Towards human brain near infrared imaging: time resolved and unresolved spectroscopy during hypoxic hypoxia

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.

Clinical utilization of near-infrared spectroscopy devices for burn depth assessment

The diagnosis of burn depth is based on a visual assessment and can be subjective. Near-infrared (NIR) spectroscopic devices were used preclinically with positive results. The purpose of this study was to test the devices in a clinical setting using easily identifiable burn wounds. Adult patients with acute superficial and full-thickness burns were enrolled. NIR point spectroscopy and imaging devices were used to collect hemodynamic data from the burn site and an adjacent unburned control site. Oxy-hemoglobin and deoxy-hemoglobin concentrations were extracted from spectroscopic data and reported as oxygen saturation and total hemoglobin. Sixteen patients (n=16) were included in the study with equal numbers in both burn wound groups. Point spectroscopy data showed an increase in oxygen saturation (p<0.0095) and total hemoglobin (<0.0001) in comparison with the respective control areas for superficial burn wounds. The opposite was true for full-thickness burns, which showed a decrease in oxygenation (p<0.0001) and total hemoglobin (p<0.0147) in comparison with control areas. NIR imaging technology provides an estimate of hemodynamic parameters and could easily distinguish superficial and full-thickness burn wounds. These results confirm that NIR devices can successfully distinguish superficial and full-thickness burn injuries.

Measurement of cerebral blood flow in dogs with near infrared spectroscopy in the reflectance mode is invalid

Near infrared spectroscopy (NIRS) is used to measure CBF (CBFNIRS) in humans, based on Fick's principle, using oxygen as an intravascular tracer. We compared CBFNIRS with CBF measured by microspheres (CBF mu) and the venous outflow technique (CBFv) in 15 dogs, altering CBF with ventilation-induced changes in PaCO2. Five hundred forty-nine CBFNIRS measurements were attempted using an integration time of 2.5 s on the saturation signal from the tongue. One hundred ninety-eight (36.1%) of the measurements fulfilled predefined criteria. The coefficient of variation (CV) for six measurements under stable conditions was 29.1%. The CBFNIRS measurements correlated best with microsphere-measured blood flows in the cortical gray matter (median 0.43, range 0.16-0.93); the contributions of the skull and dura were variable. The CBFv varied by a médian of 12% (range 0-67%) during the CBFNIRS measurements. The percentage of acceptable CBFNIRS measurements, the CV, and the correlation coefficients of the CBFNIRS were improved by using saturation signal directly from the artery and varying the integration time with an estimate of the minimum transit time. The current method of measuring CBFNIRS in the reflectance mode is in-accurate when compared with other accepted techniques.

Cerebral Monitoring by Near-Infrared Spectroscopy

Near-infrared spectroscopy (NIRS) is a noninvasive optical monitoring technology that can provide information on relative cerebral oxyhemoglobin, deoxyhemoglobin, and oxidized cytochrome aa3 concentrations. Unlike other bedside clinical monitoring technologies, NIRS provides direct information on cerebral hemoglobin oxygenation and blood volume changes. NIRS recordings have documented changes in cerebral oxygenation in fetuses during labor, critically ill premature infants, cardiopulmonary bypass patients, and adult surgical patients. This information may improve understanding of the causes of brain injury and allow detection of inadequate oxygen delivery before brain injury occurs. Future developments in NIRS technology are likely to produce practical, quantitative bedside monitors of global and regional cerebral oxygenation.

Near-infrared spectroscopy: theory and applications

In conclusion, NIRS appears to offer both a new monitoring modality and new information about cerebral oxygenation. Technical problems in the application of this technology persist, most notably determination of pathlength and the volume of tissue interrogated. Those familiar with the history of pulse oximetry will recall that although Millikan developed an ear oximeter in 1947, it was not until Aoyagi combined recognition of the pulse signal with spectroscopy in the 1970s that oximetry was transformed into a clinically applicable monitor. In much the same way, NIRS may find the same tremendous usefulness as a noninvasive monitor of cerebral oxygen utilization, pending resolution of the remaining technical problems.