Near-infrared spectroscopy measurement of the pulsatile component of cerebral blood flow and volume from arterial oscillations

Prefrontal cortex activity and functional organisation in dual-task ocular pursuit is affected by concurrent upper limb movement

Tracking a moving object with the eyes seems like a simple task but involves areas of prefrontal cortex (PFC) associated with attention, working memory and prediction. Increasing the demand on these processes with secondary tasks can affect eye movements and/or perceptual judgments. This is particularly evident in chronic or acute neurological conditions such as Alzheimer's disease or mild traumatic brain injury. Here, we combined near infrared spectroscopy and video-oculography to examine the effects of concurrent upper limb movement, which provides additional afference and efference that facilitates tracking of a moving object, in a novel dual-task pursuit protocol. We confirmed the expected effects on judgement accuracy in the primary and secondary tasks, as well as a reduction in eye velocity when the moving object was occluded. Although there was limited evidence of oculo-manual facilitation on behavioural measures, performing concurrent upper limb movement did result in lower activity in left medial PFC, as well as a change in PFC network organisation, which was shown by Graph analysis to be locally and globally more efficient. These findings extend upon previous work by showing how PFC is functionally organised to support eye-hand coordination when task demands more closely replicate daily activities.

Working and short-term memory in children with ADHD: an examination of prefrontal cortical functioning using functional Near-Infrared Spectroscopy (fNIRS)

Working memory impairments are an oft-reported deficit among children with ADHD, and complementary neuroimaging studies implicate reductions in prefrontal cortex (PFC) structure and function as a neurobiological explanation. Most imaging studies, however, rely on costly, movement-intolerant, and/or invasive methods to examine cortical differences. This is the first study to use a newer neuroimaging tool that overcomes these limitations, functional Near Infrared Spectroscopy (fNIRS), to investigate hypothesized prefrontal differences. Children (aged 8-12) with ADHD (N = 22) and typically developing (N = 18) children completed phonological working memory (PHWM) and short-term memory (PHSTM) tasks. Children with ADHD evinced poorer performance on both tasks, with greater differences observed in PHWM (Hedges' g = 0.67) relative to PHSTM (g = 0.39). fNIRS revealed reduced hemodynamic response among children with ADHD in the dorsolateral PFC while completing the PHWM task, but not within the anterior or posterior PFC. No between-group fNIRS differences were observed during the PHSTM task. Findings suggest that children with ADHD exhibit an inadequate hemodynamic response in a region of the brain that underlies PHWM abilities. The study also highlights the use of fNIRS as a cost-effective, noninvasive neuroimaging technique to localize/quantify neural activation patterns associated with executive functions.

A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients

PURPOSE

In this research, a non-invasive intracranial pressure (nICP) optical sensor was developed and evaluated in a clinical pilot study. The technology relied on infrared light to probe brain tissue, using photodetectors to capture backscattered light modulated by vascular pulsations within the brain's vascular tissue. The underlying hypothesis was that changes in extramural arterial pressure could affect the morphology of recorded optical signals (photoplethysmograms, or PPGs), and analysing these signals with a custom algorithm could enable the non-invasive calculation of intracranial pressure (nICP).

METHODS

This pilot study was the first to evaluate the nICP probe alongside invasive ICP monitoring as a gold standard. nICP monitoring occurred in 40 patients undergoing invasive ICP monitoring, with data randomly split for machine learning. Quality PPG signals were extracted and analysed for time-based features. The study employed Bland-Altman analysis and ROC curve calculations to assess nICP accuracy compared to invasive ICP data.

RESULTS

Successful acquisition of cerebral PPG signals from traumatic brain injury (TBI) patients allowed for the development of a bagging tree model to estimate nICP non-invasively. The nICP estimation exhibited 95% limits of agreement of 3.8 mmHg with minimal bias and a correlation of 0.8254 with invasive ICP monitoring. ROC curve analysis showed strong diagnostic capability with 80% sensitivity and 89% specificity.

CONCLUSION

The clinical evaluation of this innovative optical nICP sensor revealed its ability to estimate ICP non-invasively with acceptable and clinically useful accuracy. This breakthrough opens the door to further technological refinement and larger-scale clinical studies in the future.

TRIAL REGISTRATION

NCT05632302, 11th November 2022, retrospectively registered.

Eccentric cycling involves greater mental demand and cortical activation of the frontoparietal network

Eccentric, compared to concentric exercise, is proposed to involve different neuro-motor processing strategies and a higher level of mental demand. This study compared eccentric and concentric cycling at matched perceived effort and torque for the mental demand and related-cortical activation patterns. Nineteen men (30 ± 6 years) performed four different 5-min cycling conditions at 30 RPM on a semi-recumbent isokinetic cycle ergometer: (1) concentric at a moderate perceived effort (23 on the CR100® scale) without torque feedback; (2) concentric and (3) eccentric at the same average torque produced in the first condition; and (4) eccentric at the same moderate perceived effort than the first concentric condition. The conditions two to four were randomized. After each condition, mental demand was monitored using the NASA Task Load Index scale. Changes in oxy-(O2 Hb) and deoxy-(HHb) hemoglobin during exercise were measured over both prefrontal cortices and the right parietal lobe from a 15-probe layout using a continuous-wave NIRS system. Mental demand was significantly higher during eccentric compared to concentric cycling (+52%, p = 0.012) and when the exercise intensity was fixed by the torque rather than the perceived effort (+70%, p < 0.001). For both torque- or perceived effort-matched exercises, O2 Hb increased significantly (p < 0.001) in the left and right prefrontal cortices, and right parietal lobe, and HHb decreased in the left, and right, prefrontal cortices during eccentric compared to concentric cycling. This study supports that acute eccentric cycling, compared to concentric cycling, involves a higher mental demand, and frontoparietal network activation.

Functional brain connectivity after corrective cardiac surgery for critical congenital heart disease: a preliminary near-infrared spectroscopy (NIRS) report

Patients with congenital heart disease (CHD) requiring cardiac surgery in infancy are at high risk for neurodevelopmental impairments. Neonatal imaging studies have reported disruptions of brain functional organization before surgery. Yet, the extent to which functional network alterations are present after cardiac repair remains unexplored. This preliminary study aimed at investigating cortical functional connectivity in 4-month-old infants with repaired CHD, using resting-state functional near-infrared spectroscopy (fNIRS). After fNIRS signal frequency decomposition, we compared values of magnitude-squared coherence as a measure of connectivity strength, between 21 infants with corrected CHD and 31 healthy controls. We identified a subset of connections with differences between groups at an uncorrected statistical level of p < .05 while controlling for sex and maternal socioeconomic status, with most of these connections showing reduced connectivity in infants with CHD. Although none of these differences reach statistical significance after FDR correction, likely due to the small sample size, moderate to large effect sizes were found for group-differences. If replicated, these results would therefore suggest preliminary evidence that alterations of brain functional connectivity are present in the months after cardiac surgery. Additional studies involving larger sample size are needed to replicate our data, and comparisons between pre- and postoperative findings would allow to further delineate alterations of functional brain connectivity in this population.

Enhancing diffuse correlation spectroscopy pulsatile cerebral blood flow signal with near-infrared spectroscopy photoplethysmography

Significance

Combining near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS) allows for quantifying cerebral blood volume, flow, and oxygenation changes continuously and non-invasively. As recently shown, the DCS pulsatile cerebral blood flow index (pCBF i ) can be used to quantify critical closing pressure (CrCP) and cerebrovascular resistance (CVR i ).

Aim

Although current DCS technology allows for reliable monitoring of the slow hemodynamic changes, resolving pulsatile blood flow at large source-detector separations, which is needed to ensure cerebral sensitivity, is challenging because of its low signal-to-noise ratio (SNR). Cardiac-gated averaging of several arterial pulse cycles is required to obtain a meaningful waveform.

Approach

Taking advantage of the high SNR of NIRS, we demonstrate a method that uses the NIRS photoplethysmography (NIRS-PPG) pulsatile signal to model DCS pCBF i , reducing the coefficient of variation of the recovered pulsatile waveform (pCBF i - fit ) and allowing for an unprecedented temporal resolution (266 Hz) at a large source-detector separation (> 3    cm ).

Results

In 10 healthy subjects, we verified the quality of the NIRS-PPG pCBF i - fit during common tasks, showing high fidelity against pCBF i (R 2 0.98 ± 0.01 ). We recovered CrCP and CVR i at 0.25 Hz, > 10 times faster than previously achieved with DCS.

Conclusions

NIRS-PPG improves DCS pCBF i SNR, reducing the number of gate-averaged heartbeats required to recover CrCP and CVR i .

Assessment of a Non-Invasive Brain Pulse Monitor to Measure Intra-Cranial Pressure Following Acute Brain Injury

Background

Intracranial pressure (ICP) monitoring requires placing a hole in the skull through which an invasive pressure monitor is inserted into the brain. This approach has risks for the patient and is expensive. We have developed a non-invasive brain pulse monitor that uses red light to detect a photoplethysmographic (PPG) signal arising from the blood vessels on the brain's cortical surface. The brain PPG and the invasive ICP waveform share morphological features which may allow measurement of the intracranial pressure.

Methods

We enrolled critically ill patients with an acute brain injury with invasive ICP monitoring to assess the new monitor. A total of 24 simultaneous invasive ICP and brain pulse monitor PPG measurements were undertaken in 12 patients over a range of ICP levels.

Results

The waveform morphologies were similar for the invasive ICP and brain pulse monitor PPG approach. Both methods demonstrated a progressive increase in the amplitude of P2 relative to P1 with increasing ICP levels. An automated algorithm was developed to assess the PPG morphological features in relation to the ICP level. A correlation was demonstrated between the brain pulse waveform morphology and ICP levels, R²=0.66, P < 0.001.

Conclusion

The brain pulse monitor's PPG waveform demonstrated morphological features were similar to the invasive ICP waveform over a range of ICP levels, these features may provide a method to measure ICP levels.

Trial Registration

ACTRN12620000828921.

Psychedelics and fNIRS neuroimaging: exploring new opportunities

In this Outlook paper, we explain to the optical neuroimaging community as well as the psychedelic research community the great potential of using optical neuroimaging with functional near-infrared spectroscopy (fNIRS) to further explore the changes in brain activity induced by psychedelics. We explain why we believe now is the time to exploit the momentum of the current resurgence of research on the effects of psychedelics and the momentum of the increasing progress and popularity of the fNIRS technique to establish fNIRS in psychedelic research. With this article, we hope to contribute to this development.

The Quantitative Associations Between Near Infrared Spectroscopic Cerebrovascular Metrics and Cerebral Blood Flow: A Scoping Review of the Human and Animal Literature

Cerebral blood flow (CBF) is an important physiologic parameter that is vital for proper cerebral function and recovery. Current widely accepted methods of measuring CBF are cumbersome, invasive, or have poor spatial or temporal resolution. Near infrared spectroscopy (NIRS) based measures of cerebrovascular physiology may provide a means of non-invasively, topographically, and continuously measuring CBF. We performed a systematically conducted scoping review of the available literature examining the quantitative relationship between NIRS-based cerebrovascular metrics and CBF. We found that continuous-wave NIRS (CW-NIRS) was the most examined modality with dynamic contrast enhanced NIRS (DCE-NIRS) being the next most common. Fewer studies assessed diffuse correlation spectroscopy (DCS) and frequency resolved NIRS (FR-NIRS). We did not find studies examining the relationship between time-resolved NIRS (TR-NIRS) based metrics and CBF. Studies were most frequently conducted in humans and animal studies mostly utilized large animal models. The identified studies almost exclusively used a Pearson correlation analysis. Much of the literature supported a positive linear relationship between changes in CW-NIRS based metrics, particularly regional cerebral oxygen saturation (rSO2), and changes in CBF. Linear relationships were also identified between other NIRS based modalities and CBF, however, further validation is needed.

The Effects of Silicone Enclosure Colour on the Function of Optical Sensors

Simple Summary

Implantable optical sensing is a rapidly growing field that allows for continuous monitoring of internal organs’ physiological states. Near-infrared spectroscopy is an optical sensing technology allowing for low-cost, non-invasive, high-sensitivity measurement of tissue oxygenation and haemodynamic parameters. The colour of an optical sensor’s enclosure affects the sensor’s sensitivity, function, and ability to detect tissue vital signs. This study compared the optical properties of coloured silicone materials and related these properties to the function of silicone enclosed implantable near-infrared spectroscopy sensors. We demonstrated that sensor enclosures highly reflective to red and near-infrared light facilitated light propagation to the photodetector and increased the ability to detect the effects of cardiac pulsation and respiratory rhythm on tissue haemodynamics. In contrast, highly absorptive sensor enclosures resulted in better detection and monitoring of tissue oxygenation.

Abstract

The colour of the silicone enclosure of an implantable reflectance-based optical probe plays a critical role in sensor performance. Red-coloured probes that are highly reflective to near-infrared light have been found to increase photodetector power by a factor of 6 for wavelengths between 660 and 950 nm and triple the magnitude of measured cardiac pulsations compared to traditional black probes. The increase in photodetector power and cardiac pulsation magnitude is presumably due to increased spatial range resulting from a higher magnitude of superficial tissue scattering. Conversely, probes with highly absorbent colours such as black and blue result in more stable signals and are expected to have higher spatial resolution and depth of penetration.

Evaluating Interhemispheric Synchronization and Cortical Activity in Acute Stroke Patients Using Optical Hemodynamic Oscillations

OBJECTIVE

An understanding of functional interhemispheric asymmetry in ischemic stroke patients is a crucial factor in the designs of efficient programs for post-stroke rehabilitation. This study evaluates interhemispheric synchronization and cortical activities in acute stroke patients with various degrees of severity and at different post-stroke stages.

APPROACH

Twenty-three patients were recruited to participate in the experiments, including resting-state and speed finger-tapping tasks at week-1 and week-3 post-stroke. Multichannel near-infrared spectroscopy (NIRS) was used to measure the changes in hemodynamics in the bilateral prefrontal cortex (PFC), the supplementary motor area (SMA), and the sensorimotor cortex (SMC). The interhemispheric correlation coefficient (IHCC) measuring the synchronized activities in time and the wavelet phase coherence (WPCO) measuring the phasic activity in time-frequency were used to reflect the symmetry between the two hemispheres within a region. The changes in oxyhemoglobin during the finger-tapping tasks were used to present cortical activation.

MAIN RESULTS

IHCC and WPCO values in the severe-stroke were significantly lower than those in the minor-stroke at low frequency intervals during week-3 post-stroke. Cortical activation in all regions in the affected hemisphere was significantly lower than that in the unaffected hemisphere in the moderate-severe stroke measured in week-1, however, the SMC activation on the affected hemisphere was significantly enhanced in week-3 post-stroke.

SIGNIFICANCE

In this study, non-invasive NIRS was used to observe dynamic synchronization in the resting-state based on the IHCC and WPCO results as well as hemodynamic changes in a motor task in acute stroke patients. The findings suggest that NIRS could be used as a tool for early stroke assessment and evaluation of the efficacy of post-stroke rehabilitation.

Modulation of Interhemispheric Synchronization and Cortical Activity in Healthy Subjects by High-Definition Theta-Burst Electrical Stimulation

Background

Various forms of theta-burst stimulation (TBS) such as intermittent TBS (iTBS) and continuous TBS (cTBS) have been introduced as novel facilitation/suppression schemes during repetitive transcranial magnetic stimulation (rTMS), demonstrating a better efficacy than conventional paradigms. Herein, we extended the rTMS-TBS schemes to electrical stimulation of high-definition montage (HD-TBS) and investigated its neural effects on the human brain.

Methods

In a within-subject design, fifteen right-handed healthy adults randomly participated in 10 min and 2 mA HD-TBS sessions: unilateral (Uni)-iTBS, bilateral (Bi)-cTBS/iTBS, and sham stimulation over primary motor cortex regions. A 20-channel near-infrared spectroscopy (NIRS) system was covered on the bilateral prefrontal cortex (PFC), sensory motor cortex (SMC), and parietal lobe (PL) for observing cerebral hemodynamic responses in the resting-state and during fast finger-tapping tasks at pre-, during, and poststimulation. Interhemispheric correlation coefficient (IHCC) and wavelet phase coherence (WPCO) from resting-state NIRS and concentration of oxyhemoglobin during fast finger-tapping tasks were explored to reflect the symmetry between the two hemispheres and cortical activity, respectively.

Results

The IHCC and WPCO of NIRS data in the SMC region under Bi-cTBS/iTBS showed relatively small values at low-frequency bands III (0.06–0.15 Hz) and IV (0.02–0.06), indicating a significant desynchronization in both time and frequency domains. In addition, the SMC activation induced by fast finger-tapping exercise was significantly greater during Uni-iTBS as well as during and post Bi-cTBS/iTBS sessions.

Conclusions

It appears that a 10 min and 2 mA Bi-cTBS/iTBS applied over two hemispheres within the primary motor cortex region could effectively modulate the interhemispheric synchronization and cortical activation in the SMC of healthy subjects. Our study demonstrated that bilateral HD-TBS approaches is an effective noninvasive brain stimulation scheme which could be a novel therapeutic for inducing effects of neuromodulation on various neurological disorders caused by ischemic stroke or traumatic brain injuries.

A new variant position of head-up CPR may be associated with improvement in the measurements of cranial near-infrared spectroscopy suggestive of an increase in cerebral blood flow in non-traumatic out-of-hospital cardiac arrest patients: A prospective interventional pilot study

AIM OF THE STUDY

This study aimed to investigate the effect of the head-up position implemented during cardiopulmonary resuscitation (CPR) on cerebral blood flow (CBF) using near-infrared spectroscopy in out-of-hospital cardiac arrest patients.

METHODS

Baseline characteristics (age, sex, cerebral performance category before cardiac arrest, witnessed cardiac arrest, bystander CPR, first monitored rhythm, no-flow time, prehospital low-flow time, CPR duration in the emergency department (ED), and reason for stopping CPR in the ED) were recorded. The changes of CBF were derived from the optical oscillation waveform measured by near-infrared spectroscopy in adult patients with out-of-hospital cardiac arrest by alternating head-up and supine positions at 4-minute intervals while performing CPR. The CBF velocity according to the head position was also evaluated using the time derivative of the oscillation waveform.

RESULTS

During the study period, 28 patients were enrolled. The median increase in CBF in the prefrontal area in the head-up position was 14.6% (Interquartile range, 8.8-65.0), more than that in the supine position. An increase in CBF was observed in the head-up position compared with the supine position in 83.3% of the patients included in the analysis.

CONCLUSION

CBF increased when the head-up position was used during CPR in non-traumatic out-of-hospital cardiac arrest patients. abberivation OHCA: out-of-hospital cardiac arrest, ROSC: return of spontaneous circulation, CBF: cerebral blood flow, CPR: cardiopulmonary resuscitation, EMT: emergency medical technician, ACD: active chest compression-decompression, ITD: impedance threshold device, HUP: head-up position, ICP: intracranial pressure, CePP: cerebral perfusion pressure, NIRS: Near-infrared spectroscopy, ED: emergency department, ALS: advanced life support, HbO2: oxy-haemoglobin, HbR: deoxy-haemoglobin, RMS: root-mean-square, IQR: interquartile rage, TCD: transcranial doppler, CVR: cerebrovascular resistance, MAP: mean arterial pressure.

Oscillator decomposition of infant fNIRS data

The functional near-infrared spectroscopy (fNIRS) can detect hemodynamic responses in the brain and the data consist of bivariate time series of oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) on each channel. In this study, we investigate oscillatory changes in infant fNIRS signals by using the oscillator decompisition method (OSC-DECOMP), which is a statistical method for extracting oscillators from time series data based on Gaussian linear state space models. OSC-DECOMP provides a natural decomposition of fNIRS data into oscillation components in a data-driven manner and does not require the arbitrary selection of band-pass filters. We analyzed 18-ch fNIRS data (3 minutes) acquired from 21 sleeping 3-month-old infants. Five to seven oscillators were extracted on most channels, and their frequency distribution had three peaks in the vicinity of 0.01-0.1 Hz, 1.6-2.4 Hz and 3.6-4.4 Hz. The first peak was considered to reflect hemodynamic changes in response to the brain activity, and the phase difference between oxy-Hb and deoxy-Hb for the associated oscillators was at approximately 230 degrees. The second peak was attributed to cardiac pulse waves and mirroring noise. Although these oscillators have close frequencies, OSC-DECOMP can separate them through estimating their different projection patterns on oxy-Hb and deoxy-Hb. The third peak was regarded as the harmonic of the second peak. By comparing the Akaike Information Criterion (AIC) of two state space models, we determined that the time series of oxy-Hb and deoxy-Hb on each channel originate from common oscillatory activity. We also utilized the result of OSC-DECOMP to investigate the frequency-specific functional connectivity. Whereas the brain oscillator exhibited functional connectivity, the pulse waves and mirroring noise oscillators showed spatially homogeneous and independent changes. OSC-DECOMP is a promising tool for data-driven extraction of oscillation components from biological time series data.

Attention Control in Children With ADHD: An Investigation Using Functional Near Infrared Spectroscopy (fNIRS)

Attention problems are a predominant contributor to near- and far-term functional outcomes in attention-deficit/hyperactivity disorder (ADHD); however, most interventions focus on improving the alerting attentional network, which has failed to translate into improved learning for a majority of children with ADHD. Comparatively less is known regarding the executive attentional network and its overarching attention control process, which governs the ability to maintain relevant information in a highly active, interference-free state, and is intrinsic to a broad range of cognitive functions. This is the first study to compare attention control abilities in children with ADHD and typically developing (TD) children using the Visual Array Task (VAT) and to simultaneously measure hemodynamic functioning (oxyHb) using functional Near-Infrared Spectroscopy (fNIRS). Nineteen children with ADHD Combined type and 18 typically developing (TD) children aged 8 to 12 years were administered the VAT task while prefrontal activity was monitored using fNIRS. Results revealed that children with ADHD evinced large magnitude deficits in attention control and that oxyHb levels in the left dorsal lateral prefrontal cortex (dlPFC) were significantly greater in children with ADHD relative to TD children. These findings suggest that poor attention control abilities in children with ADHD may be related to increased left dlPFC activation in response to an underdeveloped and/or inefficient right dlPFC. The need to design interventions that target and strengthen attention control and its corresponding neural network is discussed based on the likelihood that attention control serves as the potential quaesitum for understanding a wide array of ADHD-related deficits.

Coronary artery disease and its impact on the pulsatile brain: A functional NIRS study

Recent studies have reported that optical indices of cerebral pulsatility are associated with cerebrovascular health in older adults. Such indices, including cerebral pulse amplitude and the pulse relaxation function (PRF), have been previously applied to quantify global and regional cerebral pulsatility. The aim of the present study was to determine whether these indices are modulated by cardiovascular status and whether they differ between individuals with low or high cardiovascular risk factors (LCVRF and HCVRF) and coronary artery disease (CAD). A total of 60 older adults aged 57-79 were enrolled in the study. Participants were grouped as LCVRF, HCVRF, and CAD. Participants were asked to walk freely on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data. Low-intensity, short-duration walking was used to test whether a brief cardiovascular challenge could increase the difference of pulsatility indices with respect to cardiovascular status. Results indicated that CAD individuals have higher global cerebral pulse amplitude compared with the other groups. Walking reduced global cerebral pulse amplitude and PRF in all groups but did not increase the difference across the groups. Instead, walking extended the spatial distribution of cerebral pulse amplitude to the anterior prefrontal cortex when CAD was compared to the CVRF groups. Further research is needed to determine whether cerebral pulse amplitude extracted from data acquired with NIRS, which is a noninvasive, inexpensive method, can provide an index to characterize the cerebrovascular status associated with CAD.

Longitudinal Impact of Physical Activity on Brain Pulsatility Index and Cognition in Older Adults with Cardiovascular Risk Factors: A NIRS Study

Recent studies have shown that optical indices of cerebral pulsatility, including cerebral pulse amplitude, are linked to cerebrovascular health. A chronically higher cerebral pulsatility is associated with cognitive decline. Although it is widely known that regular physical activity improves cognitive functions, little is known about the association between physical activity and the optical index of cerebral pulsatility. This study assessed the impact of 12 months of regular physical activity on the changes in the optical index of cerebral pulsatility and explored its association with cognition. A total of 19 older adults (aged 59-79 years) with cardiovascular risk factors (CVRF) completed the study. Low-intensity, short-duration walking as a brief cardiovascular challenge was used to study the impact of regular physical activity on post-walking changes in cerebral pulsatility index. The participants walked on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data from the frontal and motor cortex subregions. Our data indicated that 12 months of physical activity was associated with lower global cerebral pulse amplitude, which was associated with higher cognitive scores in executive functions. Further, the global cerebral pulsatility index was reduced after short-duration walking, and this reduction was greater after 12 months of regular physical activity compared with the baseline. This may be an indication of improvement in cerebrovascular response to the cardiovascular challenge after regular physical activity. This study suggests that 12 months of physical activity may support cognitive functions through improving cerebral pulsatility in older adults with CVRF.

Cortical thinning is associated with brain pulsatility in older adults: An MRI and NIRS study

Aging is accompanied by global brain atrophy occurring unequally across the brain. Cortical thinning is seen with aging with a larger loss in the frontal and temporal subregions. We explored the link between regional cortical thickness and regional cerebral pulsatility. Sixty healthy individuals were divided into two age groups, young (aged 19-31) and older (aged 65-75) adults. Each participant underwent a near-infrared spectroscopy (NIRS) scan to index regional brain pulsatility from cerebral pulse-transit-time-to-the peak-of-the-pulse (PTTp), an anatomical magnetic resonance imaging (MRI) and a phase-contrast MRI (PC-MRI) scan to measure arterial and cerebrospinal fluid (CSF) pulsatility. In older adults, the greatest association between cerebral pulsatility and cortical thickness was found in superior and middle temporal and superior, middle and inferior frontal areas, which are the regions perfused first by the internal carotid arteries. This association dropped in the postcentral and superior parietal regions. These findings suggest higher brain pulsatility as a potential risk factor contributing to cortical thinning for some brain regions more than others.

Decoding of semantic categories of imagined concepts of animals and tools in fNIRS

Objective.Semantic decoding refers to the identification of semantic concepts from recordings of an individual's brain activity. It has been previously reported in functional magnetic resonance imaging and electroencephalography. We investigate whether semantic decoding is possible with functional near-infrared spectroscopy (fNIRS). Specifically, we attempt to differentiate between the semantic categories of animals and tools. We also identify suitable mental tasks for potential brain-computer interface (BCI) applications.Approach.We explore the feasibility of a silent naming task, for the first time in fNIRS, and propose three novel intuitive mental tasks based on imagining concepts using three sensory modalities: visual, auditory, and tactile. Participants are asked to visualize an object in their minds, imagine the sounds made by the object, and imagine the feeling of touching the object. A general linear model is used to extract hemodynamic responses that are then classified via logistic regression in a univariate and multivariate manner.Main results.We successfully classify all tasks with mean accuracies of 76.2% for the silent naming task, 80.9% for the visual imagery task, 72.8% for the auditory imagery task, and 70.4% for the tactile imagery task. Furthermore, we show that consistent neural representations of semantic categories exist by applying classifiers across tasks.Significance.These findings show that semantic decoding is possible in fNIRS. The study is the first step toward the use of semantic decoding for intuitive BCI applications for communication.

Sensitivity of frequency-domain optical measurements to brain hemodynamics: simulations and human study of cerebral blood flow during hypercapnia

This study characterizes the sensitivity of noninvasive measurements of cerebral blood flow (CBF) by using frequency-domain near-infrared spectroscopy (FD-NIRS) and coherent hemodynamics spectroscopy (CHS). We considered six FD-NIRS methods: single-distance intensity and phase (SDI and SDϕ), single-slope intensity and phase (SSI and SSϕ), and dual-slope intensity and phase (DSI and DSϕ). Cerebrovascular reactivity (CVR) was obtained from the relative change in measured CBF during a step hypercapnic challenge. Greater measured values of CVR are assigned to a greater sensitivity to cerebral hemodynamics. In a first experiment with eight subjects, CVRSDϕ was greater than CVRSDI (p < 0.01), whereas CVRDSI and CVRDSϕ showed no significant difference (p > 0.5). In a second experiment with four subjects, a 5 mm scattering layer was added between the optical probe and the scalp tissue to increase the extracerebral layer thickness (L ec ), which caused CVRDSϕ to become significantly greater than CVRDSI (p < 0.05). CVRSS measurements yielded similar results as CVRDS measurements but with a greater variability, possibly resulting from instrumental artifacts in SS measurements. Theoretical simulations with two-layered media confirmed that, if the top (extracerebral) layer is more scattering than the bottom (brain) layer, the relative values of CVRDSI and CVRDSϕ depend on L ec . Specifically, the sensitivity to the brain is greater for DSI than DSϕ for a thin extracerebral layer (L ec < 13 mm), whereas it is greater for DSϕ than DSI for a thicker extracerebral layer.

Objective measurement of tinnitus using functional near-infrared spectroscopy and machine learning

Chronic tinnitus is a debilitating condition which affects 10-20% of adults and can severely impact their quality of life. Currently there is no objective measure of tinnitus that can be used clinically. Clinical assessment of the condition uses subjective feedback from individuals which is not always reliable. We investigated the sensitivity of functional near-infrared spectroscopy (fNIRS) to differentiate individuals with and without tinnitus and to identify fNIRS features associated with subjective ratings of tinnitus severity. We recorded fNIRS signals in the resting state and in response to auditory or visual stimuli from 25 individuals with chronic tinnitus and 21 controls matched for age and hearing loss. Severity of tinnitus was rated using the Tinnitus Handicap Inventory and subjective ratings of tinnitus loudness and annoyance were measured on a visual analogue scale. Following statistical group comparisons, machine learning methods including feature extraction and classification were applied to the fNIRS features to classify patients with tinnitus and controls and differentiate tinnitus at different severity levels. Resting state measures of connectivity between temporal regions and frontal and occipital regions were significantly higher in patients with tinnitus compared to controls. In the tinnitus group, temporal-occipital connectivity showed a significant increase with subject ratings of loudness. Also in this group, both visual and auditory evoked responses were significantly reduced in the visual and auditory regions of interest respectively. Naïve Bayes classifiers were able to classify patients with tinnitus from controls with an accuracy of 78.3%. An accuracy of 87.32% was achieved using Neural Networks to differentiate patients with slight/ mild versus moderate/ severe tinnitus. Our findings show the feasibility of using fNIRS and machine learning to develop an objective measure of tinnitus. Such a measure would greatly benefit clinicians and patients by providing a tool to objectively assess new treatments and patients' treatment progress.

Shedding Light on the Effects of Moderate Acute Exercise on Working Memory Performance in Healthy Older Adults: An fNIRS Study

Numerous studies have reported the beneficial effects of acute exercise on executive functions. Less is known, however, about the effects of exercise on working memory as one subcomponent of executive functions and about its effects on older adults. We investigated the effects of acute moderate-intensity exercise on working memory performance, the respective cortical hemodynamic activation patterns, and the development and persistence of such effects in healthy older adults. Forty-four participants (M: 69.18 years ± 3.92; 21 females) performed a letter 2-back task before and at three time points after (post 15 min, post 30 min, and post 45 min) either listening to an audiobook or exercising (15 min; 50% VO2-peak). Functional near-infrared spectroscopy (fNIRS) was used to assess cortical hemodynamic activation and brain-behavior correlations in the fronto-parietal working memory network. Overall, we found no group differences for working memory performance. However, only within the experimental group, 2-back performance was enhanced 15 min and 45 min post-exercise. Furthermore, 15 min post-exercise frontal activation predicted working memory performance, regardless of group. In sum, our results indicate slight beneficial effects of acute moderate-intensity exercise on working memory performance in healthy older adults. Findings are discussed in light of the cognitive aging process and moderators affecting the exercise-cognition relationship.

Assessment of the brain ischemia during orthostatic stress and lower body negative pressure in air force pilots by near-infrared spectroscopy

A methodology for the assessment of the cerebral hemodynamic reaction to normotensive hypovolemia, reduction in cerebral perfusion and orthostatic stress leading to ischemic hypoxia and reduced muscular tension is presented. Most frequently, the pilots of highly maneuverable aircraft are exposed to these phenomena. Studies were carried out using the system consisting of a chamber that generates low pressure around the lower part of the body - LBNP (lower body negative pressure) placed on the tilt table. An in-house developed 6-channel NIRS system operating at 735 and 850 nm was used in order to assess the oxygenation of the cerebral cortex, based on measurements of diffusely reflected light in reflectance geometry. The measurements were carried out on a group of 12 active pilots and cadets of the Polish Air Force Academy and 12 healthy volunteers. The dynamics of changes in cerebral oxygenation was evaluated as a response to LBNP stimuli with a simultaneous rapid change of the tilt table angle. Parameters based on calculated changes of total hemoglobin concentration were proposed allowing to evaluate differences in reactions observed in control subjects and pilots/cadets. The results of orthogonal partial least squares-discriminant analysis based on these parameters show that the subjects can be classified into their groups with 100% accuracy.

Cortical Speech Processing in Postlingually Deaf Adult Cochlear Implant Users, as Revealed by Functional Near-Infrared Spectroscopy

An experiment was conducted to investigate the feasibility of using functional near-infrared spectroscopy (fNIRS) to image cortical activity in the language areas of cochlear implant (CI) users and to explore the association between the activity and their speech understanding ability. Using fNIRS, 15 experienced CI users and 14 normal-hearing participants were imaged while presented with either visual speech or auditory speech. Brain activation was measured from the prefrontal, temporal, and parietal lobe in both hemispheres, including the language-associated regions. In response to visual speech, the activation levels of CI users in an a priori region of interest (ROI)—the left superior temporal gyrus or sulcus—were negatively correlated with auditory speech understanding. This result suggests that increased cross-modal activity in the auditory cortex is predictive of poor auditory speech understanding. In another two ROIs, in which CI users showed significantly different mean activation levels in response to auditory speech compared with normal-hearing listeners, activation levels were significantly negatively correlated with CI users’ auditory speech understanding. These ROIs were located in the right anterior temporal lobe (including a portion of prefrontal lobe) and the left middle superior temporal lobe. In conclusion, fNIRS successfully revealed activation patterns in CI users associated with their auditory speech understanding.

Assessing hearing by measuring heartbeat: The effect of sound level

Functional near-infrared spectroscopy (fNIRS) is a non-invasive brain imaging technique that measures changes in oxygenated and de-oxygenated hemoglobin concentration and can provide a measure of brain activity. In addition to neural activity, fNIRS signals contain components that can be used to extract physiological information such as cardiac measures. Previous studies have shown changes in cardiac activity in response to different sounds. This study investigated whether cardiac responses collected using fNIRS differ for different loudness of sounds. fNIRS data were collected from 28 normal hearing participants. Cardiac response measures evoked by broadband, amplitude-modulated sounds were extracted for four sound intensities ranging from near-threshold to comfortably loud levels (15, 40, 65 and 90 dB Sound Pressure Level (SPL)). Following onset of the noise stimulus, heart rate initially decreased for sounds of 15 and 40 dB SPL, reaching a significantly lower rate at 15 dB SPL. For sounds at 65 and 90 dB SPL, increases in heart rate were seen. To quantify the timing of significant changes, inter-beat intervals were assessed. For sounds at 40 dB SPL, an immediate significant change in the first two inter-beat intervals following sound onset was found. At other levels, the most significant change appeared later (beats 3 to 5 following sound onset). In conclusion, changes in heart rate were associated with the level of sound with a clear difference in response to near-threshold sounds compared to comfortably loud sounds. These findings may be used alone or in conjunction with other measures such as fNIRS brain activity for evaluation of hearing ability.

Concurrent Changes of Brain Functional Connectivity and Motor Variability When Adapting to Task Constraints

In behavioral neuroscience, the adaptability of humans facing different constraints has been addressed on one side at the brain level, where a variety of functional networks dynamically support the same performance, and on the other side at the behavioral level, where fractal properties in sensorimotor variables have been considered as a hallmark of adaptability. To bridge the gap between the two levels of observation, we have jointly investigated the changes of network connectivity in the sensorimotor cortex assessed by modularity analysis and the properties of motor variability assessed by multifractal analysis during a prolonged tapping task. Four groups of participants had to produce the same tapping performance while being deprived from 0, 1, 2, or 3 sensory feedbacks simultaneously (auditory and/or visual and/or tactile). Whereas tapping performance was not statistically different across groups, the number of brain networks involved and the degree of multifractality of the inter-tap interval series were significantly correlated, increasing as a function of feedback deprivation. Our findings provide first evidence that concomitant changes in brain modularity and multifractal properties characterize adaptations underlying unchanged performance. We discuss implications of our findings with respect to the degeneracy properties of complex systems, and the entanglement of adaptability and effective adaptation.

Different Hemodynamic Responses of the Primary Motor Cortex Accompanying Eccentric and Concentric Movements: A Functional NIRS Study

The literature contains limited evidence on how our brains control eccentric movement. A higher activation is expected in the contralateral motor cortex (M1) but consensus has not yet been reached. Therefore, the present study aimed to compare patterns of M1 activation between eccentric and concentric movements. Nine healthy participants performed in a randomized order three sets of five repetitions of eccentric or concentric movement with the dominant elbow flexors over a range of motion of 60&deg; at two velocities (30&deg;/s and 60&deg;/s). The tests were carried out using a Biodex isokinetic dynamometer with the forearm supported in the horizontal plane. The peak torque values were not significantly different between concentric and eccentric movements (p = 0.42). Hemodynamic responses of the contralateral and ipsilateral M1 were measured with a near-infrared spectroscopy system (Oxymon MkIII, Artinis). A higher contralateral M1 activity was found during eccentric movements (p = 0.04, &eta;&sup2; = 0.47) and at the velocity of 30&deg;/s (p = 0.039, &eta;&sup2; = 0.48). These preliminary findings indicate a specific control mechanism in the contralateral M1 to produce eccentric muscle actions at the angular velocities investigated, although the role of other brain areas in the motor control network cannot be excluded.

Dynamics of the human brain network revealed by time-frequency effective connectivity in fNIRS

Functional near infrared spectroscopy (fNIRS) is a promising neuroimaging method for investigating networks of cortical regions over time. We propose a directed effective connectivity method (TPDC) allowing the capture of both time and frequency evolution of the brain's networks using fNIRS data acquired from healthy subjects performing a continuous finger-tapping task. Using this method we show the directed connectivity patterns among cortical motor regions involved in the task and their significant variations in the strength of information flow exchanges. Intra and inter-hemispheric connections during the motor task with their temporal evolution are also provided. Characterisation of the fluctuations in brain connectivity opens up a new way to assess the organisation of the brain to adapt to changing task constraints, or under pathological conditions.

In-silico and in-vitro investigation of a photonic monitor for intestinal perfusion and oxygenation

The quantification of visceral organ oxygenation after trauma-related systemic hypovolemia and shock is critical to enable effective resuscitation. In this work, a photoplethysmography-based (PPG) sensor was specifically designed for probing the perfusion and oxygenation condition of intestinal tissue with the ultimate goal to monitor patients post trauma to guide resuscitation. Through Monte Carlo modeling, suitable optofluidic phantoms were determined, the wavelength and separation distance for the sensor was optimized, and sensor performance for the quantification of tissue perfusion and oxygenation was tested on the in-vitro phantom. In particular, the Monte Carlo simulated both a standard block three-layer model and a more realistic model including villi. Measurements were collected on the designed three layer optofluidic phantom and the results taken with the small form factor PPG device showed a marked improvement when using shorter visible wavelengths over the more conventional longer visible wavelengths. Overall, in this work a Monte Carlo model was developed, an optofluidic phantom was built, and a small form factor PPG sensor was developed and characterized using the phantom for perfusion and oxygenation over the visible wavelength range. The results show promise that this small form factor PPG sensor could be used as a future guide to shock-related resuscitation.

Prefrontal Hemodynamics in Toddlers at Rest: A Pilot Study of Developmental Variability

Functional near infrared spectroscopy (fNIRS) is a non-invasive functional neuroimaging modality. Although, it is amenable to use in infants and young children, there is a lack of fNIRS research within the toddler age range. In this study, we used fNIRS to measure cerebral hemodynamics in the prefrontal cortex (PFC) in 18-36 months old toddlers (n = 29) as part of a longitudinal study that enrolled typically-developing toddlers as well as those "at risk" for language and other delays based on presence of early language delays. In these toddlers, we explored two hemodynamic response indices during periods of rest during which time audiovisual children's programming was presented. First, we investigate Lateralization Index, based on differences in oxy-hemoglobin saturation from left and right prefrontal cortex. Then, we measure oxygenation variability (OV) index, based on variability in oxygen saturation at frequencies attributed to cerebral autoregulation. Preliminary findings show that lower cognitive (including language) abilities are associated with fNIRS measures of both lower OV index and more extreme Lateralization index values. These preliminary findings show the feasibility of using fNIRS in toddlers, including those at risk for developmental delay, and lay the groundwork for future studies.

Mapping cerebral pulse pressure and arterial compliance over the adult lifespan with optical imaging

Cerebrovascular health is important for maintaining a high level of cognitive performance, not only in old age, but also throughout the lifespan. Recently, it was first demonstrated that diffuse optical imaging measures of pulse amplitude and arterial compliance can provide estimates of cerebral arterial health throughout the cortex, and were associated with age, estimated cardiorespiratory fitness (eCRF), neuroanatomy and cognitive function in older adults (aged 55-87). The current study replicates and extends the original findings using a broader age range (a new adult sample aged 18-75), longer recording periods (360 s), and a more extensive optical montage (1536 channels). These methodological improvements represent a 5-fold increase in recording time and a 4-fold increase in coverage compared to the initial study. Results show that reliability for both pulse amplitude and compliance measures across recording blocks was very high (r(45) = .99 and .75, respectively). Pulse amplitude and pulse pressure were shown to correlate with age across the broader age range. We also found correlations between arterial health and both cortical and subcortical gray matter volumes. Additionally, we replicated the correlations between arterial compliance and age, eCRF, global brain atrophy, and cognitive flexibility. New regional analyses revealed that higher performance on the operation span (OSPAN) working memory task was associated with greater localized arterial compliance in frontoparietal cortex, but not with global arterial compliance. Further, greater arterial compliance in frontoparietal regions was associated with younger age and higher eCRF. These associations were not present in the visual cortex. The current study not only replicates the initial one in a sample including a much wider age range, but also provides new evidence showing that frontoparietal regions may be especially vulnerable to vascular degeneration during brain aging, with potential functional consequences in cognition.

Ambulatory diffuse optical tomography and multimodality physiological monitoring system for muscle and exercise applications

Ambulatory diffuse optical tomography (aDOT) is based on near-infrared spectroscopy (NIRS) and enables three-dimensional imaging of regional hemodynamics and oxygen consumption during a person’s normal activities. Although NIRS has been previously used for muscle assessment, it has been notably limited in terms of the number of channels measured, the extent to which subjects can be ambulatory, and/or the ability to simultaneously acquire synchronized auxiliary data such as electromyography (EMG) or electrocardiography (ECG). We describe the development of a prototype aDOT system, called NINscan-M, capable of ambulatory tomographic imaging as well as simultaneous auxiliary multimodal physiological monitoring. Powered by four AA size batteries and weighing 577 g, the NINscan-M prototype can synchronously record 64-channel NIRS imaging data, eight channels of EMG, ECG, or other analog signals, plus force, acceleration, rotation, and temperature for 24+ h at up to 250 Hz. We describe the system’s design, characterization, and performance characteristics. We also describe examples of isometric, cycle ergometer, and free-running ambulatory exercise to demonstrate tomographic imaging at 25 Hz. NINscan-M represents a multiuse tool for muscle physiology studies as well as clinical muscle assessment.

The occurrence of individual slow waves in sleep is predicted by heart rate

The integration of near-infrared spectroscopy and electroencephalography measures presents an ideal method to study the haemodynamics of sleep. While the cortical dynamics and neuro-modulating influences affecting the transition from wakefulness to sleep is well researched, the assumption has been that individual slow waves, the hallmark of deep sleep, are spontaneously occurring cortical events. By creating event-related potentials from the NIRS recording, time-locked to the onset of thousands of individual slow waves, we show the onset of slow waves is phase-locked to an ongoing oscillation in the NIRS recording. This oscillation stems from the moment to moment fluctuations of light absorption caused by arterial pulsations driven by the heart beat. The same oscillating signal can be detected if the electrocardiogram is time-locked to the onset of the slow wave. The ongoing NIRS oscillation suggests that individual slow wave initiation is dependent on that signal, and not the other way round. However, the precise causal links remain speculative. We propose several potential mechanisms: that the heart-beat or arterial pulsation acts as a stimulus which evokes a down-state; local fluctuations in energy supply may lead to a network effect of hyperpolarization; that the arterial pulsations lead to corresponding changes in the cerebral-spinal-fluid which evokes the slow wave; or that a third neural generator, regulating heart rate and slow waves may be involved.

Taking the pulse of aging: mapping pulse pressure and elasticity in cerebral arteries with optical methods

Cerebrovascular support is crucial for healthy cognitive and brain aging. Arterial stiffening is a cause of reduced brain blood flow, a predictor of cognitive decline, and a risk factor for cerebrovascular accidents and Alzheimer's disease. Arterial health is influenced by lifestyle factors, such as cardiorespiratory fitness (CRF). We investigated new noninvasive optical measures of cerebrovascular health, which provide estimates of arterial pulse parameters (pulse pressure, transit time, and compliance/elasticity) within specific cerebral arteries and cortical regions, and low-resolution maps of large superficial cerebral arteries. We studied naturally occurring variability in these parameters in adults (aged 55-87), and found that these indices of cerebrovascular health are negatively correlated with age and positively with CRF and gray and white matter volumes. Further, regional pulse transit time predicts specific neuropsychological performance.

Auditory cortex activation to natural speech and simulated cochlear implant speech measured with functional near-infrared spectroscopy

The primary goal of most cochlear implant procedures is to improve a patient's ability to discriminate speech. To accomplish this, cochlear implants are programmed so as to maximize speech understanding. However, programming a cochlear implant can be an iterative, labor-intensive process that takes place over months. In this study, we sought to determine whether functional near-infrared spectroscopy (fNIRS), a non-invasive neuroimaging method which is safe to use repeatedly and for extended periods of time, can provide an objective measure of whether a subject is hearing normal speech or distorted speech. We used a 140 channel fNIRS system to measure activation within the auditory cortex in 19 normal hearing subjects while they listed to speech with different levels of intelligibility. Custom software was developed to analyze the data and compute topographic maps from the measured changes in oxyhemoglobin and deoxyhemoglobin concentration. Normal speech reliably evoked the strongest responses within the auditory cortex. Distorted speech produced less region-specific cortical activation. Environmental sounds were used as a control, and they produced the least cortical activation. These data collected using fNIRS are consistent with the fMRI literature and thus demonstrate the feasibility of using this technique to objectively detect differences in cortical responses to speech of different intelligibility.

Validation of a novel hemodynamic model for coherent hemodynamics spectroscopy (CHS) and functional brain studies with fNIRS and fMRI

We report an experimental validation and applications of the new hemodynamic model presented in the companion article (Fantini, 2014-this issue) both in the frequency domain and in the time domain. In the frequency domain, we have performed diffuse optical measurements for coherent hemodynamics spectroscopy (CHS) on the brain and calf muscle of human subjects, showing that the hemodynamic model predictions (both in terms of spectral shapes and absolute spectral values) are confirmed experimentally. We show how the quantitative analysis based on the new model allows for autoregulation measurements from brain data, and provides an analytical description of near-infrared spiroximetry from muscle data. In the time domain, we have used data from the literature to perform a comparison between brain activation signals measured with functional near-infrared spectroscopy (fNIRS) or with blood oxygenation level dependent (BOLD) fMRI, and the corresponding signals predicted by the new model. This comparison shows an excellent agreement between the model predictions and the reported fNIRS and BOLD fMRI signals. This new hemodynamic model provides a valuable tool for brain studies with hemodynamic-based techniques.

Correlation between the arterial pulse wave of the cerebral microcirculation and CBF during breath holding and hyperventilation in human

OBJECTIVE

To evaluate if relative changes in the amplitude of the arterial pulse wave of the cerebral microcirculation (APWCM) measured by near-infrared spectroscopy (NIRS) may provide information about relative changes of cerebral blood flow (CBF) in cerebral cortex.

METHODS

In 10 healthy human volunteers, through simultaneous recording of the APWCM amplitude by means of NIRS and the mean blood flow velocity (MBFV) of middle cerebral artery by means of transcranial Doppler (TCD) at rest and during breath holding and hyperventilation, we evaluate a possible correlation between relative changes of the mean APWCM amplitude and relative changes of MBFV.

RESULTS

We found a significant linear correlation: breath holding: R(2) 0.84, p < 0.001, hyperventilation: R(2) 0.81, p<0.001.

CONCLUSION

The relative changes of the mean APWCM amplitude seem able to provide information about relative changes of CBF of cerebral cortex in healthy adult humans during breath holding and hyperventilation.

SIGNIFICANCE

APWCM detected by NIRS, a safe, repeatable, inexpensive technology and at the bedside may improve the study of cerebral cortex microcirculation in neurological diseases.

“Prolonged” migraine aura: New information on underlying mechanisms

The aim of this study is to identify the pathophysiology of “prolonged” migraine aura not clearly understood. We studied cortical cerebral microcirculation by Near Infrared Spectroscopy system (NIRS) and cerebral macrocirculation by transcranial Doppler (TCD) in 8 subjects (3 M and 5 F, age range 21–41 years) during spontaneous “prolonged” migraine aura in according to ICHD-II criteria 2004 (code 1.6.2.) up to 24 hours after the end of aura and compared the results with the headache-free periods. During aura NIRS showed a significant decrease of the Arterial Pulse Wave of Cerebral Microcirculation (APWCM) amplitude (−33 % ± 5.7), p<0.001, and a significant increase of Cerebral Tissue Oxygen Saturation (SctO2) (+15.5 % ± 5.1), p<0.001 contralateral to the symptoms of aura compared with the headache-free periods; TCD showed a significant increase of Pulsatility Index (+36.5 % ± 6.5), p<0.001 and a significant decrease of the diastolic velocity in the posterior and middle cerebral artery contralateral to the symptoms of aura compared with the headache-free periods. In conclusion during “prolonged” migraine aura we find areas of cortical hypoperfusion corresponding to the topography of aura symptoms that are the result of a decreased metabolic demand rather than an ischemic mechanism.

Quantitative measurement of cerebral blood flow in a juvenile porcine model by depth-resolved near-infrared spectroscopy

Nearly half a million children and young adults are affected by traumatic brain injury each year in the United States. Although adequate cerebral blood flow (CBF) is essential to recovery, complications that disrupt blood flow to the brain and exacerbate neurological injury often go undetected because no adequate bedside measure of CBF exists. In this study we validate a depth-resolved, near-infrared spectroscopy (NIRS) technique that provides quantitative CBF measurement despite significant signal contamination from skull and scalp tissue. The respiration rates of eight anesthetized pigs (weight: 16.2+/-0.5 kg, age: 1 to 2 months old) are modulated to achieve a range of CBF levels. Concomitant CBF measurements are performed with NIRS and CT perfusion. A significant correlation between CBF measurements from the two techniques is demonstrated (r(2)=0.714, slope=0.92, p<0.001), and the bias between the two techniques is -2.83 mL min(-1)100 g(-1) (CI(0.95): -19.63 mL min(-1)100 g(-1)-13.9 mL min(-1)100 g(-1)). This study demonstrates that accurate measurements of CBF can be achieved with depth-resolved NIRS despite significant signal contamination from scalp and skull. The ability to measure CBF at the bedside provides a means of detecting, and thereby preventing, secondary ischemia during neurointensive care.