Three-dimensional whole-head optical tomography of passive motor evoked responses in the neonate

Maternal prenatal depressive symptoms and child brain responses to affective touch at two years of age

BACKGROUND

Touch is an essential form of mother-child interaction, instigating better social bonding and emotional stability.

METHODS

We used diffuse optical tomography to explore the relationship between total haemoglobin (HbT) responses to affective touch in the child's brain at two years of age and maternal self-reported prenatal depressive symptoms (EPDS). Affective touch was implemented via slow brushing of the child's right forearm at 3 cm/s and non-affective touch via fast brushing at 30 cm/s and HbT responses were recorded on the left hemisphere.

RESULTS

We discovered a cluster in the postcentral gyrus exhibiting a negative correlation (Pearson's r = -0.84, p = 0.015 corrected for multiple comparisons) between child HbT response to affective touch and EPDS at gestational week 34. Based on region of interest (ROI) analysis, we found negative correlations between child responses to affective touch and maternal prenatal EPDS at gestational week 14 in the precentral gyrus, Rolandic operculum and secondary somatosensory cortex. The responses to non-affective touch did not correlate with EPDS in these regions.

LIMITATIONS

The number of mother-child dyads was 16. However, by utilising high-density optode arrangements, individualised anatomical models, and video and accelerometry to monitor movement, we were able to minimize methodological sources of variability in the data.

CONCLUSIONS

The results show that maternal depressive symptoms during pregnancy may be associated with reduced child responses to affective touch in the temporoparietal cortex. Responses to affective touch may be considered as potential biomarkers for psychosocial development in children. Early identification of and intervention in maternal depression may be important already during early pregnancy.

Multi-modulated frequency domain high density diffuse optical tomography

Frequency domain (FD) high density diffuse optical tomography (HD-DOT) utilising varying or combined modulation frequencies (mFD) has shown to theoretically improve the imaging accuracy as compared to conventional continuous wave (CW) measurements. Using intensity and phase data from a solid inhomogeneous phantom (NEUROPT) with three insertable rods containing different contrast anomalies, at modulation frequencies of 78 MHz, 141 MHz and 203 MHz, HD-DOT is applied and quantitatively evaluated, showing that mFD outperforms FD and CW for both absolute (iterative) and temporal (linear) tomographic imaging. The localization error (LOCA), full width half maximum (FWHM) and effective resolution (ERES) were evaluated. Across all rods, the LOCA of mFD was 61.3% better than FD and 106.1% better than CW. For FWHM, CW was 6.0% better than FD and mFD and for ERES, mFD was 1.20% better than FD and 9.83% better than CW. Using mFD data is shown to minimize the effect of inherently noisier FD phase data whilst maximising its strengths through improved contrast.

Imaging affective and non-affective touch processing in two-year-old children

Touch is an important component of early parent-child interaction and plays a critical role in the socio-emotional development of children. However, there are limited studies on touch processing amongst children in the age range from one to three years. The present study used frequency-domain diffuse optical tomography (DOT) to investigate the processing of affective and non-affective touch over left frontotemporal brain areas contralateral to the stimulated forearm in two-year-old children. Affective touch was administered by a single stroke with a soft brush over the child's right dorsal forearm at 3 cm/s, while non-affective touch was provided by multiple brush strokes at 30 cm/s. We found that in the insula, the total haemoglobin (HbT) response to slow brushing was significantly greater than the response to fast brushing (slow > fast). Additionally, a region in the postcentral gyrus, Rolandic operculum and superior temporal gyrus exhibited greater response to fast brushing than slow brushing (fast > slow). These findings confirm that an adult-like pattern of haemodynamic responses to affective and non-affective touch can be recorded in two-year-old subjects using DOT. To improve the accuracy of modelling light transport in the two-year-old subjects, we used a published age-appropriate atlas and deformed it to match the exterior shape of each subject's head. We estimated the combined scalp and skull, and grey matter (GM) optical properties by fitting simulated data to calibrated and coupling error corrected phase and amplitude measurements. By utilizing a two-compartment cerebrospinal fluid (CSF) model, the accuracy of estimation of GM optical properties and the localization of activation in the insula was improved. The techniques presented in this paper can be used to study neural development of children at different ages and illustrate that the technology is well-tolerated by most two-year-old children and not excessively sensitive to subject movement. The study points the way towards exciting possibilities in functional imaging of deeper functional areas near sulci in small children.

Wavelength and pulse energy optimization for detecting hypoxia in photoacoustic imaging of the neonatal brain: a simulation study

Cerebral hypoxia is a severe injury caused by oxygen deprivation to the brain. Hypoxia in the neonatal period increases the risk for the development of neurological disorders, including hypoxic-ischemic encephalopathy, cerebral palsy, periventricular leukomalacia, and hydrocephalus. It is crucial to recognize hypoxia as soon as possible because early intervention improves outcomes. Photoacoustic imaging, using at least two wavelengths, through a spectroscopic analysis, can measure brain oxygen saturation. Due to the spectral coloring effect arising from the dependency of optical properties of biological tissues to the wavelength of light, choosing the right wavelength-pair for efficient and most accurate oxygen saturation measurement and consequently quantifying hypoxia at a specific depth is critical. Using a realistic neonate head model and Monte Carlo simulations, we found practical wavelength-pairs that quantified regions with hypoxia most accurately at different depths down to 22 mm into the cortex neighboring the lateral ventricle. We also demonstrated, for the first time, that the accuracy of the sO₂ measurement can be increased by adjusting the level of light energy for each wavelength-pair. Considering the growing interest in photoacoustic imaging of the brain, this work will assist in a more accurate use of photoacoustic spectroscopy and help in the clinical translation of this promising imaging modality. Please note that explaining the effect of acoustic aberration of the skull is not in the scope of this study.

Quantitative evaluation of frequency domain measurements in high density diffuse optical tomography

SIGNIFICANCE

High density diffuse optical tomography (HD-DOT) as applied in functional near-infrared spectroscopy (fNIRS) is largely limited to continuous wave (CW) data. Using a single modulation frequency, frequency domain (FD) HD-DOT has recently demonstrated better localization of focal activation as compared to CW data. We show that combining CW and FD measurements and multiple modulation frequencies increases imaging performance in fNIRS.

AIM

We evaluate the benefits of multiple modulation frequencies, combining different frequencies as well as CW data in fNIRS HD-DOT.

APPROACH

A layered model was used, with activation occurring within a cortex layer. CW and FD measurements were simulated at 78, 141, and 203 MHz with and without noise. The localization error, full width half maximum, and effective resolution were evaluated.

RESULTS

Across the average of the three metrics, at 141 MHz, FD performed 8.4% better than CW, and the combination of CW and FD was 21.7% better than CW. FD measurements at 203 MHz performed 5% better than 78 MHz. Moreover, the three combined modulation frequencies of FD and CW performed up to 3.92% better than 141 MHz alone.

CONCLUSIONS

We show that combining CW and FD measurements offers better performance than FD alone, with higher modulation frequencies increasing accuracy. Combining CW and FD measurements at multiple modulation frequencies yields the best overall performance.

Evaluation of temporal moments and Fourier transformed data in time-domain diffuse optical tomography

Time-domain diffuse optical tomography (TD-DOT) uses near-infrared pulsed lasers as light sources to measure time-varying exitance on the boundary of the target. These are used to estimate optical properties of the imaged target. Several integral-transform-based moments of the time-resolved data have been utilized in TD-DOT, the most common being the mean time of flight and variance. Recently, it has been shown that Fourier transforming the time-domain data to frequency domain enables utilization of these data at one or several frequencies, producing equally as good estimates as the whole time-domain data. In this work, we present a systematic comparison of the usage of the temporal moments and Fourier transformed data in TD-DOT. Both absolute and difference imaging are evaluated using numerical simulations. The simulations show that utilizing temporal moments and Fourier transformed data in TD-DOT provides good quality reconstructions with a good estimation accuracy. These estimates are improved if more than one data type is used. Furthermore, the simulations show that the frequency-domain computations enable computationally cheaper and straightforward implementation of the inverse solver when compared to the temporal moments.

Improving vascular imaging with co-planar mutually guided photoacoustic and diffuse optical tomography: a simulation study

Diffuse optical tomography (DOT) and photoacoustic tomography (PAT) are functional imaging modalities that provide absorption coefficient maps of the tissue. Spatial resolution of DOT is relatively low due to light scattering characteristics of the tissue. On the other hand, although PAT can resolve regions of different absorptions with a high spatial resolution, measuring the absolute value of optical absorptions using PAT is challenging due to unknown light fluence distribution in the tissue. Development of image guidance techniques using a priori information of imaging target structure has been shown to increase the accuracy of DOT. PAT is one such method that can be used as a complementary modality to serve as a guide for DOT image reconstruction. On the other hand, estimated fluence map provided by DOT can be used to quantitatively correct PAT images. In this study we introduce a mutually-guided imaging system for fast and simultaneous optical and photoacoustic measurements of tissue absorption map, where DOT is guided by the PAT image and vice versa. Using the obtained absorption map of the tissue, we then estimate the tissue scattering map. We conducted this study using a series of simulations on digital phantoms and demonstrated the effectiveness of the proposed method.

Time-domain diffuse optical tomography utilizing truncated Fourier series approximation

Diffuse optical tomography (DOT) uses near infrared light for in vivo imaging of spatially varying optical parameters in biological tissues. It is known that time-resolved measurements provide the richest information on soft tissues, among other measurement types in DOT such as steady-state and intensity-modulated measurements. Therefore, several integral-transform-based moments of the time-resolved DOT measurements have been considered to estimate spatially distributed optical parameters. However, the use of such moments can result in low-contrast images and cross-talks between the reconstructed optical parameters, limiting their accuracy. In this work, we propose to utilize a truncated Fourier series approximation in time-resolved DOT. Using this approximation, we obtained optical parameter estimates with accuracy comparable to using whole time-resolved data that uses low computational time and resources. The truncated Fourier series approximation based estimates also displayed good contrast and minimal parameter cross-talk, and the estimates further improved in accuracy when multiple Fourier frequencies were used.

Estimating blood oxygenation from photoacoustic images: can a simple linear spectroscopic inversion ever work?

Linear spectroscopic inversions, in which photoacoustic amplitudes are assumed to be directly proportional to absorption coefficients, are widely used in photoacoustic imaging to estimate blood oxygen saturation because of their simplicity. Unfortunately, they do not account for the spatially varying wavelength-dependence of the light fluence within the tissue, which introduces "spectral coloring," a potentially significant source of error. However, accurately correcting for spectral coloring is challenging, so we investigated whether there are conditions, e.g., sets of wavelengths, where it is possible to ignore the spectral coloring and still obtain accurate oxygenation measurements using linear inversions. Accurate estimates of oxygenation can be obtained when the wavelengths are chosen to (i) minimize spectral coloring, (ii) avoid ill-conditioning, and (iii) maintain a sufficiently high signal-to-noise ratio (SNR) for the estimates to be meaningful. It is not obvious which wavelengths will satisfy these conditions, and they are very likely to vary for different imaging scenarios, making it difficult to find general rules. Through the use of numerical simulations, we isolated the effect of spectral coloring from sources of experimental error. It was shown that using wavelengths between 500 nm and 1000 nm yields inaccurate estimates of oxygenation and that careful selection of wavelengths in the 620- to 920-nm range can yield more accurate oxygenation values. However, this is only achievable with a good prior estimate of the true oxygenation. Even in this idealized case, it was shown that considerable care must be exercised over the choice of wavelengths when using linear spectroscopic inversions to obtain accurate estimates of blood oxygenation. This suggests that for a particular imaging scenario, obtaining accurate and reliable oxygenation estimates using linear spectroscopic inversions requires careful modeling or experimental studies of that scenario, taking account of the instrumentation, tissue anatomy, likely sO₂ range, and image formation process.

Clinical Brain Monitoring with Time Domain NIRS: A Review and Future Perspectives

Near-infrared spectroscopy (NIRS) is an optical technique that can measure brain tissue oxygenation and haemodynamics in real-time and at the patient bedside allowing medical doctors to access important physiological information. However, despite this, the use of NIRS in a clinical environment is hindered due to limitations, such as poor reproducibility, lack of depth sensitivity and poor brain-specificity. Time domain NIRS (or TD-NIRS) can resolve these issues and offer detailed information of the optical properties of the tissue, allowing better physiological information to be retrieved. This is achieved at the cost of increased instrument complexity, operation complexity and price. In this review, we focus on brain monitoring clinical applications of TD-NIRS. A total of 52 publications were identified, spanning the fields of neonatal imaging, stroke assessment, traumatic brain injury (TBI) assessment, brain death assessment, psychiatry, peroperative care, neuronal disorders assessment and communication with patient with locked-in syndrome. In all the publications, the advantages of the TD-NIRS measurement to (1) extract absolute values of haemoglobin concentration and tissue oxygen saturation, (2) assess the reduced scattering coefficient, and (3) separate between extra-cerebral and cerebral tissues, are highlighted; and emphasize the utility of TD-NIRS in a clinical context. In the last sections of this review, we explore the recent developments of TD-NIRS, in terms of instrumentation and methodologies that might impact and broaden its use in the hospital.

Time-Domain Near-Infrared Spectroscopy and Imaging: A Review

This article reviews the past and current statuses of time-domain near-infrared spectroscopy (TD-NIRS) and imaging. Although time-domain technology is not yet widely employed due to its drawbacks of being cumbersome, bulky, and very expensive compared to commercial continuous wave (CW) and frequency-domain (FD) fNIRS systems, TD-NIRS has great advantages over CW and FD systems because time-resolved data measured by TD systems contain the richest information about optical properties inside measured objects. This article focuses on reviewing the theoretical background, advanced theories and methods, instruments, and studies on clinical applications for TD-NIRS including some clinical studies which used TD-NIRS systems. Major events in the development of TD-NIRS and imaging are identified and summarized in chronological tables and figures. Finally, prospects for TD-NIRS in the near future are briefly described.

Neonatal brain injury and aberrant connectivity

Brain injury sustained during the neonatal period may disrupt development of critical structural and functional connectivity networks leading to subsequent neurodevelopmental impairment in affected children. These networks can be characterized using structural (via diffusion MRI) and functional (via resting state-functional MRI) neuroimaging techniques. Advances in neuroimaging have led to expanded application of these approaches to study term- and prematurely-born infants, providing improved understanding of cerebral development and the deleterious effects of early brain injury. Across both modalities, neuroimaging data are conducive to analyses ranging from characterization of individual white matter tracts and/or resting state networks through advanced 'connectome-style' approaches capable of identifying highly connected network hubs and investigating metrics of network topology such as modularity and small-worldness. We begin this review by summarizing the literature detailing structural and functional connectivity findings in healthy term and preterm infants without brain injury during the postnatal period, including discussion of early connectome development. We then detail common forms of brain injury in term- and prematurely-born infants. In this context, we next review the emerging body of literature detailing studies employing diffusion MRI, resting state-functional MRI and other complementary neuroimaging modalities to characterize structural and functional connectivity development in infants with brain injury. We conclude by reviewing technical challenges associated with neonatal neuroimaging, highlighting those most relevant to studying infants with brain injury and emphasizing the need for further targeted study in this high-risk population.

Spatial Distribution of Changes in Oxidised Cytochrome C Oxidase During Visual Stimulation Using Broadband Near Infrared Spectroscopy Imaging

Functional hyperaemia, characterised as an increase in concentration of oxyhaemoglobin [HbO₂] and a decrease in concentration of deoxyhaemoglobin [HHb] in response to neuronal activity, can be precisely mapped using diffuse optical spectroscopy. However, such techniques do not directly measure changes in metabolic activity during neuronal activation. Changes in the redox state of cerebral oxidised cytochrome c oxidase Δ[oxCCO] measured by broadband spectroscopy may be a more specific marker of neuronal metabolic activity. This study aims to investigate the spatial distribution of Δ[oxCCO] responses during the activation of the visual cortex in the healthy adult human brain, and reconstruct images of these changes.

Multi-channel broadband NIRS measurements were collected from the left visual cortex of four healthy volunteers using an in-house broadband spectrometer during an inverting checkerboard visual stimulation paradigm. Δ[HbO₂], Δ[HHb] and Δ[oxCCO] were calculated by fitting the broadband spectra between 780 and 900 nm using the UCLn algorithm. Centre of gravity analysis was applied to the concentration data to determine the centres of activation for [HbO2], [HHb] and [oxCCO].

All four subjects showed similar changes in [oxCCO] in the presence of a typical visual-evoked haemodynamic response in channels overlying the visual cortex. Image reconstruction of the optical data showed a clear and spatially localized activation for all three chromophores. Centre of gravity analysis showed different localisation of the changes in each of the three chromophores across the visual cortex with the x-y coordinates of the mean centres of gravity (across 4 subjects) of HbO₂, HHb and oxCCO at (63.1 mm; 24.8 mm), (56.2 mm; 21.0 mm) and (63.7 mm; 23.8 mm), respectively.

The spatial distribution of Δ[oxCCO] response appears distinct from the haemodynamic response in the human visual cortex. Image reconstruction of Δ[oxCCO] shows considerable promise as a technique to visualise regional variation in [oxCCO] in a range of scenarios.

Diffuse optical tomography to investigate the newborn brain

Over the past 15 years, functional near-infrared spectroscopy (fNIRS) has emerged as a powerful technology for studying the developing brain. Diffuse optical tomography (DOT) is an extension of fNIRS that combines hemodynamic information from dense optical sensor arrays over a wide field of view. Using image reconstruction techniques, DOT can provide images of the hemodynamic correlates to neural function that are comparable to those produced by functional magnetic resonance imaging. This review article explains the principles of DOT, and highlights the growing literature on the use of DOT in the study of healthy development of the infant brain, and the study of novel pathophysiology in infants with brain injury. Current challenges, particularly around instrumentation and image reconstruction, will be discussed, as will the future of this growing field, with particular focus on whole-brain, time-resolved DOT.

Structured illumination diffuse optical tomography for noninvasive functional neuroimaging in mice

Optical intrinsic signal (OIS) imaging has been a powerful tool for capturing functional brain hemodynamics in rodents. Recent wide field-of-view implementations of OIS have provided efficient maps of functional connectivity from spontaneous brain activity in mice. However, OIS requires scalp retraction and is limited to superficial cortical tissues. Diffuse optical tomography (DOT) techniques provide noninvasive imaging, but previous DOT systems for rodent neuroimaging have been limited either by sparse spatial sampling or by slow speed. Here, we develop a DOT system with asymmetric source-detector sampling that combines the high-density spatial sampling (0.4 mm) detection of a scientific complementary metal-oxide-semiconductor camera with the rapid (2 Hz) imaging of a few ([Formula: see text]) structured illumination (SI) patterns. Analysis techniques are developed to take advantage of the system's flexibility and optimize trade-offs among spatial sampling, imaging speed, and signal-to-noise ratio. An effective source-detector separation for the SI patterns was developed and compared with light intensity for a quantitative assessment of data quality. The light fall-off versus effective distance was also used for in situ empirical optimization of our light model. We demonstrated the feasibility of this technique by noninvasively mapping the functional response in the somatosensory cortex of the mouse following electrical stimulation of the forepaw.

Geometrically complex 3D-printed phantoms for diffuse optical imaging

Tissue-equivalent phantoms that mimic the optical properties of human and animal tissues are commonly used in diffuse optical imaging research to characterize instrumentation or evaluate an image reconstruction method. Although many recipes have been produced for generating solid phantoms with specified absorption and transport scattering coefficients at visible and near-infrared wavelengths, the construction methods are generally time-consuming and are unable to create complex geometries. We present a method of generating phantoms using a standard 3D printer. A simple recipe was devised which enables printed phantoms to be produced with precisely known optical properties. To illustrate the capability of the method, we describe the creation of an anatomically accurate, tissue-equivalent premature infant head optical phantom with a hollow brain space based on MRI atlas data. A diffuse optical image of the phantom is acquired when a high contrast target is inserted into the hollow space filled with an aqueous scattering solution.

New frontiers in time-domain diffuse optics, a review

The recent developments in time-domain diffuse optics that rely on physical concepts (e.g., time-gating and null distance) and advanced photonic components (e.g., vertical cavity source-emitting laser as light sources, single photon avalanche diode, and silicon photomultipliers as detectors, fast-gating circuits, and time-to-digital converters for acquisition) are focused. This study shows how these tools could lead on one hand to compact and wearable time-domain devices for point-of-care diagnostics down to the consumer level and on the other hand to powerful systems with exceptional depth penetration and sensitivity.

Overview of diffuse optical tomography and its clinical applications

Near-infrared diffuse optical tomography (DOT), one of the most sophisticated optical imaging techniques for observations through biological tissue, allows 3-D quantitative imaging of optical properties, which include functional and anatomical information. With DOT, it is expected to be possible to overcome the limitations of conventional near-infrared spectroscopy (NIRS) as well as offering the potential for diagnostic optical imaging. However, DOT has been under development for more than 30 years, and the difficulties in development are attributed to the fact that light is strongly scattered and that diffusive photons are used for the image reconstruction. The DOT algorithm is based on the techniques of inverse problems. The radiative transfer equation accurately describes photon propagation in biological tissue, while, because of its high computation load, the diffusion equation (DE) is often used as the forward model. However, the DE is invalid in low-scattering and/or highly absorbing regions and in the vicinity of light sources. The inverse problem is inherently ill-posed and highly undetermined. Here, we first summarize NIRS and then describe various approaches in the efforts to develop accurate and efficient DOT algorithms and present some examples of clinical applications. Finally, we discuss the future prospects of DOT.

Noninvasive Brain Physiology Monitoring for Extreme Environments: A Critical Review

Our ability to monitor the brain physiology is advancing; however, most of the technology is bulky, expensive, and designed for traditional clinical settings. With long-duration space exploration, there is a need for developing medical technologies that are reliable, low energy, portable, and semiautonomous. Our aim was to review the state of the art for noninvasive technologies capable of monitoring brain physiology in diverse settings. A literature review of PubMed and the Texas Medical Center library sites was performed using prespecified search criteria to identify portable technologies for monitoring physiological aspects of the brain physiology. Most brain-monitoring technologies require a moderate to high degree of operator skill. Some are low energy, but many require a constant external power supply. Most of the technologies lack the accuracy seen in gold standard measures, due to the need for calibration, but may be useful for screening or monitoring relative changes in a parameter. Most of the technologies use ultrasound or electromagnetic radiation as energy sources. There is an important need for further development of portable technologies that can be operated in a variety of extreme environments to monitor brain health.

Neurovascular Interactions in the Neurologically Compromised Neonatal Brain

Neurological brain injuries such as hypoxic ischaemic encephalopathy (HIE) and associated conditions such as seizures have been associated with poor developmental outcome in neonates. Our limited knowledge of the neurological and cerebrovascular processes underlying seizures limits their diagnosis and timely treatment. Diffuse optical tomography (DOT) provides haemodynamic information in the form of changes in concentration of de/oxygenated haemoglobin, which can improve our understanding of seizures and the relationship between neural and vascular processes. Using simultaneous EEG-DOT, we observed distinct haemodynamic changes which are temporally correlated with electrographic seizures. Here, we present DOT-EEG data from two neonates clinically diagnosed as HIE. Our results highlight the wealth of mutually-informative data that can be obtained using DOT-EEG techniques to understand neurovascular coupling in HIE neonates.

Regional Changes in Cerebral Oxygenation During Repeated Passive Movement Measured by Functional Near-infrared Spectroscopy

The aim of this study is to investigate the influence of passive movement repetition frequency at 1.5-Hz and 1-Hz on changes in cerebral oxygenation and assess the temporal properties of these changes using functional near-infrared spectroscopy (fNIRS). No significant differences in systemic hemodynamics were observed between resting and passive movement phases for either 1.5-Hz or 1-Hz trial. Changes in cortical oxygenation as measured by fNIRS in bilateral supplementary motor cortex (SMC), left primary motor cortex (M1), left primary somatosensory cortex (S1), and left posterior association area (PAA) during passive movement of the right index finger revealed greater cortical activity at only 1.5-Hz movement frequency. However, there were no significant differences in the time for peak oxyhemoglobin (oxyHb) among regions (bilateral SMC, 206.4 ± 14.4 s; left M1, 199.1 ± 14.8 s; left S1, 207.3 ± 9.4 s; left PAA, 219.1 ± 10.2 s). Therefore, our results that passive movement above a specific frequency may be required to elicit a changed in cerebral oxygenation, and the times of peak ΔoxyHb did not differ significantly among measured regions.

Nonlinear approach to difference imaging in diffuse optical tomography

Difference imaging aims at recovery of the change in the optical properties of a body based on measurements before and after the change. Conventionally, the image reconstruction is based on using difference of the measurements and a linear approximation of the observation model. One of the main benefits of the linearized difference reconstruction is that the approach has a good tolerance to modeling errors, which cancel out partially in the subtraction of the measurements. However, a drawback of the approach is that the difference images are usually only qualitative in nature and their spatial resolution can be weak because they rely on the global linearization of the nonlinear observation model. To overcome the limitations of the linear approach, we investigate a nonlinear approach for difference imaging where the images of the optical parameters before and after the change are reconstructed simultaneously based on the two datasets. We tested the feasibility of the method with simulations and experimental data from a phantom and studied how the approach tolerates modeling errors like domain truncation, optode coupling errors, and domain shape errors.

Hyperspectral optical tomography of intrinsic signals in the rat cortex

We introduce a tomographic approach for three-dimensional imaging of evoked hemodynamic activity, using broadband illumination and diffuse optical tomography (DOT) image reconstruction. Changes in diffuse reflectance in the rat somatosensory cortex due to stimulation of a single whisker were imaged at a frame rate of 5 Hz using a hyperspectral image mapping spectrometer. In each frame, images in 38 wavelength bands from 484 to 652 nm were acquired simultaneously. For data analysis, we developed a hyperspectral DOT algorithm that used the Rytov approximation to quantify changes in tissue concentration of oxyhemoglobin ([Formula: see text]) and deoxyhemoglobin (ctHb) in three dimensions. Using this algorithm, the maximum changes in [Formula: see text] and ctHb were found to occur at [Formula: see text] and [Formula: see text] beneath the surface of the cortex, respectively. Rytov tomographic reconstructions revealed maximal spatially localized increases and decreases in [Formula: see text] and ctHb of [Formula: see text] and [Formula: see text], respectively, with these maximum changes occurring at [Formula: see text] poststimulus. The localized optical signals from the Rytov approximation were greater than those from modified Beer-Lambert, likely due in part to the inability of planar reflectance to account for partial volume effects.

A Unified Sparse Recovery and Inference Framework for Functional Diffuse Optical Tomography Using Random Effect Model

Diffuse optical tomography (DOT) is a non-invasive imaging technique to reconstruct optical properties of biological tissues using near-infrared light, and it has been successfully used to measure functional brain activities via changes in cerebral blood volume and cerebral blood oxygenation. However, DOT presents a severely ill-posed inverse problem, so various types of regularization should be incorporated to overcome low spatial resolution and lack of depth sensitivity. Another limitation of the conventional DOT reconstruction methods is that an inference step is separately performed after the reconstruction, so complicated interaction between reconstruction and regularization is difficult to analyze. To overcome these technical difficulties, we propose a unified sparse recovery framework using a random effect model whose termination criterion is determined by the statistical inference. Both numerical and experimental results confirm that the proposed method outperforms the conventional approaches.

Functional Imaging of the Developing Brain at the Bedside Using Diffuse Optical Tomography

While histological studies and conventional magnetic resonance imaging (MRI) investigations have elucidated the trajectory of structural changes in the developing brain, less is known regarding early functional cerebral development. Recent investigations have demonstrated that resting-state functional connectivity MRI (fcMRI) can identify networks of functional cerebral connections in infants. However, technical and logistical challenges frequently limit the ability to perform MRI scans early or repeatedly in neonates, particularly in those at greatest risk for adverse neurodevelopmental outcomes. High-density diffuse optical tomography (HD-DOT), a portable imaging modality, potentially enables early continuous and quantitative monitoring of brain function in infants. We introduce an HD-DOT imaging system that combines advancements in cap design, ergonomics, and data analysis methods to allow bedside mapping of functional brain development in infants. In a cohort of healthy, full-term neonates scanned within the first days of life, HD-DOT results demonstrate strong congruence with those obtained using co-registered, subject-matched fcMRI and reflect patterns of typical brain development. These findings represent a transformative advance in functional neuroimaging in infants, and introduce HD-DOT as a powerful and practical method for quantitative mapping of early functional brain development in normal and high-risk neonates.

Mapping cortical haemodynamics during neonatal seizures using diffuse optical tomography: a case study

Seizures in the newborn brain represent a major challenge to neonatal medicine. Neonatal seizures are poorly classified, under-diagnosed, difficult to treat and are associated with poor neurodevelopmental outcome. Video-EEG is the current gold-standard approach for seizure detection and monitoring. Interpreting neonatal EEG requires expertise and the impact of seizures on the developing brain remains poorly understood. In this case study we present the first ever images of the haemodynamic impact of seizures on the human infant brain, obtained using simultaneous diffuse optical tomography (DOT) and video-EEG with whole-scalp coverage. Seven discrete periods of ictal electrographic activity were observed during a 60 minute recording of an infant with hypoxic-ischaemic encephalopathy. The resulting DOT images show a remarkably consistent, high-amplitude, biphasic pattern of changes in cortical blood volume and oxygenation in response to each electrographic event. While there is spatial variation across the cortex, the dominant haemodynamic response to seizure activity consists of an initial increase in cortical blood volume prior to a large and extended decrease typically lasting several minutes. This case study demonstrates the wealth of physiologically and clinically relevant information that DOT-EEG techniques can yield. The consistency and scale of the haemodynamic responses observed here also suggest that DOT-EEG has the potential to provide improved detection of neonatal seizures.

Reconstruction of localized fluorescent target from multi-view continuous-wave surface images of small animal with lp sparsity regularization

Fluorescence diffuse optical tomography using a multi-view continuous-wave and non-contact measurement system and an algorithm incorporating the lp (0 < p ≤ 1) sparsity regularization reconstructs a localized fluorescent target in a small animal. The measurement system provides a total of 25 fluorescence surface 2D-images of an object, which are acquired by a CCD camera from five different angles of view with excitation from five different angles. Fluorescence surface emissions from five different angles of view are simultaneously imaged on the CCD sensor, thus leading to fast acquisition of the 25 images within three minutes. The distributions of the fluorophore are reconstructed by solving the inverse problem based on the photon diffusion equations. In the reconstruction process incorporating the lp sparsity regularization, the regularization term is reformulated as a differentiable function for gradient-based non-linear optimization. Numerical simulations and phantom experiments show that the use of the lp sparsity regularization improves the localization of the target and quantitativeness of the fluorophore concentration. A mouse experiment demonstrates that a localized fluorescent target in a mouse is successfully reconstructed.

MONSTIR II: a 32-channel, multispectral, time-resolved optical tomography system for neonatal brain imaging

We detail the design, construction and performance of the second generation UCL time-resolved optical tomography system, known as MONSTIR II. Intended primarily for the study of the newborn brain, the system employs 32 source fibres that sequentially transmit picosecond pulses of light at any four wavelengths between 650 and 900 nm. The 32 detector channels each contain an independent photo-multiplier tube and temporally correlated photon-counting electronics that allow the photon transit time between each source and each detector position to be measured with high temporal resolution. The system's response time, temporal stability, cross-talk, and spectral characteristics are reported. The efficacy of MONSTIR II is demonstrated by performing multi-spectral imaging of a simple phantom.

Pre-seizure state identified by diffuse optical tomography

In epilepsy it has been challenging to detect early changes in brain activity that occurs prior to seizure onset and to map their origin and evolution for possible intervention. Here we demonstrate using a rat model of generalized epilepsy that diffuse optical tomography (DOT) provides a unique functional neuroimaging modality for noninvasively and continuously tracking such brain activities with high spatiotemporal resolution. We detected early hemodynamic responses with heterogeneous patterns, along with intracranial electroencephalogram gamma power changes, several minutes preceding the electroencephalographic seizure onset, supporting the presence of a "pre-seizure" state. We also observed the decoupling between local hemodynamic and neural activities. We found widespread hemodynamic changes evolving from local regions of the bilateral cortex and thalamus to the entire brain, indicating that the onset of generalized seizures may originate locally rather than diffusely. Together, these findings suggest DOT represents a powerful tool for mapping early seizure onset and propagation pathways.

Multi-channel medical device for time domain functional near infrared spectroscopy based on wavelength space multiplexing

We have designed a compact dual wavelength (687 nm, 826 nm) multi-channel (16 sources, 8 detectors) medical device for muscle and brain imaging based on time domain functional near infrared spectroscopy. The system employs the wavelength space multiplexing approach to reduce wavelength cross-talk and increase signal-to-noise ratio. System performances have been tested on homogeneous and heterogeneous tissue phantoms following specifically designed protocols for photon migration instruments. Preliminary in vivo measurements have been performed to validate the instrument capability to monitor hemodynamic parameters changes in the arm muscle during arterial occlusion and in the adult head during a motor task experiment.

Statistical analysis of high density diffuse optical tomography

High density diffuse optical tomography (HD-DOT) is a noninvasive neuroimaging modality with moderate spatial resolution and localization accuracy. Due to portability and wear-ability advantages, HD-DOT has the potential to be used in populations that are not amenable to functional magnetic resonance imaging (fMRI), such as hospitalized patients and young children. However, whereas the use of event-related stimuli designs, general linear model (GLM) analysis, and imaging statistics are standardized and routine with fMRI, such tools are not yet common practice in HD-DOT. In this paper we adapt and optimize fundamental elements of fMRI analysis for application to HD-DOT. We show the use of event-related protocols and GLM de-convolution analysis in un-mixing multi-stimuli event-related HD-DOT data. Statistical parametric mapping (SPM) in the framework of a general linear model is developed considering the temporal and spatial characteristics of HD-DOT data. The statistical analysis utilizes a random field noise model that incorporates estimates of the local temporal and spatial correlations of the GLM residuals. The multiple-comparison problem is addressed using a cluster analysis based on non-stationary Gaussian random field theory. These analysis tools provide access to a wide range of experimental designs necessary for the study of the complex brain functions. In addition, they provide a foundation for understanding and interpreting HD-DOT results with quantitative estimates for the statistical significance of detected activation foci.

Singular value decomposition based regularization prior to spectral mixing improves crosstalk in dynamic imaging using spectral diffuse optical tomography

The spectrally constrained diffuse optical tomography (DOT) method relies on incorporating spectral prior information directly into the image reconstruction algorithm, thereby correlating the underlying optical properties across multiple wavelengths. Although this method has been shown to provide a solution that is stable, the use of conventional Tikhonov-type regularization techniques can lead to additional crosstalk between parameters, particularly in linear, single-step dynamic imaging applications. This is due mainly to the suboptimal regularization of the spectral Jacobian matrix, which smoothes not only the image-data space, but also the spectral mapping space. In this work a novel regularization technique based on the singular value decomposition (SVD) is presented that preserves the spectral prior information while regularizing the Jacobian matrix, leading to dramatically reduced crosstalk between the recovered parameters. Using simulated data, images of changes in oxygenated and deoxygenated hemoglobin concentrations are reconstructed via the SVD-based approach and compared with images reconstructed by using non-spectral and conventional spectral methods. In a 2D, two wavelength example, it is shown that the proposed approach provides a 98% reduction in crosstalk between recovered parameters as compared with conventional spectral reconstruction algorithms, and 60% as compared with non-spectrally constrained algorithms. Using a subject specific multilayered model of the human head, a noiseless dynamic simulation of cortical activation is performed to further demonstrate such improvement in crosstalk. However, with the addition of realistic noise in the data, both non-spectral and proposed algorithms perform similarly, indicating that the use of spectrally constrained reconstruction algorithms in dynamic DOT may be limited by the contrast of the signal as well as the noise characteristics of the system.

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.

Fast multispectral diffuse optical tomography system for in vivo three-dimensional imaging of seizure dynamics

We describe a multispectral continuous-wave diffuse optical tomography (DOT) system that can be used for in vivo three-dimensional (3-D) imaging of seizure dynamics. Fast 3-D data acquisition is realized through a time multiplexing approach based on a parallel lighting configuration--our system can achieve 0.12 ms per source per wavelength and up to a 14 Hz sampling rate for a full set of data for 3-D DOT image reconstruction. The system is validated using both static and dynamic tissue-like phantoms. An initial in vivo experiment using a rat model of seizure is also demonstrated.

Image quality analysis of high-density diffuse optical tomography incorporating a subject-specific head model

High-density diffuse optical tomography (HD-DOT) methods have shown significant improvement in localization accuracy and image resolution compared to traditional topographic near infrared spectroscopy of the human brain. In this work we provide a comprehensive evaluation of image quality in visual cortex mapping via a simulation study with the use of an anatomical head model derived from MRI data of a human subject. A model of individual head anatomy provides the surface shape and internal structure that allow for the construction of a more realistic physical model for the forward problem, as well as the use of a structural constraint in the inverse problem. The HD-DOT model utilized here incorporates multiple source-detector separations with continuous-wave data with added noise based on experimental results. To evaluate image quality we quantify the localization error and localized volume at half maximum (LVHM) throughout a region of interest within the visual cortex and systematically analyze the use of whole-brain tissue spatial constraint within image reconstruction. Our results demonstrate that an image quality with less than 10 mm in localization error and 1000 m³ in LVHM can be obtained up to 13 mm below the scalp surface with a typical unconstrained reconstruction and up to 18 mm deep when a whole-brain spatial constraint based on the brain tissue is utilized.

Validating atlas-guided DOT: a comparison of diffuse optical tomography informed by atlas and subject-specific anatomies

We describe the validation of an anatomical brain atlas approach to the analysis of diffuse optical tomography (DOT). Using MRI data from 32 subjects, we compare the diffuse optical images of simulated cortical activation reconstructed using a registered atlas with those obtained using a subject's true anatomy. The error in localization of the simulated cortical activations when using a registered atlas is due to a combination of imperfect registration, anatomical differences between atlas and subject anatomies and the localization error associated with diffuse optical image reconstruction. When using a subject-specific MRI, any localization error is due to diffuse optical image reconstruction only. In this study we determine that using a registered anatomical brain atlas results in an average localization error of approximately 18 mm in Euclidean space. The corresponding error when the subject's own MRI is employed is 9.1 mm. In general, the cost of using atlas-guided DOT in place of subject-specific MRI-guided DOT is a doubling of the localization error. Our results show that despite this increase in error, reasonable anatomical localization is achievable even in cases where the subject-specific anatomy is unavailable.

A brief review on the history of human functional near-infrared spectroscopy (fNIRS) development and fields of application

This review is aimed at celebrating the upcoming 20th anniversary of the birth of human functional near-infrared spectroscopy (fNIRS). After the discovery in 1992 that the functional activation of the human cerebral cortex (due to oxygenation and hemodynamic changes) can be explored by NIRS, human functional brain mapping research has gained a new dimension. fNIRS or optical topography, or near-infrared imaging or diffuse optical imaging is used mainly to detect simultaneous changes in optical properties of the human cortex from multiple measurement sites and displays the results in the form of a map or image over a specific area. In order to place current fNIRS research in its proper context, this paper presents a brief historical overview of the events that have shaped the present status of fNIRS. In particular, technological progresses of fNIRS are highlighted (i.e., from single-site to multi-site functional cortical measurements (images)), introduction of the commercial multi-channel systems, recent commercial wireless instrumentation and more advanced prototypes.

Source localization approach for functional DOT using MUSIC and FDR control

In this paper, we formulate diffuse optical tomography (DOT) problems as a source localization problem and propose a MUltiple SIgnal Classification (MUSIC) algorithm for functional brain imaging application. By providing MUSIC spectra for major chromophores such as oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR), we are able to investigate the spatial distribution of brain activities. Moreover, the false discovery rate (FDR) algorithm can be applied to control the family-wise error in the MUSIC spectra. The minimum distance between the center of mass in DOT and the Montreal Neurological Institute (MNI) coordinates of target regions in experiments was between approximately 6 and 18 mm, and the displacement of the center of mass in DOT and fMRI ranged between 12 and 28 mm, which demonstrate the legitimacy of the DOT-based imaging. The proposed brain mapping method revealed its potential as an alternative algorithm to monitor the brain activation.

A quantitative spatial comparison of high-density diffuse optical tomography and fMRI cortical mapping

Functional neuroimaging commands a dominant role in current neuroscience research. However its use in bedside clinical and certain neuro-scientific studies has been limited because the current tools lack the combination of being non-invasive, non-ionizing and portable while maintaining moderate resolution and localization accuracy. Optical neuroimaging satisfies many of these requirements, but, until recent advances in high-density diffuse optical tomography (HD-DOT), has been hampered by limited resolution. While early results of HD-DOT have been promising, a quantitative voxel-wise comparison and validation of HD-DOT against the gold standard of functional magnetic resonance imaging (fMRI) has been lacking. Herein, we provide such an analysis within the visual cortex using matched visual stimulation protocols in a single group of subjects (n=5) during separate HD-DOT and fMRI scanning sessions. To attain the needed voxel-to-voxel co-registration between HD-DOT and fMRI image spaces, we implemented subject-specific head modeling that incorporated MRI anatomy, detailed segmentation, and alignment of source and detector positions. Comparisons of the visual responses found an average localization error between HD-DOT and fMRI of 4.4+/-1mm, significantly less than the average distance between cortical gyri. This specificity demonstrates that HD-DOT has sufficient image quality to be useful as a surrogate for fMRI.

Somatosensory activation of two fingers can be discriminated with ultrahigh-density diffuse optical tomography

Topographic non-invasive near infrared spectroscopy (NIRS) has become a well-established tool for functional brain imaging. Applying up to 100 optodes over the head of a subject, allows achieving a spatial resolution in the centimeter range. This resolution is poor compared to other functional imaging tools. However, recently it was shown that diffuse optical tomography (DOT) as an extension of NIRS based on high-density (HD) probe arrays and supplemented by an advanced image reconstruction procedure allows describing activation patterns with a spatial resolution in the millimeter range. Building on these findings, we hypothesize that HD-DOT may render very focal activations accessible which would be missed by the traditionally used sparse arrays. We examined activation patterns in the primary somatosensory cortex, since its somatotopic organization is very fine-grained. We performed a vibrotactile stimulation study of the first and fifth finger in eight human subjects, using a 900-channel continuous-wave DOT imaging system for achieving a higher resolution than conventional topographic NIRS. To compare the results to a well-established high-resolution imaging technique, the same paradigm was investigated in the same subjects by means of functional magnetic resonance imaging (fMRI). In this work, we tested the advantage of ultrahigh-density probe arrays and show that highly focal activations would be missed by classical next-nearest neighbor NIRS approach, but also by DOT, when using a sparse probe array. Distinct activation patterns for both fingers correlated well with the expected neuroanatomy in five of eight subjects. Additionally we show that activation for different fingers is projected to different tissue depths in the DOT image. Comparison to the fMRI data yielded similar activation foci in seven out of ten finger representations in these five subjects when comparing the lateral localization of DOT and fMRI results.

Improvement of image quality of time-domain diffuse optical tomography with l sparsity regularization

An l(p) (0 < p ≤ 1) sparsity regularization is applied to time-domain diffuse optical tomography with a gradient-based nonlinear optimization scheme to improve the spatial resolution and the robustness to noise. The expression of the l(p) sparsity regularization is reformulated as a differentiable function of a parameter to avoid the difficulty in calculating its gradient in the optimization process. The regularization parameter is selected by the L-curve method. Numerical experiments show that the l(p) sparsity regularization improves the spatial resolution and recovers the difference in the absorption coefficients between two targets, although a target with a small absorption coefficient may disappear due to the strong effect of the l(p) sparsity regularization when the value of p is too small. The l(p) sparsity regularization with small p values strongly localizes the target, and the reconstructed region of the target becomes smaller as the value of p decreases. A phantom experiment validates the numerical simulations.

Reduction of image artifacts induced by change in the optode coupling in time-resolved diffuse optical tomography

Tomographic images of the optical properties can be reconstructed using inversion algorithms for diffuse optical tomography (DOT); however, changes in the optode coupling that occurs while obtaining an object's measurements may often lead to the presence of artifacts in the reconstructed images. To reduce the number of artifacts induced by optode coupling, previous studies have introduced (unknown) coupling coefficients in reconstruction algorithms, which were found to be effective for continuous wave- and frequency-domain DOT. This study aims to investigate the effects of optode calibration on the reconstructed images of time-domain DOT. Here, coupling coefficients are incorporated into the time-domain DOT algorithm based on a modified generalized pulse spectrum technique. The images of the absorption coefficient are reconstructed in various numerical simulations, phantom experiments, and in vivo experiments of time-domain DOT. As a result, the artifacts resulting from changes in optode coupling are reduced in the reconstructed images of the absorption coefficient, thereby demonstrating that introduction of coupling coefficients is effective in time-domain DOT. Moreover, numerical simulations, phantom experiments, and in vivo studies have validated this algorithm.

Reduction of Poisson noise in measured time-resolved data for time-domain diffuse optical tomography

A method to reduce noise for time-domain diffuse optical tomography (DOT) is proposed. Poisson noise which contaminates time-resolved photon counting data is reduced by use of maximum a posteriori estimation. The noise-free data are modeled as a Markov random process, and the measured time-resolved data are assumed as Poisson distributed random variables. The posterior probability of the occurrence of the noise-free data is formulated. By maximizing the probability, the noise-free data are estimated, and the Poisson noise is reduced as a result. The performances of the Poisson noise reduction are demonstrated in some experiments of the image reconstruction of time-domain DOT. In simulations, the proposed method reduces the relative error between the noise-free and noisy data to about one thirtieth, and the reconstructed DOT image was smoothed by the proposed noise reduction. The variance of the reconstructed absorption coefficients decreased by 22% in a phantom experiment. The quality of DOT, which can be applied to breast cancer screening etc., is improved by the proposed noise reduction.

Diffuse optical cortical mapping using the boundary element method

Cortical mapping, also called optical topography is a new medical imaging modality which allows the non-invasive investigation of the outer layers of the cortex. This technique is challenging and the geometry of the subject is very often over-simplified. We aim here to localize activated regions of an anatomically accurate brain. A Boundary Element Method is used for the forward model. The reconstruction of perturbations in the absorption coefficient is demonstrated in a geometrically realistic simulation and in vivo. These results show that diffuse optical imaging of the head can provide reliable activity maps when anatomical data is available.

Assessment of the frequency-domain multi-distance method to evaluate the brain optical properties: Monte Carlo simulations from neonate to adult

The near infrared spectroscopy (NIRS) frequency-domain multi-distance (FD-MD) method allows for the estimation of optical properties in biological tissue using the phase and intensity of radiofrequency modulated light at different source-detector separations. In this study, we evaluated the accuracy of this method to retrieve the absorption coefficient of the brain at different ages. Synthetic measurements were generated with Monte Carlo simulations in magnetic resonance imaging (MRI)-based heterogeneous head models for four ages: newborn, 6 and 12 month old infants, and adult. For each age, we determined the optimal set of source-detector separations and estimated the corresponding errors. Errors arise from different origins: methodological (FD-MD) and anatomical (curvature, head size and contamination by extra-cerebral tissues). We found that the brain optical absorption could be retrieved with an error between 8-24% in neonates and infants, while the error increased to 19-44% in adults over all source-detector distances. The dominant contribution to the error was found to be the head curvature in neonates and infants, and the extra-cerebral tissues in adults.

Functional white-laser imaging to study brain oxygen uncoupling/recoupling in songbirds

Contrary to the intense debate about brain oxygen dynamics and its uncoupling in mammals, very little is known in birds. In zebra finches, picosecond optical tomography with a white laser and a streak camera can measure in vivo oxyhemoglobin (HbO(2)) and deoxyhemoglobin (Hb) concentration changes following physiologic stimulation (familiar calls and songs). Picosecond optical tomography showed sufficient submicromolar sensitivity to resolve the fast changes in the hippocampus and auditory forebrain areas with 250 μm resolution. The time course is composed of (1) an early 2-second-long event with a significant decrease in Hb and HbO(2) levels of -0.7 and -0.9 μmol/L, respectively, (2) a subsequent increase in blood oxygen availability with a plateau of HbO(2) (+0.3 μmol/L), and (3) pronounced vasodilatation events immediately after the end of the stimulus. One of the findings of our study is the direct link between blood oxygen level-dependent signals previously published in birds and our results. Furthermore, the early vasoconstriction event and poststimulus ringing seem to be more pronounced in birds than in mammals. These results in birds, tachymetabolic vertebrates with a long lifespan, can potentially yield new insights, e.g., into brain aging.