Comparison of time-resolved and -unresolved measurements of deoxyhemoglobin in brain

How the heterogeneity of the severely injured brain affects hybrid diffuse optical signals: case examples and guidelines

Significance

A shortcoming of the routine clinical use of diffuse optics (DO) in the injured head has been that the results from commercial near-infrared spectroscopy-based devices are not reproducible, often give physiologically invalid values, and differ among systems. Besides the limitations due to the physics of continuous-wave light sources, one culprit is the head heterogeneity and the underlying morphological and functional abnormalities of the probed tissue.

Aim

The aim is to investigate the effect that different tissue alterations in the damaged head have on DO signals and provide guidelines to avoid data misinterpretation.

Approach

DO measurements and computed tomography scans were acquired on brain-injured patients. The relationship between the signals and the underlying tissue types was classified on a case-by-case basis.

Results

Examples and suggestions to establish quality control routines were provided. The findings suggested guidelines for carrying out DO measurements and speculations toward improved devices.

Conclusions

We advocate for the standardization of the DO measurements to secure a role for DO in neurocritical care. We suggest that blind measurements are unacceptably problematic due to confounding effects and care using a priori and a posteriori quality control routines that go beyond an assessment of the signal-to-noise ratio that is typically utilized.

Bioelectronic devices for light-based diagnostics and therapies

Light has broad applications in medicine as a tool for diagnosis and therapy. Recent advances in optical technology and bioelectronics have opened opportunities for wearable, ingestible, and implantable devices that use light to continuously monitor health and precisely treat diseases. In this review, we discuss recent progress in the development and application of light-based bioelectronic devices. We summarize the key features of the technologies underlying these devices, including light sources, light detectors, energy storage and harvesting, and wireless power and communications. We investigate the current state of bioelectronic devices for the continuous measurement of health and on-demand delivery of therapy. Finally, we highlight major challenges and opportunities associated with light-based bioelectronic devices and discuss their promise for enabling digital forms of health care.

Fast estimation of adult cerebral blood content and oxygenation with hyperspectral time-resolved near-infrared spectroscopy

Near-infrared spectroscopy (NIRS) can measure tissue blood content and oxygenation; however, its use for adult neuromonitoring is challenging due to significant contamination from their thick extracerebral layers (ECL; primarily scalp and skull). This report presents a fast method for accurate estimation of adult cerebral blood content and oxygenation from hyperspectral time resolved NIRS (trNIRS) data. A two-phase fitting method, based on a two-layer head model (ECL and brain), was developed. Phase 1 uses spectral constraints to accurately estimate the baseline blood content and oxygenation in both layers, which are then used by Phase 2 to correct for the ECL contamination of the late-arriving photons. The method was validated with in silico data from Monte-Carlo simulations of hyperspectral trNIRS in a realistic model of the adult head obtained from a high-resolution MRI. Phase 1 recovered cerebral blood oxygenation and total hemoglobin with an accuracy of 2.7 ± 2.5 and 2.8 ± 1.8%, respectively, with unknown ECL thickness, and 1.5 ± 1.4 and 1.7 ± 1.1% when the ECL thickness was known. Phase 2 recovered these parameters with an accuracy of 1.5 ± 1.5 and 3.1 ± 0.9%, respectively. Future work will include further validation in tissue-mimicking phantoms with various top layer thicknesses and in a pig model of the adult head before human applications.

Analytical solution of the vector radiative transfer equation for single scattered radiance

In this paper, derivation of the analytical solution of the vector radiative transfer equation for the single scattered radiance of three-dimensional semi-infinite media with a refractive index mismatch at the boundary is presented. In particular, the solution is obtained in the spatial domain and spatial frequency domain. Besides the general derivation, determination of the amplitude scattering matrix, which is required for the analytical solution, is given in detail. Furthermore, the incorporation of Fresnel equations due to a refractive index mismatch at the boundary is presented. Finally, verification of the derived formulas is performed using a self-implemented electrical field Monte Carlo method based on Jones formalism. For this purpose, the solution based on Jones formalism is converted to Stokes-Mueller formalism. For the verification, spherical particles are assumed as scatterers, whereby arbitrary size distributions can be considered.

Continuous-wave parallel interferometric near-infrared spectroscopy (CW NIRS) with a fast two-dimensional camera

Interferometric near-infrared spectroscopy (iNIRS) is an optical method that noninvasively measures the optical and dynamic properties of the human brain in vivo. However, the original iNIRS technique uses single-mode fibers for light collection, which reduces the detected light throughput. The reduced light throughput is compensated by the relatively long measurement or integration times (∼1 sec), which preclude monitoring of rapid blood flow changes that could be linked to neural activation. Here, we propose parallel interferometric near-infrared spectroscopy (πNIRS) to overcome this limitation. In πNIRS we use multi-mode fibers for light collection and a high-speed, two-dimensional camera for light detection. Each camera pixel acts effectively as a single iNIRS channel. So, the processed signals from each pixel are spatially averaged to reduce the overall integration time. Moreover, interferometric detection provides us with the unique capability of accessing complex information (amplitude and phase) about the light remitted from the sample, which with more than 8000 parallel channels, enabled us to sense the cerebral blood flow with only a 10 msec integration time (∼100x faster than conventional iNIRS). In this report, we have described the theoretical foundations and possible ways to implement πNIRS. Then, we developed a prototype continuous wave (CW) πNIRS system and validated it in liquid phantoms. We used our CW πNIRS to monitor the pulsatile blood flow in a human forearm in vivo. Finally, we demonstrated that CW πNIRS could monitor activation of the prefrontal cortex by recording the change in blood flow in the forehead of the subject while he was reading an unknown text.

Distance insensitive reflectance setup for the spectrally resolved determination of the optical properties of highly turbid media

A measurement system for a distance insensitive acquisition of the reflectance from turbid media is presented. The geometric relationships of the detection unit are discussed theoretically and subsequently verified using Monte Carlo simulations. In addition, an experimental setup is presented to prove the theoretical considerations and simulations. The use of the presented measurement system allows measurements of the reflectance in a distance range of approximately 2.5cm with a deviation of less than ±0.5% for highly scattering media. This contrasts with the use of a fiber in a classical detection unit placed at a defined angle and position relative to the sample surface, which results in deviations of ±30% in the measured reflectance over the same distance range.

Different brain activation patterns in the prefrontal area between self-paced and high-speed driving tasks

The purpose of this study was to investigate the effects on prefrontal cortex brain activity when participants attempted to stop a car accurately at a stop line when driving at different speeds using functional near-infrared spectroscopy (fNIRS). Twenty healthy subjects with driving experience drove their own cars for a distance of 60 m five times each at their own pace or as fast as possible. The variation in the distance between the stop line and the car was not significantly different between the self-paced and high-speed tasks. However, oxygenated hemoglobin concentration in the prefrontal cortex was significantly higher in the high-speed task than in the self-paced task. These findings suggest that driving at high speed requires more divided attention than driving at self-paced speed, even though the participants were able to stop the car at the same distance from the target. This study shows the advantages and usefulness of fNIRS .

Non-Invasive and Minimally-Invasive Cerebral Autoregulation Assessment: A Narrative Review of Techniques and Implications for Clinical Research

The process of cerebral vessels regulating constant cerebral blood flow over a wide range of systemic arterial pressures is termed cerebral autoregulation (CA). Static and dynamic autoregulation are two types of CA measurement techniques, with the main difference between these measures relating to the time scale used. Static autoregulation looks at the long-term change in blood pressures, while dynamic autoregulation looks at the immediate change. Techniques that provide regularly updating measures are referred to as continuous, whereas intermittent techniques take a single at point in time. However, a technique being continuous or intermittent is not implied by if the technique measures autoregulation statically or dynamically. This narrative review outlines technical aspects of non-invasive and minimally-invasive modalities along with providing details on the non-invasive and minimally-invasive measurement techniques used for CA assessment. These non-invasive techniques include neuroimaging methods, transcranial Doppler, and near-infrared spectroscopy while the minimally-invasive techniques include positron emission tomography along with magnetic resonance imaging and radiography methods. Further, the advantages and limitations are discussed along with how these methods are used to assess CA. At the end, the clinical considerations regarding these various techniques are highlighted.

Fabricated Flexible Composite for a UV-LED Color Filter and Anti-Counterfeiting Application of Calcium Molybdate Phosphor Synthesized at Room Temperature

Crystalline CaMoO₄ and rare-earth-doped CaMoO₄:RE³⁺ (RE = Tb, Eu) phosphors were synthesized at room temperature using a co-precipitation method. The crystal structure of the synthesized powder was a tetragonal structure with a main diffraction peak (112) phase. When CaMoO₄ was excited at 295 nm, it showed a central peak of 498 nm and light emission in a wide range of 420 to 700 nm. Rare-earth-ion-doped CaMoO₄:Tb³⁺ was excited at 288 nm and a green light emission was observed at 544 nm, and CaMoO₄:Eu³⁺ was excited at 292 nm and a red light emission was observed at 613 nm. To take advantage of the light-emitting characteristics, a flexible composite was manufactured and a color filter that could be used for UV-LEDs was manufactured. In addition, it was suggested that an ink that could be checked only by UV light could be produced and applied to banknotes so as to prevent counterfeiting.

Near Infrared Spectroscopy for High-Temporal Resolution Cerebral Physiome Characterization in TBI: A Narrative Review of Techniques, Applications, and Future Directions

Multimodal monitoring has been gaining traction in the critical care of patients following traumatic brain injury (TBI). Through providing a deeper understanding of the individual patient's comprehensive physiologic state, or "physiome," following injury, these methods hold the promise of improving personalized care and advancing precision medicine. One of the modalities being explored in TBI care is near-infrared spectroscopy (NIRS), given it's non-invasive nature and ability to interrogate microvascular and tissue oxygen metabolism. In this narrative review, we begin by discussing the principles of NIRS technology, including spatially, frequency, and time-resolved variants. Subsequently, the applications of NIRS in various phases of clinical care following TBI are explored. These applications include the pre-hospital, intraoperative, neurocritical care, and outpatient/rehabilitation setting. The utility of NIRS to predict functional outcomes and evaluate dysfunctional cerebrovascular reactivity is also discussed. Finally, future applications and potential advancements in NIRS-based physiologic monitoring of TBI patients are presented, with a description of the potential integration with other omics biomarkers.

Frontotemporal activation differs between perception of simulated cochlear implant speech and speech in background noise: An image-based fNIRS study

In this study we used functional near-infrared spectroscopy (fNIRS) to investigate neural responses in normal-hearing adults as a function of speech recognition accuracy, intelligibility of the speech stimulus, and the manner in which speech is distorted. Participants listened to sentences and reported aloud what they heard. Speech quality was distorted artificially by vocoding (simulated cochlear implant speech) or naturally by adding background noise. Each type of distortion included high and low-intelligibility conditions. Sentences in quiet were used as baseline comparison. fNIRS data were analyzed using a newly developed image reconstruction approach. First, elevated cortical responses in the middle temporal gyrus (MTG) and middle frontal gyrus (MFG) were associated with speech recognition during the low-intelligibility conditions. Second, activation in the MTG was associated with recognition of vocoded speech with low intelligibility, whereas MFG activity was largely driven by recognition of speech in background noise, suggesting that the cortical response varies as a function of distortion type. Lastly, an accuracy effect in the MFG demonstrated significantly higher activation during correct perception relative to incorrect perception of speech. These results suggest that normal-hearing adults (i.e., untrained listeners of vocoded stimuli) do not exploit the same attentional mechanisms of the frontal cortex used to resolve naturally degraded speech and may instead rely on segmental and phonetic analyses in the temporal lobe to discriminate vocoded speech.

Near-Infrared Time-Resolved Spectroscopy for Assessing Brown Adipose Tissue Density in Humans: A Review

Brown adipose tissue (BAT) mediates adaptive thermogenesis upon food intake and cold exposure, thus potentially contributing to the prevention of lifestyle-related diseases. ¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) with computed tomography (CT) (¹⁸FDG-PET/CT) is a standard method for assessing BAT activity and volume in humans. ¹⁸FDG-PET/CT has several limitations, including high device cost and ionizing radiation and acute cold exposure necessary to maximally stimulate BAT activity. In contrast, near-infrared spectroscopy (NIRS) has been used for measuring changes in O₂-dependent light absorption in the tissue in a non-invasive manner, without using radiation. Among NIRS, time-resolved NIRS (NIR_TRS) can quantify the concentrations of oxygenated and deoxygenated hemoglobin ([oxy-Hb] and [deoxy-Hb], respectively) by emitting ultrashort (100 ps) light pulses and counts photons, which are scattered and absorbed in the tissue. The basis for assessing BAT density (BAT-d) using NIR_TRS is that the vascular density in the supraclavicular region, as estimated using Hb concentration, is higher in BAT than in white adipose tissue. In contrast, relatively low-cost continuous wavelength NIRS (NIR_CWS) is employed for measuring relative changes in oxygenation in tissues. In this review, we provide evidence for the validity of NIR_TRS and NIR_CWS in estimating human BAT characteristics. The indicators (Ind_NIRS) examined were [oxy-Hb]_sup, [deoxy-Hb]_sup, total hemoglobin [total-Hb]_sup, Hb O₂ saturation (StO_2sup), and reduced scattering coefficient ( μs sup' ) in the supraclavicular region, as determined by NIR_TRS, and relative changes in corresponding parameters, as determined by NIR_CWS. The evidence comprises the relationships between the Ind_NIRS investigated and those determined by ¹⁸FDG-PET/CT; the correlation between the Ind_NIRS and cold-induced thermogenesis; the relationship of the Ind_NIRS to parameters measured by ¹⁸FDG-PET/CT, which responded to seasonal temperature fluctuations; the relationship of the Ind_NIRS and plasma lipid metabolites; the analogy of the Ind_NIRS to chronological and anthropometric data; and changes in the Ind_NIRS following thermogenic food supplementation. The [total-Hb]_sup and [oxy-Hb]_sup determined by NIR_TRS, but not parameters determined by NIR_CWS, exhibited significant correlations with cold-induced thermogenesis parameters and plasma androgens in men in winter or analogies to ¹⁸FDG-PET. We conclude that NIR_TRS can provide useful information for assessing BAT-d in a simple, rapid, non-invasive way, although further validation study is still needed.

Modulation of Cortical Activity by High-Frequency Whole-Body Vibration Exercise: An fNIRS Study

CONTEXT

Whole-body vibration (WBV) has shown many positive effects on the human body in rehabilitation and clinical settings in which vibration has been used to elicit muscle contractions in spastic and paretic muscles.

OBJECTIVE

The purpose of this study was to investigate whether WBV exercise (WBVe) differently modulates the cortical activity associated with motor and prefrontal function based on its frequency.

METHODS

A total of 18 healthy male adults (mean age: 25.3 [2.4] y) participated in this study and performed WBVe (Galileo Advanced plus; Novotec Medical, Pforzheim, Germany) under 3 different vibration frequency conditions (4-mm amplitude with 10-, 20-, and 27-Hz frequencies) and a control condition (0-mm amplitude with 0-Hz frequency). Each condition consisted of 2 alternating tasks (squatting and standing) every 30 seconds for 5 repetitions. All subjects performed the 4 conditions in a randomized order.

MAIN OUTCOME MEASURE

Cortical activation during WBVe was measured by relative changes in oxygenated hemoglobin concentration over the primary motor cortex, premotor cortex, supplementary motor area, and prefrontal and somatosensory cortices using functional near-infrared spectroscopy.

RESULTS

Oxygenated hemoglobin concentration was higher during the 27-Hz vibration condition than the control and 10-Hz vibration conditions. Specifically, these changes were pronounced in the bilateral primary motor cortex (P < .05) and right prefrontal cortex (P < .05). In contrast, no significant changes in oxygenated hemoglobin concentration were observed in any of the cortical areas during the 10-Hz vibration condition compared with the control condition.

CONCLUSION

This study provides evidence that the motor network and prefrontal cortical areas of healthy adult males can be activated by 27-Hz WBVe. However, WBVe at lower frequencies did not induce significant changes in cortical activation.

Review of early development of near-infrared spectroscopy and recent advancement of studies on muscle oxygenation and oxidative metabolism

Near-infrared spectroscopy (NIRS) has become an increasingly valuable tool to monitor tissue oxygenation (Toxy) in vivo. Observations of changes in the absorption of light with Toxy have been recognized as early as 1876, leading to a milestone NIRS paper by Jöbsis in 1977. Changes in the absorption and scatting of light in the 700-850-nm range has been successfully used to evaluate Toxy. The most practical devices use continuous-wave light providing relative values of Toxy. Phase-modulated or pulsed light can monitor both absorption and scattering providing more accurate signals. NIRS provides excellent time resolution (~ 10 Hz), and multiple source-detector pairs can be used to provide low-resolution imaging. NIRS has been applied to a wide range of populations. Continued development of NIRS devices in terms of lower cost, better detection of both absorption and scattering, and smaller size will lead to a promising future for NIRS studies.

Portable Near-Infrared Technologies and Devices for Noninvasive Assessment of Tissue Hemodynamics

Tissue hemodynamics, including the blood flow, oxygenation, and oxygen metabolism, are closely associated with many diseases. As one of the portable optical technologies to explore human physiology and assist in healthcare, near-infrared diffuse optical spectroscopy (NIRS) for tissue oxygenation measurement has been developed for four decades. In recent years, a dynamic NIRS technology, namely, diffuse correlation spectroscopy (DCS), has been emerging as a portable tool for tissue blood flow measurement. In this article, we briefly describe the basic principle and algorithms for static NIRS and dynamic NIRS (i.e., DCS). Then, we elaborate on the NIRS instrumentation, either commercially available or custom-made, as well as their applications to physiological studies and clinic. The extension of NIRS/DCS from spectroscopy to imaging was depicted, followed by introductions of advanced algorithms that were recently proposed. The future prospective of the NIRS/DCS and their feasibilities for routine utilization in hospital is finally discussed.

A near-infrared fluorescent probe for evaluating endogenous hydrogen peroxide during ischemia/reperfusion injury

A fluorescent probe, Cy-ArB, is developed for real-time monitoring of H₂O₂ fluctuations in cells and in vivo during ischemia/reperfusion processes.

Shining a Light on Awareness: A Review of Functional Near-Infrared Spectroscopy for Prolonged Disorders of Consciousness

Qualitative clinical assessments of the recovery of awareness after severe brain injury require an assessor to differentiate purposeful behavior from spontaneous behavior. As many such behaviors are minimal and inconsistent, behavioral assessments are susceptible to diagnostic errors. Advanced neuroimaging tools can bypass behavioral responsiveness and reveal evidence of covert awareness and cognition within the brains of some patients, thus providing a means for more accurate diagnoses, more accurate prognoses, and, in some instances, facilitated communication. The majority of reports to date have employed the neuroimaging methods of functional magnetic resonance imaging, positron emission tomography, and electroencephalography (EEG). However, each neuroimaging method has its own advantages and disadvantages (e.g., signal resolution, accessibility, etc.). Here, we describe a burgeoning technique of non-invasive optical neuroimaging—functional near-infrared spectroscopy (fNIRS)—and review its potential to address the clinical challenges of prolonged disorders of consciousness. We also outline the potential for simultaneous EEG to complement the fNIRS signal and suggest the future directions of research that are required in order to realize its clinical potential.

Two-color interpolation of the absorption response for quantitative acousto-optic imaging

Diffuse optical tomography (DOT) is a reliable and widespread technique for monitoring qualitative changes in absorption inside highly scattering media. It has been shown, however, that acousto-optic (AO) imaging can provide significantly more qualitative information without the need for inversion algorithms due to the spatial resolution afforded by ultrasound probing. In this Letter, we show how, by using multiple-wavelength AO imaging, it is also possible to perform quantitative measurements of absorber concentration inside scattering media.

Miniaturized pulsed laser source for time-domain diffuse optics routes to wearable devices

We validate a miniaturized pulsed laser source for use in time-domain (TD) diffuse optics, following rigorous and shared protocols for performance assessment of this class of devices. This compact source (12×6  mm2) has been previously developed for range finding applications and is able to provide short, high energy (∼100  ps, ∼0.5  nJ) optical pulses at up to 1 MHz repetition rate. Here, we start with a basic level laser characterization with an analysis of suitability of this laser for the diffuse optics application. Then, we present a TD optical system using this source and its performances in both recovering optical properties of tissue-mimicking homogeneous phantoms and in detecting localized absorption perturbations. Finally, as a proof of concept of in vivo application, we demonstrate that the system is able to detect hemodynamic changes occurring in the arm of healthy volunteers during a venous occlusion. Squeezing the laser source in a small footprint removes a key technological bottleneck that has hampered so far the realization of a miniaturized TD diffuse optics system, able to compete with already assessed continuous-wave devices in terms of size and cost, but with wider performance potentialities, as demonstrated by research over the last two decades.

Functional near infra-red spectroscopy (fNIRS) in schizophrenia: A review

The research on the alterations in functional connectivity in schizophrenia has been facilitated by development of an array of functional neuroimaging techniques. Functional Near Infra Red Spectroscopy (fNIRS) is a novel diffuse optical neuromonitring method with its own advantages and limitations. The advantages of fNIRS have made it to be frequently used as a research tool by medical community in different settings. In fNIRS the property of haemoglobin to absorb near infrared light is used to measure brain activity. It provides the indirect measurement of the neuronal activity in the areas of interest. The advantage of fNIRS being less restrictive has made it to be used more commonly in the research of psychiatric disorders in general, schizophrenia in particular. The fNIRS studies on patients with schizophrenia have shown haemodynamic hypo activation primarily in the prefrontal cortex during various cognitive tasks. In this review, initially we have briefly explained the basic principles of fNIRS followed by detailed review of fNIRS findings in patients with schizophrenia.

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.

Uniqueness in multispectral constant-wave epi-illumination imaging

Multispectral tissue imaging based on optical cameras and continuous-wave tissue illumination is commonly used in medicine and biology. Surprisingly, there is a characteristic absence of a critical look at the quantities that can be uniquely characterized from optically diffuse matter by multispectral imaging. Here, we investigate the fundamental question of uniqueness in epi-illumination measurements from turbid media obtained at multiple wavelengths. By utilizing an analytical model, tissue-mimicking phantoms, and an in vivo imaging experiment we show that independent of the bands employed, spectral measurements cannot uniquely retrieve absorption and scattering coefficients. We also establish that it is, nevertheless, possible to uniquely quantify oxygen saturation and the Mie scattering power-a previously undocumented uniqueness condition.

NIR Spectroscopic Detection of Breast Cancer

Near infrared spectroscopy (NIRS) utilizes intrinsic optical absorption signals of blood, water, and lipid concentration available in the NIR window (600–1000 nm) as well as a developing array of extrinsic organic compounds to detect and localize cancer. This paper reviews optical cancer detection made possible through high tumor-tissue signal-to-noise ratio (SNR) and providing biochemical and physiological data in addition to those obtained via other methods.

NIRS detects cancers in vivo through a combination of blood volume and oxygenation from measurements of oxy- and deoxy-hemoglobin giving signals of tumor angiogenesis and hypermetabolism. The Chance lab tends towards CW breast cancer systems using manually scannable detectors with calibrated low pressure tissue contact. These systems calculate angiogenesis and hypermetabolism by using a pair of wavelengths and referencing the mirror image position of the contralateral breast to achieve high ROC/AUC. Time domain and frequency domain spectroscopy were also used to study similar intrinsic breast tumor characteristics such as high blood volume. Other NIRS metrics are water-fat ratio and the optical scattering coefficient. An extrinsic FDA approved dye, ICG, has been used to measure blood pooling with extravasation, similar to Gadolinium in MRI.

A key future development in NIRS will be new Molecular Beacons targeting cancers and fluorescing in the NIR window to enhance in vivo tumor-tissue ratios and to afford biochemical specificity with the potential for effective photodynamic anti-cancer therapies.

Hemodynamic signals in fNIRS

Near-infrared spectroscopy (NIRS) was originally designed for clinical monitoring of tissue oxygenation, and it has also been developed into a useful tool in neuroimaging studies, with the so-called functional NIRS (fNIRS). With NIRS, cerebral activation is detected by measuring the cerebral hemoglobin (Hb), where however, the precise correlation between NIRS signal and neural activity remains to be fully understood. This can in part be attributed to the situation that NIRS signals are inherently subject to contamination by signals arising from extracerebral tissue. In recent years, several approaches have been investigated to distinguish between NIRS signals originating in cerebral tissue and signals originating in extracerebral tissue. Selective measurements of cerebral Hb will enable a further evolution of fNIRS. This chapter is divided into six sections: first a summary of the basic theory of NIRS, NIRS signals arising in the activated areas, correlations between NIRS signals and fMRI signals, correlations between NIRS signals and neural activities, and the influence of a variety of extracerebral tissue on NIRS signals and approaches to this issue are reviewed. Finally, future prospects of fNIRS are described.

Noninvasive Surface Imaging of Breast Cancer in Humans using a Hand-held Optical Imager

X-ray mammography, the current gold standard for breast cancer detection, has a 20% false-negative rate (cancer is undetected) and increases in younger women with denser breast tissue. Diffuse optical imaging (DOI) is a safe (nonionizing), and relatively inexpensive method for noninvasive imaging of breast cancer in human subjects (including dense breast tissues) by providing physiological information (e.g. oxy- and deoxy- hemoglobin concentration). At the Optical Imaging Laboratory, a hand-held optical imager has been developed which employs a breast contourable probe head to perform simultaneous illumination and detection of large surfaces towards near real-time imaging of human breast cancer. Gen-1 and gen-2 versions of the handheld optical imager have been developed and previously demonstrated imaging in tissue phantoms and healthy human subjects. Herein, the hand-held optical imagers are applied towards in vivo imaging of breast cancer subjects in an attempt to determine the ability of the imager to detect breast tumors. Five female human subjects (ages 51-74) diagnosed with breast cancer were imaged with the gen-1 optical imager prior to surgical intervention. One of the subjects was also imaged with the gen-2 optical imager. Both imagers use 785 nm laser diode sources and ICCD camera detectors to generate 2D surfaces maps of total hemoglobin absorption. The subjects lay in supine position and images were collected at various locations on both the ipsilateral (tumor-containing) and contralateral (non-tumor containing) breasts. The optical images (2D surface maps of optical absorption due to total hemoglobin concentration) show regions of higher intensity at the tumor location, which is indicative of increased vasculature and higher blood content due to the presence of the tumor. Additionally, a preliminary result indicates the potential to image lymphatic spread. This study demonstrates the potential of the hand-held optical devices to noninvasively image breast cancer in human subjects.

Motor response investigation in individuals with cerebral palsy using near infrared spectroscopy: pilot study

Cerebral palsy (CP) describes a group of motor impairment syndromes secondary to genetic that may be due to acquired disorders of the developing brain. In this study, near infrared spectroscopy (NIRS) is used to investigate the prefrontal cortical activation and lateralization in response to the planning and execution of motor skills in controls and individuals with CP. The prefrontal cortex, which plays a dominant role in the planning and execution of motor skill stimulus, is noninvasively imaged using a continuous wave-based NIRS system. During the study, 7 controls (4 right-handed and 3 left-handed) and 2 individuals with CP (1 right-handed and 1 left-handed) over 18 years of age performed 30 s of a ball throwing task followed by 30 s rest in a 5-block paradigm. The optical signal acquired from the NIRS system was processed to elucidate the activation and lateralization in the prefrontal region of controls and individuals with CP. The preliminary result indicated a difference in activation between the task and rest conditions in all the participant types. Bilateral dominance was observed in the prefrontal cortex of controls in response to planning and execution of motor skill tasks, while an ipsilateral dominance was observed in individuals with CP. In conjunction, similar contralateral dominance was observed during rest periods, both in controls and individuals with CP.

The application of near infrared spectroscopy in nutritional intervention studies

Functional near infrared spectroscopy (NIRS) is a non-invasive optical imaging technique used to monitor cerebral blood flow (CBF) and by proxy neuronal activation. The use of NIRS in nutritional intervention studies is a relatively novel application of this technique, with only a small, but growing, number of trials published to date. These trials—in which the effects on CBF following administration of dietary components such as caffeine, polyphenols and omega-3 polyunsaturated fatty acids are assessed—have successfully demonstrated NIRS as a sensitive measure of change in hemodynamic response during cognitive tasks in both acute and chronic treatment intervention paradigms. The existent research in this area has been limited by the constraints of the technique itself however advancements in the measurement technology, paired with studies endeavoring increased sophistication in number and locations of channels over the head should render the use of NIRS in nutritional interventions particularly valuable in advancing our understanding of the effects of nutrients and dietary components on the brain.

Efficient data extraction method for near-infrared spectroscopy (NIRS) systems with high spatial and temporal resolution

An hardware-efficient method for the extraction of hemodynamic responses in near-infrared spectroscopy systems is proposed to increase the spatial and temporal resolution. The performance improvement is attributed to high signal-to-noise ratio receivers, a modulation scheme, and a multi-input-multi-output based data extraction algorithm. The proposed system shows more than twofold improvement in the figure of merit compared to conventional designs. Experimental results support the validity of the proposed system.

Cortical hemoglobin concentration changes underneath the coil after single-pulse transcranial magnetic stimulation: a near-infrared spectroscopy study

Using near-infrared spectroscopy (NIRS) and multichannel probes, we studied hemoglobin (Hb) concentration changes when single-pulse transcranial magnetic stimulation (TMS) was applied over the left hemisphere primary motor cortex (M1). Seventeen measurement probes were centered over left M1. Subjects were studied in both active and relaxed conditions, with TMS intensity set at 100%, 120%, and 140% of the active motor threshold. The magnetic coils were placed so as to induce anteromedially directed currents in the brain. Hb concentration changes were more prominent at channels over M1 and posterior to it. Importantly, Hb concentration changes at M1 after TMS differed depending on whether the target muscle was in an active or relaxed condition. In the relaxed condition, Hb concentration increased up to 3–6 s after TMS, peaking at ∼6 s, and returned to the baseline. In the active condition, a smaller increase in Hb concentrations continued up to 3–6 s after TMS (early activation), followed by a decrease in Hb concentration from 9 to 12 s after TMS (delayed deactivation). Hb concentration changes in the active condition at higher stimulus intensities were more pronounced at locations posterior to M1 than at M1. We conclude that early activation occurs when M1 is activated transsynaptically. The relatively late deactivation may result from the prolonged inhibition of the cerebral cortex after activation. The posterior-dominant activation at higher intensities in the active condition may result from an additional activation of the sensory cortex due to afferent inputs from muscle contraction evoked by the TMS.

Diffuse optical imaging using spatially and temporally modulated light

The authors describe the development of diffuse optical imaging (DOI) technologies, specifically the use of spatial and temporal modulation to control near infrared light propagation in thick tissues. We present theory and methods of DOI focusing on model-based techniques for quantitative, in vivo measurements of endogenous tissue absorption and scattering properties. We specifically emphasize the common conceptual framework of the scalar photon density wave for both temporal and spatial frequency-domain approaches. After presenting the history, theoretical foundation, and instrumentation related to these methods, we provide a brief review of clinical and preclinical applications from our research as well as our outlook on the future of DOI technology.

Functional near-infrared spectroscopy for the assessment of speech related tasks

Over the past years functional near-infrared spectroscopy (fNIRS) has substantially contributed to the understanding of language and its neural correlates. In contrast to other imaging techniques, fNIRS is well suited to study language function in healthy and psychiatric populations due to its cheap and easy application in a quiet and natural measurement setting. Its relative insensitivity for motion artifacts allows the use of overt speech tasks and the investigation of verbal conversation. The present review focuses on the numerous contributions of fNIRS to the field of language, its development, and related psychiatric disorders but also on its limitations and chances for the future.

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.

Functional near-infrared spectroscopy (fNIRS) of brain function during active balancing using a video game system

Functional near-infrared spectroscopy (fNIRS) is a portable, non-invasive, brain imaging technology that uses low levels of non-ionizing light to record changes in cerebral blood flow in the brain through optical sensors placed on the surface of the scalp. These signals are recorded via flexible fiber optic cables, which allow neuroimaging experiments to be conducted on participants while performing tasks such as standing or walking. FNIRS has the potential to provide new insights into the evolution of brain activation during ambulatory motor learning tasks and standing tasks to probe balance and vestibular function. In this study, a 32 channel fNIRS system was used to record blood flow changes in the frontal, motor, sensory, and temporal cortices during active balancing associated with playing a video game simulating downhill skiing (Nintendo Wii™; Wii-fit™). Using fNIRS, we found activation of superior temporal gyrus, which was modulated by the difficulty of the balance task. This region had been previously implicated in vestibular function from other animal and human studies.

Towards the next generation of near-infrared spectroscopy

Although near-infrared spectroscopy (NIRS) was originally designed for clinical monitoring of tissue oxygenation, it has also been developing into a useful tool for neuroimaging studies (functional NIRS). Over the past 30 years, technology has developed and NIRS has found a wide range of applications. However, the accuracy and reliability of NIRS have not yet been widely accepted, mainly because of the difficulties in selective and quantitative detection of signals arising in cerebral tissue, which subject the use of NIRS to a number of practical restrictions. This review summarizes the strengths and advantages of NIRS over other neuroimaging modalities and demonstrates specific examples. The issues of selective quantitative measurement of cerebral haemoglobin during brain activation are also discussed, together with the problems of applying the methods of functional magnetic resonance imaging data analysis to NIRS data analysis. Finally, near-infrared optical tomography--the next generation of NIRS--is described as a potential technique to overcome the limitations of NIRS.

Simulation of near-infrared light absorption considering individual head and prefrontal cortex anatomy: implications for optical neuroimaging

Functional near-infrared spectroscopy (fNIRS) is an established optical neuroimaging method for measuring functional hemodynamic responses to infer neural activation. However, the impact of individual anatomy on the sensitivity of fNIRS measuring hemodynamics within cortical gray matter is still unknown. By means of Monte Carlo simulations and structural MRI of 23 healthy subjects (mean age: 25.0±2.8 years), we characterized the individual distribution of tissue-specific NIR-light absorption underneath 24 prefrontal fNIRS channels. We, thereby, investigated the impact of scalp-cortex distance (SCD), frontal sinus volume as well as sulcal morphology on gray matter volumes (V(gray)) traversed by NIR-light, i.e. anatomy-dependent fNIRS sensitivity. The NIR-light absorption between optodes was distributed describing a rotational ellipsoid with a mean penetration depth of (23.6±0.7) mm considering the deepest 5% of light. Of the detected photon packages scalp and bone absorbed (96.4±9.7)% and V(gray) absorbed (3.1±1.8)% of the energy. The mean V(gray) volume (1.1±0.4) cm3 was negatively correlated (r=-.76) with the SCD and frontal sinus volume (r=-.57) and was reduced by 41.5% in subjects with relatively large compared to small frontal sinus. Head circumference was significantly positively correlated with the mean SCD (r=.46) and the traversed frontal sinus volume (r=.43). Sulcal morphology had no significant impact on V(gray). Our findings suggest to consider individual SCD and frontal sinus volume as anatomical factors impacting fNIRS sensitivity. Head circumference may represent a practical measure to partly control for these sources of error variance.

Optical tecnology developments in biomedicine: history, current and future

Biomedical optics is a rapidly emerging field for medical imaging and diagnostics. This paper reviews several biomedical optical technologies that have been developed and translated for either clinical or pre-clinical applications. Specifically, we focus on the following technologies: 1) near-infrared spectroscopy and tomography, 2) optical coherence tomography, 3) fluorescence spectroscopy and imaging, and 4) optical molecular imaging. There representative biomedical applications are also discussed here.

DHA-rich oil modulates the cerebral haemodynamic response to cognitive tasks in healthy young adults: a near IR spectroscopy pilot study

The impact of dietary n-3 PUFA on behavioural outcomes has been widely researched; however, very little attention has been given to their impact on brain functioning in physiological terms. A total of twenty-two healthy adults took part in this double-blind, placebo-controlled study, wherein the cerebral haemodynamic effects of 12 weeks of daily dietary supplementation with either 1 g DHA-rich or 1 g EPA-rich fish oil (FO) or placebo (1 g olive oil) were assessed. Relative changes in the concentration of oxygenated Hb (oxy-Hb) and deoxygenated Hb were assessed in the prefrontal cortex using near IR spectroscopy (NIRS) during the performance of four computerised cognitive tasks. Supplementation with DHA-rich FO, in comparison with placebo, resulted in a significant increase in the concentrations of oxy-Hb and total levels of Hb, indicative of increased cerebral blood flow (CBF), during the cognitive tasks. In comparison, no effect on CBF was observed following supplementation with EPA-rich FO, where concentration changes in the chromophores followed the same pattern as placebo. These encouraging pilot data warrant further application of NIRS in this area.

The feasibility of real-time in vivo optical detection of blood-brain barrier disruption with indocyanine green

Osmotic disruption of the blood-brain barrier (BBB) by intraarterial mannitol injection is sometimes required for the delivery of chemotherapeutic drugs to brain tissue. Osmotic disruption is affected by a number of factors, and there is a significant variability in the degree and distribution of BBB disruption in clinical and experimental settings. Brain tissue concentrations of indocyanine green (ICG) can be measured by optical techniques. The aim of this experiment was to determine whether the disruption of the BBB significantly altered the regional pharmacokinetics of ICG. We were able to track in vivo brain tissue concentrations of ICG in 13 New Zealand white rabbits by employing a novel optical approach. Evan's blue was used to assess the distribution of BBB disruption on post mortem examination. BBB disruption by intraarterial mannitol injection was found to be highly variable, and only five of the 13 animals demonstrated the disruption at the site of optical measurements. In these animals, we observed a ninefold increase in ICG concentrations and fourfold increase in the area under the concentration-time curve, compared to those without BBB disruption at the site of measurement. This study shows the feasibility of optical monitoring of BBB disruption with intravenous (IV) ICG injections. Virtual real-time optical monitoring of the BBB disruption could help improve intraarterial delivery of chemotherapeutic drugs.

On-line effects of quadripulse transcranial magnetic stimulation (QPS) on the contralateral hemisphere studied with somatosensory evoked potentials and near infrared spectroscopy

To evaluate on-line effects of quadripulse stimulation (QPS) over the primary motor cortex (M1) on cortical areas in the contralateral hemisphere. QPS consisted of 24 bursts of transcranial magnetic stimulation (TMS) pulses with an inter-burst interval of 5 s for 2 min (for on-line effect study) or 360 bursts for 30 min (for after-effect study). Each burst consisted of four TMS pulses (i.e. QPS) separated by an interstimulus interval of 5 or 50 ms (QPS-5 or QPS-50). QPSs were delivered over the left M1. Experiment 1 [on-line effect on somatosensory evoked potential (SEP)]: Left median nerve SEPs were recorded before, during and after QPS. Experiment 2 (after effect on SEP): After-effects of QPS were evaluated by following up SEPs after the QPS sessions. Experiment 3 (on-line effect on NIRS): Near infrared spectroscopy (NIRS) was also recorded at the right hemisphere during all QPS paradigms. Both QPS-5 and QPS-50 enlarged a cortical component of the contralateral SEP during stimulation. On the other hand, concerning the after effects, QPS-5 over M1 potentiated the contralateral SEP and QPS-50 tended to depress it. In NIRS study, both QPS-5 and QPS-50 induced a significant oxy-Hb decrease (deactivation pattern) at the right hemisphere during stimulation whereas sham stimulations unaffected them. We have shown the unidirectional on-line effects evoked by QPS-5 and QPS-50 on both SEP and NIRS, and bidirectional after effects on SEP at the contralateral hemisphere. The discrepancy between on-line effect and after effect may be explained by the differences in the underlying mechanisms between them. The former may be mainly explained by pure electrophysiological property changes in the membrane or synapses. The latter may be explained by synaptic efficacy changes which need some protein syntheses at least partly. Another discrepancy shown here is the direction of on-line effects. Electrophysiological (SEP) function was potentiated by both QPSs whereas hemodynamic (NIRS) function was depressed. This may be explained by which sensory areas contribute to NIRS or SEP generation.

Rapid noninvasive continuous monitoring of oxygenation in cerebral ischemia and hypoxia

The brain is most sensitively dependent on oxygen to maintain its normal function. Methods to assess the degree of its oxygenation have generally been invasive and indirect. Rapid assessment of brain oxygenation is particularly vital during cerebrospinal ischemia and hypoxia. We have developed a noninvasive electro-optical method using pulsed near-infrared (NIR) light to quantify brain oxygenation during ischemia and hypoxia in anesthetized rabbits. Cerebral ischemia was induced through 30-40 s of bi-lateral carotid artery occlusion. Cerebral hypoxia was induced by varying inspired oxygen levels. The NIR light response to the interventions was expressed in terms of relative absorption (RA). Results showed that our pulsed NIR system could rapidly detect sudden alterations in oxygenation and blood flow to the brain. The response patterns during cerebral ischemia and hypoxia were significantly different, although both decreased brain oxygenation. The overall RA response to ischemia was much faster (in seconds) than during hypoxia (in minutes). These different response patterns can serve as early warning signal of low brain oxygenation and to discriminate the cause of the diminished oxygenation. The present pulsed NIR system is capable to provide a rapid, noninvasive and continuous monitoring of such decreases in brain oxygenation.