underlying recent advances in magnetic resonance imaging of the developing brain

Over the last decade, magnetic resonance (MR) imaging has become an essential tool in the evaluation of both in vivo human brain development and perinatal brain injury. Recent technology including MR-compatible neonatal incubators, neonatal head coils, advanced MR pulse sequences, and 3-T field strength magnets allow high-quality MR imaging studies to be performed on sick neonates. This article will review basic principles and concepts underlying recent advances in MR spectroscopy, diffusion, perfusion, and volumetric MR imaging. These techniques provide quantitative assessment and novel insight of both brain development and brain injury in the immature brain. Knowledge of normal developmental changes in quantitative MR values is also essential to interpret pathologic cases.

Effect of bladderbox alarms during venoarterial extracorporeal membrane oxygenation on cerebral oxygenation and hemodynamics in lambs

To determine the effects of bladderbox alarms during venoarterial extracorporeal membrane oxygenation (va-ECMO) on cerebral oxygenation and hemodynamics, six lambs were prospectively treated with va-ECMO and bladderbox alarms were simulated. Changes in concentrations of oxyhemoglobin (deltacO2Hb), deoxyhemoglobin (deltacHHb), and total Hb (deltactHb) were measured using near infrared spectrophotometry. Fluctuations in Hb oxygenation index (deltaHbD) and cerebral blood volume (deltaCBV) were calculated. Heart rate (HR), mean arterial pressure (MAP), blood flow in the left carotid artery (Qcar), and central venous pressure (CVP) were registered. Bladderbox alarms were simulated by increasing the ECMO flow or partially clamping the venous cannula and resolved by decreasing the ECMO flow, unclamping the cannula, or intravascular volume administration. CBV, HbD, MAP, and Qcar decreased significantly during bladderbox alarms, whereas HR and CVP increased. After the bladderbox alarms, CBV and HbD increased significantly to values above baseline. For HbD, this increase was higher during intravascular volume administration.MAP, Qcar, and CVP recovered to preexperiment values but increased further with volume administration. HR was increased at the end of our measurements. We conclude that Bladderbox alarms during va-ECMO treatment result in significant fluctuations in cerebral oxygenation and hemodynamics, a possible risk factor for intracranial lesions.

Brain cortical mapping by simultaneous recording of functional near infrared spectroscopy and electroencephalograms from the whole brain during right median nerve stimulation

To investigate relationships between hemodynamic responses and neural activities in the somatosensory cortices, hemodynamic responses by near infrared spectroscopy (NIRS) and electroencephalograms (EEGs) were recorded simultaneously while subjects received electrical stimulation in the right median nerve. The statistical significance of the hemodynamic responses was evaluated by a general linear model (GLM) with the boxcar design matrix convoluted with Gaussian function. The resulting NIRS and EEGs data were stereotaxically superimposed on the reconstructed brain of each subject. The NIRS data indicated that changes in oxy-hemoglobin concentration increased at the contralateral primary somatosensory (SI) area; responses then spread to the more posterior and ipsilateral somatosensory areas. The EEG data indicated that positive somatosensory evoked potentials peaking at 22 ms latency (P22) were recorded from the contralateral SI area. Comparison of these two sets of data indicated that the distance between the dipoles of P22 and NIRS channels with maximum hemodynamic responses was less than 10 mm, and that the two topographical maps of hemodynamic responses and current source density of P22 were significantly correlated. Furthermore, when onset of the boxcar function was delayed 5-15 s (onset delay), hemodynamic responses in the bilateral parietal association cortices posterior to the SI were more strongly correlated to electrical stimulation. This suggests that GLM analysis with onset delay could reveal the temporal ordering of neural activation in the hierarchical somatosensory pathway, consistent with the neurophysiological data. The present results suggest that simultaneous NIRS and EEG recording is useful for correlating hemodynamic responses to neural activity.

Right prefrontal brain activation due to Stroop interference is altered in attention-deficit hyperactivity disorder - A functional near-infrared spectroscopy study

Attention-deficit hyperactivity disorder is a common finding in school children. Because it was suggested to be related to frontal lobe dysfunction, we hypothesized that brain activation would be altered during an event-related color-word matching Stroop task in comparison to a healthy control group. Twelve medication-free boys suffering from attention-deficit hyperactivity disorder were compared with 12 education- and age-matched healthy boys. As an imaging method we applied functional near-infrared spectroscopy, because it is particularly insensitive to movement artifacts and, accordingly, well suited for studies in children. Generally, the Stroop task led to activations in the lateral prefrontal cortex of both patients and control subjects. Moreover, data suggest that Stroop interference elicited (presumably compensatory) higher oxygen consumption and brain activation in the right dorsolateral prefrontal cortex of boys with attention-deficit hyperactivity disorder. This effect was not confounded by behavioral differences, because boys with attention-deficit hyperactivity disorder showed only a non-specifically increased reaction time in comparison with control subjects. In sum, our results indicate that attention-deficit hyperactivity disorder is characterized by functional impairments of the dorsolateral prefrontal cortex. Our study further establishes functional near-infrared spectroscopy as an imaging tool for studies in neurodevelopment and child and adolescent psychiatry.

Changes in cerebral oxygenation and hemodynamics during cranial ultrasound in preterm infants

OBJECTIVES

To evaluate whether application of a transducer on the anterior fontanelle during cranial ultrasound (US) examination effects cerebral hemodynamics and oxygenation in preterm infants. STUDY DESIGN*: During cranial US examination, changes in cerebral blood oxygenation (cHbD) and cerebral blood volume (CBV) were assessed using near infrared spectrophotometry (NIRS) in 76 infants (GA 30.7 (4.1)wk, BW 1423 (717)g) within two days after birth. Ten of these infants (GA 29.1 (1.6)wk, BW 1092 (455)g) were studied again at a postnatal age of one week. RESULTS*: We obtained stable and consistent NIRS registrations in 54 infants within the first two days after birth. Twenty-eight of these infants showed a decrease in cHbD (0.59 (0.54) micromol/100g) during the scanning procedure while CBV did not change. Twenty-four infants showed no changes in NIRS and 2 infants showed an atypical NIRS response during cranial US examination. At the postnatal age of one week, stable and consistent NIRS registrations were obtained in 7 infants. None of these infants showed changes in NIRS variables during cranial US examination.

CONCLUSIONS

Application of an US transducer on the anterior fontanelle causes changes in cerebral oxygenation and hemodynamics in a substantial number of preterm infants. ( *values are expressed as median (interquartile range)).