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Zinos A, Wagner JC, Beardsley SA, Chen WL, Conant L, Malloy M, Heffernan J, Quirk B, Prost R, Maheshwari M, Sugar J, Whelan HT. Spatial correspondence of cortical activity measured with whole head fNIRS and fMRI: Toward clinical use within subject. Neuroimage 2024; 290:120569. [PMID: 38461959 DOI: 10.1016/j.neuroimage.2024.120569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/15/2023] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
Functional near infrared spectroscopy (fNIRS) and functional magnetic resonance imaging (fMRI) both measure the hemodynamic response, and so both imaging modalities are expected to have a strong correspondence in regions of cortex adjacent to the scalp. To assess whether fNIRS can be used clinically in a manner similar to fMRI, 22 healthy adult participants underwent same-day fMRI and whole-head fNIRS testing while they performed separate motor (finger tapping) and visual (flashing checkerboard) tasks. Analyses were conducted within and across subjects for each imaging approach, and regions of significant task-related activity were compared on the cortical surface. The spatial correspondence between fNIRS and fMRI detection of task-related activity was good in terms of true positive rate, with fNIRS overlap of up to 68 % of the fMRI for analyses across subjects (group analysis) and an average overlap of up to 47.25 % for individual analyses within subject. At the group level, the positive predictive value of fNIRS was 51 % relative to fMRI. The positive predictive value for within subject analyses was lower (41.5 %), reflecting the presence of significant fNIRS activity in regions without significant fMRI activity. This could reflect task-correlated sources of physiologic noise and/or differences in the sensitivity of fNIRS and fMRI measures to changes in separate (vs. combined) measures of oxy and de-oxyhemoglobin. The results suggest whole-head fNIRS as a noninvasive imaging modality with promising clinical utility for the functional assessment of brain activity in superficial regions of cortex physically adjacent to the skull.
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Affiliation(s)
- Anthony Zinos
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
| | - Julie C Wagner
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
| | - Scott A Beardsley
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA; Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Wei-Liang Chen
- Center for Neuroscience Research, Children's National Medical Center, George Washington University, Washington DC, USA
| | - Lisa Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Marsha Malloy
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Neurology, Children's Wisconsin, Milwaukee, WI, USA
| | - Joseph Heffernan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brendan Quirk
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robert Prost
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mohit Maheshwari
- Department of Radiology, Children's Wisconsin, Milwaukee, WI, USA
| | - Jeffrey Sugar
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Harry T Whelan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Neurology, Children's Wisconsin, Milwaukee, WI, USA
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Kassab A, Hinnoutondji Toffa D, Robert M, Lesage F, Peng K, Khoa Nguyen D. Hemodynamic changes associated with common EEG patterns in critically ill patients: Pilot results from continuous EEG-fNIRS study. Neuroimage Clin 2021; 32:102880. [PMID: 34773798 PMCID: PMC8594770 DOI: 10.1016/j.nicl.2021.102880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/21/2022]
Abstract
Functional near-infrared spectroscopy (fNIRS) is currently the only non-invasive method allowing for continuous long-term assessment of cerebral hemodynamic. We evaluate the feasibility of using continueous electroencephalgraphy (cEEG)-fNIRS to study the cortical hemodynamic associated with status epilepticus (SE), burst suppression (BS) and periodic discharges (PDs). Eleven adult comatose patients admitted to the neuroICU for SE were recruited, and cEEG-fNIRS monitoring was performed to measure concentration changes in oxygenated (HbO) and deoxygenated hemoglobin (HbR). Seizures were associated with a large increase HbO and a decrease in HbR whose durations were positively correlated with the seizures' length. Similar observations were made for hemodynamic changes associated with bursts, showing overall increases in HbO and decreases in HbR relative to the suppression periods. PDs were seen to induce widespread HbO increases and HbR decreases. These results suggest that normal neurovascular coupling is partially retained with the hemodynamic response to the detected EEG patterns in these patients. However, the shape and distribution of the response were highly variable. This work highlighted the feasibility of conducting long-term cEEG-fNIRS to monitor hemodynamic changes over a large cortical area in critically ill patients, opening new routes for better understanding and management of abnormal EEG patterns in neuroICU.
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Affiliation(s)
- Ali Kassab
- Department of Neurological Sciences, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec H3C 3J7, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, 900 Saint Denis St., Montreal, Quebec H2X 0A9, Canada.
| | - Dènahin Hinnoutondji Toffa
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, 900 Saint Denis St., Montreal, Quebec H2X 0A9, Canada.
| | - Manon Robert
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, 900 Saint Denis St., Montreal, Quebec H2X 0A9, Canada.
| | - Frédéric Lesage
- Biomedical Engineering Institute, École Polytechnique de Montréal, 2500 Chemin de Polytechnique, Montréal, Quebec H3T 1J4, Canada; Research Center, Montreal Heart Institute, 5000 Rue Bélanger, Montreal, Quebec H1T 1C8, Canada.
| | - Ke Peng
- Department of Neurological Sciences, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec H3C 3J7, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, 900 Saint Denis St., Montreal, Quebec H2X 0A9, Canada.
| | - Dang Khoa Nguyen
- Department of Neurological Sciences, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec H3C 3J7, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, 900 Saint Denis St., Montreal, Quebec H2X 0A9, Canada; Division of Neurology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, 1000 Saint Denis St, Montreal, Quebec (H2X OC1), Canada.
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Comparison of Whole-Head Functional Near-Infrared Spectroscopy With Functional Magnetic Resonance Imaging and Potential Application in Pediatric Neurology. Pediatr Neurol 2021; 122:68-75. [PMID: 34301451 DOI: 10.1016/j.pediatrneurol.2021.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Changes in cerebral blood flow in response to neuronal activation can be measured by time-dependent fluctuations in hemoglobin species within the brain; this is the basis of functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy (fNIRS). There is a clinical need for portable neural imaging systems, such as fNIRS, to accommodate patients who are unable to tolerate an MR environment. OBJECTIVE Our objective was to compare task-related full-head fNIRS and fMRI signals across cortical regions. METHODS Eighteen healthy adults completed a same-day fNIRS-fMRI study, in which they performed right- and left-hand finger tapping tasks and a semantic-decision tones-decision task. First- and second-level general linear models were applied to both datasets. RESULTS The finger tapping task showed that significant fNIRS channel activity over the contralateral primary motor cortex corresponded to surface fMRI activity. Similarly, significant fNIRS channel activity over the bilateral temporal lobe corresponded to the same primary auditory regions as surface fMRI during the semantic-decision tones-decision task. Additional channels were significant for this task that did not correspond to surface fMRI activity. CONCLUSION Although both imaging modalities showed left-lateralized activation for language processing, the current fNIRS analysis did not show concordant or expected localization at the level necessary for clinical use in individual pediatric epileptic patients. Future work is needed to show whether fNIRS and fMRI are comparable at the source level so that fNIRS can be used in a clinical setting on individual patients. If comparable, such an imaging approach could be applied to children with neurological disorders.
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Liu X, Tekes A, Perin J, Chen MW, Soares BP, Massaro AN, Govindan RB, Parkinson C, Chavez-Valdez R, Northington FJ, Brady KM, Lee JK. Wavelet Autoregulation Monitoring Identifies Blood Pressures Associated With Brain Injury in Neonatal Hypoxic-Ischemic Encephalopathy. Front Neurol 2021; 12:662839. [PMID: 33995258 PMCID: PMC8113412 DOI: 10.3389/fneur.2021.662839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/22/2021] [Indexed: 11/15/2022] Open
Abstract
Dysfunctional cerebrovascular autoregulation may contribute to neurologic injury in neonatal hypoxic-ischemic encephalopathy (HIE). Identifying the optimal mean arterial blood pressure (MAPopt) that best supports autoregulation could help identify hemodynamic goals that support neurologic recovery. In neonates who received therapeutic hypothermia for HIE, we hypothesized that the wavelet hemoglobin volume index (wHVx) would identify MAPopt and that blood pressures closer to MAPopt would be associated with less brain injury on MRI. We also tested a correlation-derived hemoglobin volume index (HVx) and single- and multi-window data processing methodology. Autoregulation was monitored in consecutive 3-h periods using near infrared spectroscopy in an observational study. The neonates had a mean MAP of 54 mmHg (standard deviation: 9) during hypothermia. Greater blood pressure above the MAPopt from single-window wHVx was associated with less injury in the paracentral gyri (p = 0.044; n = 63), basal ganglia (p = 0.015), thalamus (p = 0.013), and brainstem (p = 0.041) after adjustments for sex, vasopressor use, seizures, arterial carbon dioxide level, and a perinatal insult score. Blood pressure exceeding MAPopt from the multi-window, correlation HVx was associated with less injury in the brainstem (p = 0.021) but not in other brain regions. We conclude that applying wavelet methodology to short autoregulation monitoring periods may improve the identification of MAPopt values that are associated with brain injury. Having blood pressure above MAPopt with an upper MAP of ~50–60 mmHg may reduce the risk of brain injury during therapeutic hypothermia. Though a cause-and-effect relationship cannot be inferred, the data support the need for randomized studies of autoregulation and brain injury in neonates with HIE.
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Affiliation(s)
- Xiuyun Liu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Aylin Tekes
- Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Jamie Perin
- Department of Pediatrics, Center for Child and Community Health Research, Johns Hopkins University, Baltimore, MD, United States
| | - May W Chen
- Division of Neonatology, Johns Hopkins University, Baltimore, MD, United States
| | - Bruno P Soares
- Department of Radiology, University of Vermont, Burlington, VT, United States
| | - An N Massaro
- Fetal Medicine Institute, Children's National Health System, Washington, DC, United States.,The George Washington University School of Medicine, Washington, DC, United States.,Division of Neonatology, Children's National Health System, Washington, DC, United States
| | - Rathinaswamy B Govindan
- Fetal Medicine Institute, Children's National Health System, Washington, DC, United States.,The George Washington University School of Medicine, Washington, DC, United States
| | | | - Raul Chavez-Valdez
- Division of Neonatology, Johns Hopkins University, Baltimore, MD, United States
| | | | - Ken M Brady
- Department of Anesthesiology, Lurie Children's Hospital, Chicago, IL, United States
| | - Jennifer K Lee
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
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Chen WL, Wagner J, Heugel N, Sugar J, Lee YW, Conant L, Malloy M, Heffernan J, Quirk B, Zinos A, Beardsley SA, Prost R, Whelan HT. Functional Near-Infrared Spectroscopy and Its Clinical Application in the Field of Neuroscience: Advances and Future Directions. Front Neurosci 2020; 14:724. [PMID: 32742257 PMCID: PMC7364176 DOI: 10.3389/fnins.2020.00724] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/17/2020] [Indexed: 01/20/2023] Open
Abstract
Similar to functional magnetic resonance imaging (fMRI), functional near-infrared spectroscopy (fNIRS) detects the changes of hemoglobin species inside the brain, but via differences in optical absorption. Within the near-infrared spectrum, light can penetrate biological tissues and be absorbed by chromophores, such as oxyhemoglobin and deoxyhemoglobin. What makes fNIRS more advantageous is its portability and potential for long-term monitoring. This paper reviews the basic mechanisms of fNIRS and its current clinical applications, the limitations toward more widespread clinical usage of fNIRS, and current efforts to improve the temporal and spatial resolution of fNIRS toward robust clinical usage within subjects. Oligochannel fNIRS is adequate for estimating global cerebral function and it has become an important tool in the critical care setting for evaluating cerebral oxygenation and autoregulation in patients with stroke and traumatic brain injury. When it comes to a more sophisticated utilization, spatial and temporal resolution becomes critical. Multichannel NIRS has improved the spatial resolution of fNIRS for brain mapping in certain task modalities, such as language mapping. However, averaging and group analysis are currently required, limiting its clinical use for monitoring and real-time event detection in individual subjects. Advances in signal processing have moved fNIRS toward individual clinical use for detecting certain types of seizures, assessing autonomic function and cortical spreading depression. However, its lack of accuracy and precision has been the major obstacle toward more sophisticated clinical use of fNIRS. The use of high-density whole head optode arrays, precise sensor locations relative to the head, anatomical co-registration, short-distance channels, and multi-dimensional signal processing can be combined to improve the sensitivity of fNIRS and increase its use as a wide-spread clinical tool for the robust assessment of brain function.
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Affiliation(s)
- Wei-Liang Chen
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States.,School of Medicine, University of Washington, Seattle, WA, United States
| | - Julie Wagner
- Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Nicholas Heugel
- Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jeffrey Sugar
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Yu-Wen Lee
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States
| | - Lisa Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Marsha Malloy
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States
| | - Joseph Heffernan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Brendan Quirk
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Anthony Zinos
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Scott A Beardsley
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Robert Prost
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Harry T Whelan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States
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Lee JK, Poretti A, Perin J, Huisman TAGM, Parkinson C, Chavez-Valdez R, O'Connor M, Reyes M, Armstrong J, Jennings JM, Gilmore MM, Koehler RC, Northington FJ, Tekes A. Optimizing Cerebral Autoregulation May Decrease Neonatal Regional Hypoxic-Ischemic Brain Injury. Dev Neurosci 2016; 39:248-256. [PMID: 27978510 DOI: 10.1159/000452833] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/24/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Therapeutic hypothermia provides incomplete neuroprotection for neonatal hypoxic-ischemic encephalopathy (HIE). We examined whether hemodynamic goals that support autoregulation are associated with decreased brain injury and whether these relationships are affected by birth asphyxia or vary by anatomic region. METHODS Neonates cooled for HIE received near-infrared spectroscopy autoregulation monitoring to identify the mean arterial blood pressure with optimized autoregulatory function (MAPOPT). Blood pressure deviation from MAPOPT was correlated with brain injury on MRI after adjusting for the effects of arterial carbon dioxide, vasopressors, seizures, and birth asphyxia severity. RESULTS Blood pressure deviation from MAPOPT related to neurologic injury in several regions independent of birth asphyxia severity. Greater duration and deviation of blood pressure below MAPOPT were associated with greater injury in the paracentral gyri and white matter. Blood pressure within MAPOPT related to lesser injury in the white matter, putamen and globus pallidus, and brain stem. Finally, blood pressures that exceeded MAPOPT were associated with reduced injury in the paracentral gyri. CONCLUSIONS Blood pressure deviation from optimal autoregulatory vasoreactivity was associated with MRI markers of brain injury that, in many regions, were independent of the initial birth asphyxia. Targeting hemodynamic ranges to optimize autoregulation has potential as an adjunctive therapy to hypothermia for HIE.
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Affiliation(s)
- Jennifer K Lee
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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