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Gossé LK, Pinti P, Wiesemann F, Elwell CE, Jones EJH. Developing customized NIRS-EEG for infant sleep research: methodological considerations. NEUROPHOTONICS 2023; 10:035010. [PMID: 37753324 PMCID: PMC10519625 DOI: 10.1117/1.nph.10.3.035010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 09/28/2023]
Abstract
Significance Studies using simultaneous functional near-infrared spectroscopy (fNIRS)-electroencephalography (EEG) during natural sleep in infancy are rare. Developments for combined fNIRS-EEG for sleep research that ensure optimal comfort as well as good coupling and data quality are needed. Aim We describe the steps toward developing a comfortable, wearable NIRS-EEG headgear adapted specifically for sleeping infants ages 5 to 9 months and present the experimental procedures and data quality to conduct infant sleep research using combined fNIRS-EEG. Approach N = 49 5- to 9-month-old infants participated. In phase 1, N = 26 (10 = slept) participated using the non-wearable version of the NIRS-EEG headgear with 13-channel-wearable EEG and 39-channel fiber-based NIRS. In phase 2, N = 23 infants (21 = slept) participated with the wireless version of the headgear with 20-channel-wearable EEG and 47-channel wearable NIRS. We used QT-NIRS to assess the NIRS data quality based on the good time window percentage, included channels, nap duration, and valid EEG percentage. Results The infant nap rate during phase 1 was ∼ 40 % (45% valid EEG data) and increased to 90% during phase 2 (100% valid EEG data). Infants slept significantly longer with the wearable system than the non-wearable system. However, there were more included good channels based on QT-NIRS in study phase 1 (61%) than phase 2 (50%), though this difference was not statistically significant. Conclusions We demonstrated the usability of an integrated NIRS-EEG headgear during natural infant sleep with both non-wearable and wearable NIRS systems. The wearable NIRS-EEG headgear represents a good compromise between data quality, opportunities of applications (home visits and toddlers), and experiment success (infants' comfort, longer sleep duration, and opportunities for caregiver-child interaction).
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Affiliation(s)
- Louisa K. Gossé
- Birkbeck, University of London, Centre for Brain and Cognitive Development, London, United Kingdom
| | - Paola Pinti
- Birkbeck, University of London, Centre for Brain and Cognitive Development, London, United Kingdom
| | - Frank Wiesemann
- Research and Development, Procter & Gamble, Schwalbach am Taunus, Germany
| | - Clare E. Elwell
- University College London, Department of Medical Physics and Biomedical Engineering, Biomedical Optics Research Laboratory, London, United Kingdom
| | - Emily J. H. Jones
- Birkbeck, University of London, Centre for Brain and Cognitive Development, London, United Kingdom
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2
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Optical Monitoring in Neonatal Seizures. Cells 2022; 11:cells11162602. [PMID: 36010678 PMCID: PMC9407001 DOI: 10.3390/cells11162602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/30/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Neonatal seizures remain a significant cause of morbidity and mortality worldwide. The past decade has resulted in substantial progress in seizure detection and understanding the impact seizures have on the developing brain. Optical monitoring such as cerebral near-infrared spectroscopy (NIRS) and broadband NIRS can provide non-invasive continuous real-time monitoring of the changes in brain metabolism and haemodynamics. AIM To perform a systematic review of optical biomarkers to identify changes in cerebral haemodynamics and metabolism during the pre-ictal, ictal, and post-ictal phases of neonatal seizures. METHOD A systematic search was performed in eight databases. The search combined the three broad categories: (neonates) AND (NIRS) AND (seizures) using the stepwise approach following PRISMA guidance. RESULTS Fifteen papers described the haemodynamic and/or metabolic changes observed with NIRS during neonatal seizures. No randomised controlled trials were identified during the search. Studies reported various changes occurring in the pre-ictal, ictal, and post-ictal phases of seizures. CONCLUSION Clear changes in cerebral haemodynamics and metabolism were noted during the pre-ictal, ictal, and post-ictal phases of seizures in neonates. Further studies are necessary to determine whether NIRS-based methods can be used at the cot-side to provide clear pathophysiological data in real-time during neonatal seizures.
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3
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Early development of sleep and brain functional connectivity in term-born and preterm infants. Pediatr Res 2022; 91:771-786. [PMID: 33859364 DOI: 10.1038/s41390-021-01497-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 12/22/2022]
Abstract
The proper development of sleep and sleep-wake rhythms during early neonatal life is crucial to lifelong neurological well-being. Recent data suggests that infants who have poor quality sleep demonstrate a risk for impaired neurocognitive outcomes. Sleep ontogenesis is a complex process, whereby alternations between rudimentary brain states-active vs. wake and active sleep vs. quiet sleep-mature during the last trimester of pregnancy. If the infant is born preterm, much of this process occurs in the neonatal intensive care unit, where environmental conditions might interfere with sleep. Functional brain connectivity (FC), which reflects the brain's ability to process and integrate information, may become impaired, with ensuing risks of compromised neurodevelopment. However, the specific mechanisms linking sleep ontogenesis to the emergence of FC are poorly understood and have received little investigation, mainly due to the challenges of studying causal links between developmental phenomena and assessing FC in newborn infants. Recent advancements in infant neuromonitoring and neuroimaging strategies will allow for the design of interventions to improve infant sleep quality and quantity. This review discusses how sleep and FC develop in early life, the dynamic relationship between sleep, preterm birth, and FC, and the challenges associated with understanding these processes. IMPACT: Sleep in early life is essential for proper functional brain development, which is essential for the brain to integrate and process information. This process may be impaired in infants born preterm. The connection between preterm birth, early development of brain functional connectivity, and sleep is poorly understood. This review discusses how sleep and brain functional connectivity develop in early life, how these processes might become impaired, and the challenges associated with understanding these processes. Potential solutions to these challenges are presented to provide direction for future research.
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Wearable, Integrated EEG-fNIRS Technologies: A Review. SENSORS 2021; 21:s21186106. [PMID: 34577313 PMCID: PMC8469799 DOI: 10.3390/s21186106] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 02/04/2023]
Abstract
There has been considerable interest in applying electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) simultaneously for multimodal assessment of brain function. EEG–fNIRS can provide a comprehensive picture of brain electrical and hemodynamic function and has been applied across various fields of brain science. The development of wearable, mechanically and electrically integrated EEG–fNIRS technology is a critical next step in the evolution of this field. A suitable system design could significantly increase the data/image quality, the wearability, patient/subject comfort, and capability for long-term monitoring. Here, we present a concise, yet comprehensive, review of the progress that has been made toward achieving a wearable, integrated EEG–fNIRS system. Significant marks of progress include the development of both discrete component-based and microchip-based EEG–fNIRS technologies; modular systems; miniaturized, lightweight form factors; wireless capabilities; and shared analogue-to-digital converter (ADC) architecture between fNIRS and EEG data acquisitions. In describing the attributes, advantages, and disadvantages of current technologies, this review aims to provide a roadmap toward the next generation of wearable, integrated EEG–fNIRS systems.
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5
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Cortical hemodynamic mechanisms of reversal learning using high-resolution functional near-infrared spectroscopy: A pilot study. Neurophysiol Clin 2021; 51:409-424. [PMID: 34481708 DOI: 10.1016/j.neucli.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Reversal learning is widely used to analyze cognitive flexibility and characterize behavioral abnormalities associated with impulsivity and disinhibition. Recent studies using fMRI have focused on regions involved in reversal learning with negative and positive reinforcers. Although the frontal cortex has been consistently implicated in reversal learning, few studies have focused on whether reward and punishment may have different effects on lateral frontal structures in these tasks. METHODS During this pilot study on eight healthy subjects, we used functional near infra-red spectroscopy (fNIRS) to characterize brain activity dynamics and differentiate the involvement of frontal structures in learning driven by reward and punishment. RESULTS We observed functional hemispheric asymmetries between punishment and reward processing by fNIRS following reversal of a learned rule. Moreover, the left dorsolateral prefrontal cortex (l-DLPFC) and inferior frontal gyrus (IFG) were activated under the reward condition only, whereas the orbito-frontal cortex (OFC) was significantly activated under the punishment condition, with a tendency towards activation for the right cortical hemisphere (r-DLPFC and r-IFG). Our results are compatible with the suggestion that the DLPFC is involved in the detection of contingency change. We propose a new representation for reward and punishment, with left lateralization for the reward process. CONCLUSIONS The results of this pilot study provide insights into the indirect neural mechanisms of reversal learning and behavioral flexibility and confirm the use of fNIRS imaging in reversal-learning tasks as a translational strategy, particularly in subjects who cannot undergo fMRI recordings.
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Bale G, Mitra S, Tachtsidis I. Metabolic brain measurements in the newborn: Advances in optical technologies. Physiol Rep 2020; 8:e14548. [PMID: 32889790 PMCID: PMC7507543 DOI: 10.14814/phy2.14548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 01/12/2023] Open
Abstract
Neonatal monitoring in neonatal intensive care is pushing the technological boundaries of newborn brain monitoring in order to improve patient outcome. There is an urgent need of a cot side, real time monitoring for assessment of brain injury severity and neurodevelopmental outcome, in particular for term newborn infants with hypoxic-ischemic brain injury. This topical review discusses why brain tissue metabolic monitoring is important in this group of infants and introduces the currently used neuromonitoring techniques for metabolic monitoring in the neonatal intensive care unit (NICU). New optical techniques that can monitor changes in brain metabolism together with brain hemodynamics at the cot side are presented. Early studies from these emerging technologies have demonstrated their potential to deliver continuous information regarding cerebral physiological changes in sick newborn infants in real time. The promises of these new tools as well as their potential limitations are discussed.
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Affiliation(s)
- Gemma Bale
- Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Subhabrata Mitra
- Neonatology, EGA Institute for Women's HealthUniversity College LondonLondonUK
| | - Ilias Tachtsidis
- Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
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Yang M, Yang Z, Yuan T, Feng W, Wang P. A Systemic Review of Functional Near-Infrared Spectroscopy for Stroke: Current Application and Future Directions. Front Neurol 2019; 10:58. [PMID: 30804877 PMCID: PMC6371039 DOI: 10.3389/fneur.2019.00058] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background: Survivors of stroke often experience significant disability and impaired quality of life. The recovery of motor or cognitive function requires long periods. Neuroimaging could measure changes in the brain and monitor recovery process in order to offer timely treatment and assess the effects of therapy. A non-invasive neuroimaging technique near-infrared spectroscopy (NIRS) with its ambulatory, portable, low-cost nature without fixation of subjects has attracted extensive attention. Methods: We conducted a comprehensive literature review in order to review the use of NIRS in stroke or post-stroke patients in July 2018. NCBI Pubmed database, EMBASE database, Cochrane Library and ScienceDirect database were searched. Results: Overall, we reviewed 66 papers. NIRS has a wide range of application, including in monitoring upper limb, lower limb recovery, motor learning, cortical function recovery, cerebral hemodynamic changes, cerebral oxygenation, as well as in therapeutic method, clinical researches, and evaluation of the risk for stroke. Conclusions: This study provides a preliminary evidence of the application of NIRS in stroke patients as a monitoring, therapeutic, and research tool. Further studies could give more emphasize on the combination of NIRS with other techniques and its utility in the prevention of stroke.
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Affiliation(s)
- Muyue Yang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai, China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Yang
- Core Facility of West China Hospital, Sichuan University, Chengdu, China
| | - Tifei Yuan
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wuwei Feng
- Department of Neurology, Medical University of South Carolina, Charleston, SC, United States
| | - Pu Wang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai, China
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8
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Chalia M, Dempsey LA, Cooper RJ, Lee CW, Gibson AP, Hebden JC, Austin T. Diffuse optical tomography for the detection of perinatal stroke at the cot side: a pilot study. Pediatr Res 2019; 85:1001-1007. [PMID: 30759451 PMCID: PMC6760550 DOI: 10.1038/s41390-018-0263-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/10/2018] [Accepted: 11/17/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Perinatal stroke is a potentially debilitating injury, often under-diagnosed in the neonatal period. We conducted a pilot study investigating the role of the portable, non-invasive brain monitoring technique, diffuse optical tomography (DOT), as an early detection tool for infants with perinatal stroke. METHODS Four stroke-affected infants were scanned with a DOT system within the first 3 days of life and compared to four healthy control subjects. Spectral power, correlation, and phase lag between interhemispheric low frequency (0.0055-0.3 Hz) hemoglobin signals were assessed. Optical data analyses were conducted with and without magnetic resonance imaging (MRI)-guided stroke localization to assess the efficacy of DOT when used without stroke anatomical information. RESULTS Interhemispheric correlations of both oxyhemoglobin and deoxyhemoglobin concentration were significantly reduced in the stroke-affected group within the very low (0.0055-0.0095 Hz) and resting state (0.01-0.08 Hz) frequencies (p < 0.003). There were no interhemispheric differences for spectral power. These results were observed even without MRI stroke localization. CONCLUSION This suggests that DOT and correlation-based analyses in the low-frequency range can potentially aid the early detection of perinatal stroke, prior to MRI acquisition. Additional methodological advances are required to increase the sensitivity and specificity of this technique.
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Affiliation(s)
- Maria Chalia
- 0000 0004 0383 8386grid.24029.3dNeonatal Intensive Care Unit, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ UK
| | - Laura A. Dempsey
- 0000000121901201grid.83440.3bDepartment of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT UK
| | - Robert J. Cooper
- 0000000121901201grid.83440.3bDepartment of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT UK
| | - Chuen-Wai Lee
- 0000 0004 0383 8386grid.24029.3dNeonatal Intensive Care Unit, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ UK
| | - Adam P. Gibson
- 0000000121901201grid.83440.3bDepartment of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT UK
| | - Jeremy C. Hebden
- 0000000121901201grid.83440.3bDepartment of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT UK
| | - Topun Austin
- Neonatal Intensive Care Unit, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK.
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Chiarelli AM, Zappasodi F, Di Pompeo F, Merla A. Simultaneous functional near-infrared spectroscopy and electroencephalography for monitoring of human brain activity and oxygenation: a review. NEUROPHOTONICS 2017; 4:041411. [PMID: 28840162 PMCID: PMC5566595 DOI: 10.1117/1.nph.4.4.041411] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/24/2017] [Indexed: 05/24/2023]
Abstract
Multimodal monitoring has become particularly common in the study of human brain function. In this context, combined, synchronous measurements of functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) are getting increased interest. Because of the absence of electro-optical interference, it is quite simple to integrate these two noninvasive recording procedures of brain activity. fNIRS and EEG are both scalp-located procedures. fNIRS estimates brain hemodynamic fluctuations relying on spectroscopic measurements, whereas EEG captures the macroscopic temporal dynamics of brain electrical activity through passive voltages evaluations. The "orthogonal" neurophysiological information provided by the two technologies and the increasing interest in the neurovascular coupling phenomenon further encourage their integration. This review provides, together with an introduction regarding the principles and future directions of the two technologies, an evaluation of major clinical and nonclinical applications of this flexible, low-cost combination of neuroimaging modalities. fNIRS-EEG systems exploit the ability of the two technologies to be conducted in an environment or experimental setting and/or on subjects that are generally not suited for other neuroimaging modalities, such as functional magnetic resonance imaging, positron emission tomography, and magnetoencephalography. fNIRS-EEG brain monitoring settles itself as a useful multimodal tool for brain electrical and hemodynamic activity investigation.
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Affiliation(s)
- Antonio M. Chiarelli
- University of Illinois at Urbana Champaign, Beckman Institute, Urbana, Illinois, United States
| | - Filippo Zappasodi
- Università G. d’Annunzio, Department of Neuroscience, Imaging and Clinical Science, Chieti, Italy
- Università G. d’Annunzio, Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Francesco Di Pompeo
- Università G. d’Annunzio, Department of Neuroscience, Imaging and Clinical Science, Chieti, Italy
- Università G. d’Annunzio, Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Arcangelo Merla
- Università G. d’Annunzio, Department of Neuroscience, Imaging and Clinical Science, Chieti, Italy
- Università G. d’Annunzio, Institute for Advanced Biomedical Technologies, Chieti, Italy
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10
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Lee CW, Cooper RJ, Austin T. Diffuse optical tomography to investigate the newborn brain. Pediatr Res 2017; 82:376-386. [PMID: 28419082 DOI: 10.1038/pr.2017.107] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 02/06/2017] [Indexed: 11/09/2022]
Abstract
Over the past 15 years, functional near-infrared spectroscopy (fNIRS) has emerged as a powerful technology for studying the developing brain. Diffuse optical tomography (DOT) is an extension of fNIRS that combines hemodynamic information from dense optical sensor arrays over a wide field of view. Using image reconstruction techniques, DOT can provide images of the hemodynamic correlates to neural function that are comparable to those produced by functional magnetic resonance imaging. This review article explains the principles of DOT, and highlights the growing literature on the use of DOT in the study of healthy development of the infant brain, and the study of novel pathophysiology in infants with brain injury. Current challenges, particularly around instrumentation and image reconstruction, will be discussed, as will the future of this growing field, with particular focus on whole-brain, time-resolved DOT.
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Affiliation(s)
- Chuen Wai Lee
- neoLAB, The Evelyn Perinatal Imaging Centre, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Neonatology, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Robert J Cooper
- neoLAB, The Evelyn Perinatal Imaging Centre, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Topun Austin
- neoLAB, The Evelyn Perinatal Imaging Centre, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Neonatology, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Galderisi A, Brigadoi S, Cutini S, Moro SB, Lolli E, Meconi F, Benavides-Varela S, Baraldi E, Amodio P, Cobelli C, Trevisanuto D, Dell’Acqua R. Long-term continuous monitoring of the preterm brain with diffuse optical tomography and electroencephalography: a technical note on cap manufacturing. NEUROPHOTONICS 2016; 3:045009. [PMID: 28042587 PMCID: PMC5180615 DOI: 10.1117/1.nph.3.4.045009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/29/2016] [Indexed: 06/06/2023]
Abstract
Diffuse optical tomography (DOT) has recently proved useful for detecting whole-brain oxygenation changes in preterm and term newborns' brains. The data recording phase in prior explorations was limited up to a maximum of a couple of hours, a time dictated by the need to minimize skin damage caused by the protracted contact with optode holders and interference with concomitant clinical/nursing procedures. In an attempt to extend the data recording phase, we developed a new custom-made cap for multimodal DOT and electroencephalography acquisitions for the neonatal population. The cap was tested on a preterm neonate (28 weeks gestation) for a 7-day continuous monitoring period. The cap was well tolerated by the neonate, who did not suffer any evident discomfort and/or skin damage. Montage and data acquisition using our cap was operated by an attending nurse with no difficulty. DOT data quality was remarkable, with an average of 92% of reliable channels, characterized by the clear presence of the heartbeat in most of them.
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Affiliation(s)
- Alfonso Galderisi
- University of Padova, Neonatal Intensive Care Unit, Department of Woman’s and Child’s Health, via Giustiniani 3, 35128 Padova, Italy
| | - Sabrina Brigadoi
- University of Padova, Department of Developmental Psychology, via Venezia 8, 35131 Padova, Italy
| | - Simone Cutini
- University of Padova, Department of Developmental Psychology, via Venezia 8, 35131 Padova, Italy
- University of Padova, Padua Neuroscience Center, via Venezia 8, 35131 Padova, Italy
| | - Sara Basso Moro
- University of Padova, Department of Neuroscience, via Giustiniani 2, 35128 Padova, Italy
| | - Elisabetta Lolli
- University of Padova, Neonatal Intensive Care Unit, Department of Woman’s and Child’s Health, via Giustiniani 3, 35128 Padova, Italy
| | - Federica Meconi
- University of Padova, Department of Developmental Psychology, via Venezia 8, 35131 Padova, Italy
| | - Silvia Benavides-Varela
- University of Padova, Department of Developmental Psychology, via Venezia 8, 35131 Padova, Italy
| | - Eugenio Baraldi
- University of Padova, Neonatal Intensive Care Unit, Department of Woman’s and Child’s Health, via Giustiniani 3, 35128 Padova, Italy
| | - Piero Amodio
- University of Padova, Department of Medicine, via Giustiniani 2, 35128 Padova, Italy
| | - Claudio Cobelli
- University of Padova, Department of Information Engineering, via Gradenigo 6/b, 35131 Padova, Italy
| | - Daniele Trevisanuto
- University of Padova, Neonatal Intensive Care Unit, Department of Woman’s and Child’s Health, via Giustiniani 3, 35128 Padova, Italy
| | - Roberto Dell’Acqua
- University of Padova, Department of Developmental Psychology, via Venezia 8, 35131 Padova, Italy
- University of Padova, Padua Neuroscience Center, via Venezia 8, 35131 Padova, Italy
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Abstract
A mismatch between cerebral oxygen supply and demand can lead to cerebral hypoxia/ischemia and deleterious outcomes. Cerebral oxygenation monitoring is an important aspect of multimodality neuromonitoring. It is increasingly deployed whenever intracranial pressure monitoring is indicated. Although there is a large body of evidence demonstrating an association between cerebral hypoxia/ischemia and poor outcomes, it remains to be determined whether restoring cerebral oxygenation leads to improved outcomes. Randomized prospective studies are required to address uncertainties about cerebral oxygenation monitoring and management. This article describes the different methods of monitoring cerebral oxygenation, their indications, evidence base, limitations, and future perspectives.
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Affiliation(s)
- Matthew A Kirkman
- Neurocritical Care Unit, The National Hospital for Neurology and Neurosurgery, University College London Hospitals, Queen Square, London WC1N 3BG, UK
| | - Martin Smith
- Neurocritical Care Unit, The National Hospital for Neurology and Neurosurgery, University College London Hospitals, Queen Square, London WC1N 3BG, UK.
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13
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Peng K, Pouliot P, Lesage F, Nguyen DK. Multichannel continuous electroencephalography-functional near-infrared spectroscopy recording of focal seizures and interictal epileptiform discharges in human epilepsy: a review. NEUROPHOTONICS 2016; 3:031402. [PMID: 26958576 PMCID: PMC4750425 DOI: 10.1117/1.nph.3.3.031402] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/08/2015] [Indexed: 05/11/2023]
Abstract
Functional near-infrared spectroscopy (fNIRS) has emerged as a promising neuroimaging technique as it allows noninvasive and long-term monitoring of cortical hemodynamics. Recent work by our group and others has revealed the potential of fNIRS, combined with electroencephalography (EEG), in the context of human epilepsy. Hemodynamic brain responses attributed to epileptic events, such as seizures and interictal epileptiform discharges (IEDs), are routinely observed with a good degree of statistical significance and in concordance with clinical presentation. Recording done with over 100 channels allows sufficiently large coverage of the epileptic focus and other areas. Three types of seizures have been documented: frontal lobe seizures, temporal lobe seizures, and posterior seizures. Increased oxygenation was observed in the epileptic focus in most cases, while rapid but similar hemodynamic variations were identified in the contralateral homologous region. While investigating IEDs, it was shown that their hemodynamic effect is observable with fNIRS, that their response is associated with significant (inhibitive) nonlinearities, and that the sensitivity and specificity of fNIRS to localize the epileptic focus can be estimated in a sample of 40 patients. This paper first reviews recent EEG-fNIRS developments in epilepsy research and then describes applications to the study of focal seizures and IEDs.
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Affiliation(s)
- Ke Peng
- École Polytechnique de Montréal, Département de génie électrique and Institut de génie biomédical, C.P. 6079, Succursale Centre-ville, Montréal, Quebec H3C3A7, Canada
| | - Philippe Pouliot
- École Polytechnique de Montréal, Département de génie électrique and Institut de génie biomédical, C.P. 6079, Succursale Centre-ville, Montréal, Quebec H3C3A7, Canada
- Institut de Cardiologie de Montréal, Centre de recherche, 5000 rue Bélanger est, Montréal, Quebec H1T1C8, Canada
| | - Frédéric Lesage
- École Polytechnique de Montréal, Département de génie électrique and Institut de génie biomédical, C.P. 6079, Succursale Centre-ville, Montréal, Quebec H3C3A7, Canada
- Institut de Cardiologie de Montréal, Centre de recherche, 5000 rue Bélanger est, Montréal, Quebec H1T1C8, Canada
| | - Dang Khoa Nguyen
- Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, Service de neurologie, 1560 rue Sherbrooke est, Montréal, Quebec H2L4M1, Canada
- Address all correspondence to: Dang Khoa Nguyen, E-mail:
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14
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Chalia M, Lee CW, Dempsey LA, Edwards AD, Singh H, Michell AW, Everdell NL, Hill RW, Hebden JC, Austin T, Cooper RJ. Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy. NEUROPHOTONICS 2016; 3:031408. [PMID: 27446969 PMCID: PMC4945004 DOI: 10.1117/1.nph.3.3.031408] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/23/2016] [Indexed: 05/24/2023]
Abstract
Burst suppression (BS) is an electroencephalographic state associated with a profound inactivation of the brain. BS and pathological discontinuous electroencephalography (EEG) are often observed in term-age infants with neurological injury and can be indicative of a poor outcome and lifelong disability. Little is known about the neurophysiological mechanisms of BS or how the condition relates to the functional state of the neonatal brain. We used simultaneous EEG and diffuse optical tomography (DOT) to investigate whether bursts of EEG activity in infants with hypoxic ischemic encephalopathy are associated with an observable cerebral hemodynamic response. We were able to identify significant changes in concentration of both oxy and deoxyhemoglobin that are temporally correlated with EEG bursts and present a relatively consistent morphology across six infants. Furthermore, DOT reveals patient-specific spatial distributions of this hemodynamic response that may be indicative of a complex pattern of cortical activation underlying discontinuous EEG activity that is not readily apparent in scalp EEG.
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Affiliation(s)
- Maria Chalia
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, Department of Neonatology, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
| | - Chuen Wai Lee
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, Department of Neonatology, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
| | - Laura A. Dempsey
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- University College London, Department of Medical Physics and Biomedical Engineering, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom
| | - Andrea D. Edwards
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, Department of Neonatology, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
| | - Harsimrat Singh
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- University College London, Department of Medical Physics and Biomedical Engineering, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom
| | - Andrew W. Michell
- Cambridge University Hospitals NHS Foundation Trust, Department of Clinical Neurophysiology, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
| | - Nicholas L. Everdell
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- University College London, Department of Medical Physics and Biomedical Engineering, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom
| | - Reuben W. Hill
- University College London, Department of Medical Physics and Biomedical Engineering, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom
| | - Jeremy C. Hebden
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- University College London, Department of Medical Physics and Biomedical Engineering, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom
| | - Topun Austin
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, Department of Neonatology, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
| | - Robert J. Cooper
- Cambridge University Hospitals NHS Foundation Trust, The Rosie Hospital, The Evelyn Perinatal Imaging Centre, neoLAB, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom
- University College London, Department of Medical Physics and Biomedical Engineering, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom
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15
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Singh H, Cooper R, Lee CW, Dempsey L, Brigadoi S, Edwards A, Airantzis D, Everdell N, Michell A, Holder D, Austin T, Hebden J. Neurovascular Interactions in the Neurologically Compromised Neonatal Brain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 876:485-492. [PMID: 26782249 DOI: 10.1007/978-1-4939-3023-4_61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Neurological brain injuries such as hypoxic ischaemic encephalopathy (HIE) and associated conditions such as seizures have been associated with poor developmental outcome in neonates. Our limited knowledge of the neurological and cerebrovascular processes underlying seizures limits their diagnosis and timely treatment. Diffuse optical tomography (DOT) provides haemodynamic information in the form of changes in concentration of de/oxygenated haemoglobin, which can improve our understanding of seizures and the relationship between neural and vascular processes. Using simultaneous EEG-DOT, we observed distinct haemodynamic changes which are temporally correlated with electrographic seizures. Here, we present DOT-EEG data from two neonates clinically diagnosed as HIE. Our results highlight the wealth of mutually-informative data that can be obtained using DOT-EEG techniques to understand neurovascular coupling in HIE neonates.
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Affiliation(s)
- H Singh
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK. .,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK.
| | - R Cooper
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - C W Lee
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - L Dempsey
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - S Brigadoi
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - A Edwards
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - D Airantzis
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - N Everdell
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - A Michell
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - D Holder
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - T Austin
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - J Hebden
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
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16
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Govindan RB, Massaro A, Chang T, Vezina G, du Plessis A. A novel technique for quantitative bedside monitoring of neurovascular coupling. J Neurosci Methods 2015; 259:135-142. [PMID: 26684362 DOI: 10.1016/j.jneumeth.2015.11.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 11/24/2015] [Accepted: 11/27/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is no current method for continuous quantification of neurovascular coupling (NVC) in spontaneous brain activity. To fill this void, we propose a novel method to quantify NVC using electroencephalogram (EEG) and near-infrared spectroscopy (NIRS) data. NEW METHOD Since EEG and NIRS measure physiologic changes occurring at different time scales, we bring them into a common dynamical time frame (DTF). To achieve this, we partition both signals into one-second epochs and calculate the standard deviation of the EEG and the average value of the NIRS for each epoch. We then quantify the NVC by calculating spectral coherence between the two signals in the DTF. The resulting NVC will have a low resolution with all of its content localized below 1Hz. RESULTS After validating this framework on simulated data, we applied this approach to EEG and NIRS signals collected from four term infants undergoing therapeutic hypothermia for neonatal encephalopathy. Two of these infants showed no evidence of structural brain injury, and the other two died during the course of the therapy. The intact survivors showed emergence of NVC during hypothermia and/or after rewarming. In contrast, the two critically ill infants, who subsequently died, lacked this feature. COMPARISON WITH EXISTING METHODS Existing methods quantify NVC by averaging neurovascular signals based on certain events (for example seizure) in the EEG activity, whereas our approach quantifies coupling between spontaneous background EEG and NIRS. CONCLUSION Real-time continuous monitoring of NVC may be a promising physiologic signal for cerebral monitoring in future.
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Affiliation(s)
- R B Govindan
- Division of Fetal and Transitional Medicine, Fetal Medicine Institute, Children's National Health System, 111 Michigan Ave NW, Washington, DC 20010, USA.
| | - An Massaro
- Division of Neonatology, Children's National, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Taeun Chang
- Division of Neurology, Children's National, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Adré du Plessis
- Division of Fetal and Transitional Medicine, Fetal Medicine Institute, Children's National Health System, 111 Michigan Ave NW, Washington, DC 20010, USA
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17
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Zhang Y, Tan F, Xu X, Duan L, Liu H, Tian F, Zhu CZ. Multiregional functional near-infrared spectroscopy reveals globally symmetrical and frequency-specific patterns of superficial interference. BIOMEDICAL OPTICS EXPRESS 2015; 6:2786-802. [PMID: 26309744 PMCID: PMC4541508 DOI: 10.1364/boe.6.002786] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 05/25/2015] [Accepted: 06/16/2015] [Indexed: 05/07/2023]
Abstract
Linear regression with short source-detector separation channels (S-channels) as references is an efficient way to overcome significant physiological interference from the superficial layer for functional near-infrared spectroscopy (fNIRS). However, the co-located configuration of S-channels and long source-detector separation channels (L-channels) is difficult to achieve in practice. In this study, we recorded superficial interference with S-channels in multiple scalp regions. We found that superficial interference has overall frequency-specific and globally symmetrical patterns. The performance of linear regression is also dependent on these patterns, indicating the possibility of simplifying the S-channel configurations for multiregional fNIRS imaging.
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Affiliation(s)
- Yujin Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Fulun Tan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Xu Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Lian Duan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Hanli Liu
- Department of Bioengineering, the University of Texas at Arlington, Arlington, TX 76010 USA
| | - Fenghua Tian
- Department of Bioengineering, the University of Texas at Arlington, Arlington, TX 76010 USA
| | - Chao-Zhe Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
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18
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Dempsey LA, Cooper RJ, Roque T, Correia T, Magee E, Powell S, Gibson AP, Hebden JC. Data-driven approach to optimum wavelength selection for diffuse optical imaging. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:016003. [PMID: 25562501 DOI: 10.1117/1.jbo.20.1.016003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 12/01/2014] [Indexed: 05/23/2023]
Abstract
The production of accurate and independent images of the changes in concentration of oxyhemoglobin and deoxyhemoglobin by diffuse optical imaging is heavily dependent on which wavelengths of near-infrared light are chosen to interrogate the target tissue. Although wavelengths can be selected by theoretical methods, in practice the accuracy of reconstructed images will be affected by wavelength-specific and system-specific factors such as laser source power and detector sensitivity. We describe the application of a data-driven approach to optimum wavelength selection for the second generation of University College London's multichannel, time-domain optical tomography system (MONSTIR II). By performing a functional activation experiment using 12 different wavelengths between 690 and 870 nm, we were able to identify the combinations of 2, 3, and 4 wavelengths which most accurately reproduced the results obtained using all 12 wavelengths via an imaging approach. Our results show that the set of 2, 3, and 4 wavelengths which produce the most accurate images of functional activation are [770, 810], [770, 790, 850], and [730, 770, 810, 850] respectively, but also that the system is relatively robust to wavelength selection within certain limits. Although these results are specific to MONSTIR II, the approach we developed can be applied to other multispectral near-infrared spectroscopy and optical imaging systems.
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Affiliation(s)
- Laura A Dempsey
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London WC1E 6BT, United Kingdom
| | - Robert J Cooper
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London WC1E 6BT, United Kingdom
| | - Tania Roque
- Faculty of Sciences of the University of Lisbon, Institute of Biophysics and Biomedical Engineering, Lisbon 1749-016, Portugal
| | - Teresa Correia
- University College London, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, London WC1E 6BT, United Kingdom
| | - Elliott Magee
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London WC1E 6BT, United Kingdom
| | - Samuel Powell
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London WC1E 6BT, United KingdomdUniversity College London, Department of Computer Science, London WC1E 6BT, United Kingdom
| | - Adam P Gibson
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London WC1E 6BT, United Kingdom
| | - Jeremy C Hebden
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London WC1E 6BT, United Kingdom
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19
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Zhang T, Zhou J, Carney PR, Jiang H. Towards real-time detection of seizures in awake rats with GPU-accelerated diffuse optical tomography. J Neurosci Methods 2014; 240:28-36. [PMID: 25445250 DOI: 10.1016/j.jneumeth.2014.10.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/06/2014] [Accepted: 10/21/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND Advancement in clinically relevant studies like seizure interruption using functional neuro imaging tools has shown that specific changes in hemodynamics precede and accompany seizure onset and propagation. However, preclinical seizure experiments need to be conducted in awake animals with images reconstructed and displayed in real-time. METHODS This article describes an approach that can be utilized to tackle these challenges. A subject specific head interface and restraining method was designed to allow for DOT to imaging of hemodynamic changes in unanesthetized rats during evoked acute seizures. Using CUDA programming model, the finite-element based nonlinear iterative algorithm for image reconstruction was parallelized. RESULTS Early hemodynamic changes were monitored in real time and observed tens of seconds prior to seizure onset. Utilizing the massive parallelization offered by graphic processing units (GPU), DOT was extended to online image reconstruction within 1s. COMPARISON WITH EXISTING METHODS Pre-seizure state related hemodynamic changes were detected in awake rats. 3D monitoring of hemodynamic changes was performed in real time with our parallelized image reconstruction procedure. CONCLUSION Diffuse optical tomography (DOT) is a promising neuroimaging tool for the investigation of seizures in awake animals.
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Affiliation(s)
- Tao Zhang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Junli Zhou
- Department of Pediatrics, University of Florida, Gainesville, FL 32611, USA
| | - Paul R Carney
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA; Department of Pediatrics, University of Florida, Gainesville, FL 32611, USA; Department of Neurology, University of Florida, Gainesville, FL 32611, USA; Department of Neuroscience, University of Florida, Gainesville, FL 32611, USA
| | - Huabei Jiang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA.
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20
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Singh H, Cooper RJ, Wai Lee C, Dempsey L, Edwards A, Brigadoi S, Airantzis D, Everdell N, Michell A, Holder D, Hebden JC, Austin T. Mapping cortical haemodynamics during neonatal seizures using diffuse optical tomography: a case study. Neuroimage Clin 2014; 5:256-65. [PMID: 25161892 PMCID: PMC4141980 DOI: 10.1016/j.nicl.2014.06.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 01/08/2023]
Abstract
Seizures in the newborn brain represent a major challenge to neonatal medicine. Neonatal seizures are poorly classified, under-diagnosed, difficult to treat and are associated with poor neurodevelopmental outcome. Video-EEG is the current gold-standard approach for seizure detection and monitoring. Interpreting neonatal EEG requires expertise and the impact of seizures on the developing brain remains poorly understood. In this case study we present the first ever images of the haemodynamic impact of seizures on the human infant brain, obtained using simultaneous diffuse optical tomography (DOT) and video-EEG with whole-scalp coverage. Seven discrete periods of ictal electrographic activity were observed during a 60 minute recording of an infant with hypoxic-ischaemic encephalopathy. The resulting DOT images show a remarkably consistent, high-amplitude, biphasic pattern of changes in cortical blood volume and oxygenation in response to each electrographic event. While there is spatial variation across the cortex, the dominant haemodynamic response to seizure activity consists of an initial increase in cortical blood volume prior to a large and extended decrease typically lasting several minutes. This case study demonstrates the wealth of physiologically and clinically relevant information that DOT-EEG techniques can yield. The consistency and scale of the haemodynamic responses observed here also suggest that DOT-EEG has the potential to provide improved detection of neonatal seizures.
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Affiliation(s)
- Harsimrat Singh
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK
| | - Robert J. Cooper
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK
| | - Chuen Wai Lee
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Laura Dempsey
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK
| | - Andrea Edwards
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Sabrina Brigadoi
- Department of Developmental Psychology, University of Padova, Padova, Italy
| | - Dimitrios Airantzis
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK
| | - Nick Everdell
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK
| | - Andrew Michell
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Department of Neurophysiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - David Holder
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK
| | - Jeremy C. Hebden
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK
| | - Topun Austin
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK
- Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
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21
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Brigadoi S, Aljabar P, Kuklisova-Murgasova M, Arridge SR, Cooper RJ. A 4D neonatal head model for diffuse optical imaging of pre-term to term infants. Neuroimage 2014; 100:385-94. [PMID: 24954280 DOI: 10.1016/j.neuroimage.2014.06.028] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 05/23/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022] Open
Abstract
Diffuse optical tomography is most accurate when an individual's MRI data can be used as a spatial prior for image reconstruction and for visualization of the resulting images of changes in oxy- and deoxy-hemoglobin concentration. As this necessitates an MRI scan to be performed for each study, which undermines many of the advantages of diffuse optical methods, the use of registered atlases to model the individual's anatomy is becoming commonplace. Infant studies require carefully age-matched atlases because of the rapid growth and maturation of the infant brain. In this paper, we present a 4D neonatal head model which, for each week from 29 to 44 weeks post-menstrual age, includes: 1) a multi-layered tissue mask which identifies extra-cerebral layers, cerebrospinal fluid, gray matter, white matter, cerebellum and brainstem, 2) a high-density tetrahedral head mesh, 3) surface meshes for the scalp, gray-matter and white matter layers and 4) cranial landmarks and 10-5 locations on the scalp surface. This package, freely available online at www.ucl.ac.uk/medphys/research/4dneonatalmodel can be applied by users of near-infrared spectroscopy and diffuse optical tomography to optimize probe locations, optimize image reconstruction, register data to cortical locations and ultimately improve the accuracy and interpretation of diffuse optical techniques in newborn populations.
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Affiliation(s)
- Sabrina Brigadoi
- Department of Developmental Psychology, University of Padova, Italy.
| | - Paul Aljabar
- Centre for the Developing Brain and Department of Biomedical Engineering, Division of Imaging Sciences, King's College London, UK
| | - Maria Kuklisova-Murgasova
- Centre for the Developing Brain and Department of Biomedical Engineering, Division of Imaging Sciences, King's College London, UK
| | - Simon R Arridge
- Department of Computer Science, University College London, UK
| | - Robert J Cooper
- Biomedical Optics Research Laboratory, Department of Medical Physics and Bioengineering, University College London, UK
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22
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Zhang T, Zhou J, Jiang R, Yang H, Carney PR, Jiang H. Pre-seizure state identified by diffuse optical tomography. Sci Rep 2014; 4:3798. [PMID: 24445927 PMCID: PMC3896905 DOI: 10.1038/srep03798] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 12/30/2013] [Indexed: 11/23/2022] Open
Abstract
In epilepsy it has been challenging to detect early changes in brain activity that occurs prior to seizure onset and to map their origin and evolution for possible intervention. Here we demonstrate using a rat model of generalized epilepsy that diffuse optical tomography (DOT) provides a unique functional neuroimaging modality for noninvasively and continuously tracking such brain activities with high spatiotemporal resolution. We detected early hemodynamic responses with heterogeneous patterns, along with intracranial electroencephalogram gamma power changes, several minutes preceding the electroencephalographic seizure onset, supporting the presence of a "pre-seizure" state. We also observed the decoupling between local hemodynamic and neural activities. We found widespread hemodynamic changes evolving from local regions of the bilateral cortex and thalamus to the entire brain, indicating that the onset of generalized seizures may originate locally rather than diffusely. Together, these findings suggest DOT represents a powerful tool for mapping early seizure onset and propagation pathways.
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Affiliation(s)
- Tao Zhang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida Gainesville, FL 32611, USA
| | - Junli Zhou
- Department of Pediatrics, University of Florida Gainesville, FL 32611, USA
| | - Ruixin Jiang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida Gainesville, FL 32611, USA
| | - Hao Yang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida Gainesville, FL 32611, USA
| | - Paul R. Carney
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida Gainesville, FL 32611, USA
- Department of Pediatrics, University of Florida Gainesville, FL 32611, USA
- Department of Neurology, University of Florida Gainesville, FL 32611, USA
- Department of Neuroscience, University of Florida Gainesville, FL 32611, USA
| | - Huabei Jiang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida Gainesville, FL 32611, USA
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23
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Kirkman MA, Smith M. Intracranial pressure monitoring, cerebral perfusion pressure estimation, and ICP/CPP-guided therapy: a standard of care or optional extra after brain injury? Br J Anaesth 2013; 112:35-46. [PMID: 24293327 DOI: 10.1093/bja/aet418] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Measurement of intracranial pressure (ICP) and mean arterial pressure (MAP) is used to derive cerebral perfusion pressure (CPP) and to guide targeted therapy of acute brain injury (ABI) during neurointensive care. Here we provide a narrative review of the evidence for ICP monitoring, CPP estimation, and ICP/CPP-guided therapy after ABI. Despite its widespread use, there is currently no class I evidence that ICP/CPP-guided therapy for any cerebral pathology improves outcomes; indeed some evidence suggests that it makes no difference, and some that it may worsen outcomes. Similarly, no class I evidence can currently advise the ideal CPP for any form of ABI. 'Optimal' CPP is likely patient-, time-, and pathology-specific. Further, CPP estimation requires correct referencing (at the level of the foramen of Monro as opposed to the level of the heart) for MAP measurement to avoid CPP over-estimation and adverse patient outcomes. Evidence is emerging for the role of other monitors of cerebral well-being that enable the clinician to employ an individualized multimodality monitoring approach in patients with ABI, and these are briefly reviewed. While acknowledging difficulties in conducting robust prospective randomized studies in this area, such high-quality evidence for the utility of ICP/CPP-directed therapy in ABI is urgently required. So, too, is the wider adoption of multimodality neuromonitoring to guide optimal management of ICP and CPP, and a greater understanding of the underlying pathophysiology of the different forms of ABI and what exactly the different monitoring tools used actually represent.
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Affiliation(s)
- M A Kirkman
- Neurocritical Care Unit, The National Hospital for Neurology and Neurosurgery, University College London Hospitals, Queen Square, London WC1N 3BG, UK
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Yücel MA, Selb J, Boas DA, Cash SS, Cooper RJ. Reducing motion artifacts for long-term clinical NIRS monitoring using collodion-fixed prism-based optical fibers. Neuroimage 2013; 85 Pt 1:192-201. [PMID: 23796546 DOI: 10.1016/j.neuroimage.2013.06.054] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/23/2013] [Accepted: 06/14/2013] [Indexed: 11/30/2022] Open
Abstract
As the applications of near-infrared spectroscopy (NIRS) continue to broaden and long-term clinical monitoring becomes more common, minimizing signal artifacts due to patient movement becomes more pressing. This is particularly true in applications where clinically and physiologically interesting events are intrinsically linked to patient movement, as is the case in the study of epileptic seizures. In this study, we apply an approach common in the application of EEG electrodes to the application of specialized NIRS optical fibers. The method provides improved optode-scalp coupling through the use of miniaturized optical fiber tips fixed to the scalp using collodion, a clinical adhesive. We investigate and quantify the performance of this new method in minimizing motion artifacts in healthy subjects, and apply the technique to allow continuous NIRS monitoring throughout epileptic seizures in two epileptic in-patients. Using collodion-fixed fibers reduces the percent signal change of motion artifacts by 90% and increases the SNR by 6 and 3 fold at 690 and 830 nm wavelengths respectively when compared to a standard Velcro-based array of optical fibers. The SNR has also increased by 2 fold during rest conditions without motion with the new probe design because of better light coupling between the fiber and scalp. The change in both HbO and HbR during motion artifacts is found to be statistically lower for the collodion-fixed fiber probe. The collodion-fixed optical fiber approach has also allowed us to obtain good quality NIRS recording of three epileptic seizures in two patients despite excessive motion in each case.
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Affiliation(s)
- Meryem A Yücel
- HMS/MIT/MGH Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Harvard Medical School, Charlestown, MA, USA.
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Cooper RJ, Selb J, Gagnon L, Phillip D, Schytz HW, Iversen HK, Ashina M, Boas DA. A systematic comparison of motion artifact correction techniques for functional near-infrared spectroscopy. Front Neurosci 2012; 6:147. [PMID: 23087603 PMCID: PMC3468891 DOI: 10.3389/fnins.2012.00147] [Citation(s) in RCA: 255] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/17/2012] [Indexed: 11/29/2022] Open
Abstract
Near-infrared spectroscopy (NIRS) is susceptible to signal artifacts caused by relative motion between NIRS optical fibers and the scalp. These artifacts can be very damaging to the utility of functional NIRS, particularly in challenging subject groups where motion can be unavoidable. A number of approaches to the removal of motion artifacts from NIRS data have been suggested. In this paper we systematically compare the utility of a variety of published NIRS motion correction techniques using a simulated functional activation signal added to 20 real NIRS datasets which contain motion artifacts. Principle component analysis, spline interpolation, wavelet analysis, and Kalman filtering approaches are compared to one another and to standard approaches using the accuracy of the recovered, simulated hemodynamic response function (HRF). Each of the four motion correction techniques we tested yields a significant reduction in the mean-squared error (MSE) and significant increase in the contrast-to-noise ratio (CNR) of the recovered HRF when compared to no correction and compared to a process of rejecting motion-contaminated trials. Spline interpolation produces the largest average reduction in MSE (55%) while wavelet analysis produces the highest average increase in CNR (39%). On the basis of this analysis, we recommend the routine application of motion correction techniques (particularly spline interpolation or wavelet analysis) to minimize the impact of motion artifacts on functional NIRS data.
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Affiliation(s)
- Robert J Cooper
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School Charlestown, MA, USA
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Cheng R, Shang Y, Hayes D, Saha SP, Yu G. Noninvasive optical evaluation of spontaneous low frequency oscillations in cerebral hemodynamics. Neuroimage 2012; 62:1445-54. [DOI: 10.1016/j.neuroimage.2012.05.069] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/11/2012] [Accepted: 05/24/2012] [Indexed: 01/15/2023] Open
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