A Newcomer's Guide to Functional Near Infrared Spectroscopy Experiments

Noninvasive cardiac hemodynamics monitoring of acute myocardial ischemia in rats using near-infrared spectroscopy: A pilot study

Noninvasive and real-time optical detection of cardiac hemodynamics dysfunction during myocardial ischemia remains challenging. In this study, we developed a near-infrared spectroscopy device to monitor rats' myocardial hemodynamics. The well-designed system can accurately reflect the hemodynamics changes by the classic upper limb ischemia test. Systemic hypoxia by disconnecting to the ventilator and cardiac ischemia by coronary artery slipknot ligation was conducted to monitor myocardial hemodynamics. When systemic hypoxia occurred, ΔHbR and ΔtHb increased significantly, whereas ΔHbO decreased rapidly. When coronary blood flow was obstructed by slipknots, cardiothoracic ΔHbO immediately begins to decline, while ΔHbR also significantly increases. Simultaneously, SpO2 did not show any obvious changes during myocardial ischemia, while SpO2 decreased significantly during systemic hypoxia. These results demonstrated that cardiothoracic hemodynamics stemmed from myocardial ischemia. This pilot study demonstrated the practicality of noninvasive, low-cost optical monitoring for cardiac oxygenation dysfunction in rats.

Heart Rate Variability and Pulse Rate Variability: Do Anatomical Location and Sampling Rate Matter?

Wearable technology and neuroimaging equipment using photoplethysmography (PPG) have become increasingly popularized in recent years. Several investigations deriving pulse rate variability (PRV) from PPG have demonstrated that a slight bias exists compared to concurrent heart rate variability (HRV) estimates. PPG devices commonly sample at ~20-100 Hz, where the minimum sampling frequency to derive valid PRV metrics is unknown. Further, due to different autonomic innervation, it is unknown if PRV metrics are harmonious between the cerebral and peripheral vasculature. Cardiac activity via electrocardiography (ECG) and PPG were obtained concurrently in 54 participants (29 females) in an upright orthostatic position. PPG data were collected at three anatomical locations: left third phalanx, middle cerebral artery, and posterior cerebral artery using a Finapres NOVA device and transcranial Doppler ultrasound. Data were sampled for five minutes at 1000 Hz and downsampled to frequencies ranging from 20 to 500 Hz. HRV (via ECG) and PRV (via PPG) were quantified and compared at 1000 Hz using Bland-Altman plots and coefficient of variation (CoV). A sampling frequency of ~100-200 Hz was required to produce PRV metrics with a bias of less than 2%, while a sampling rate of ~40-50 Hz elicited a bias smaller than 20%. At 1000 Hz, time- and frequency-domain PRV measures were slightly elevated compared to those derived from HRV (mean bias: ~1-8%). In conjunction with previous reports, PRV and HRV were not surrogate biomarkers due to the different nature of the collected waveforms. Nevertheless, PRV estimates displayed greater validity at a lower sampling rate compared to HRV estimates.

Retrieval of chromophore concentration changes in a digital human head model using analytical mean partial pathlengths of photons

Significance

Continuous-wave functional near-infrared spectroscopy has proved to be a valuable tool for assessing hemodynamic activity in the human brain in a non-invasively and inexpensive way. However, most of the current processing/analysis methods assume the head is a homogeneous medium, and hence do not appropriately correct for the signal coming from the scalp. This effect can be reduced by considering light propagation in a layered model of the human head, being the Monte Carlo (MC) simulations the gold standard to this end. However, this implies large computation times and demanding hardware capabilities.

Aim

In this work, we study the feasibility of replacing the homogeneous model and the MC simulations by means of analytical multilayered models, combining in this way, the speed and simplicity of implementation of the former with the robustness and accuracy of the latter.

Approach

Oxy- and deoxyhemoglobin (HbO and HbR, respectively) concentration changes were proposed in two different layers of a magnetic resonance imaging (MRI)-based meshed model of the human head, and then these changes were retrieved by means of (i) a typical homogeneous reconstruction and (ii) a theoretical layered reconstruction.

Results

Results suggest that the use of analytical models of light propagation in layered models outperforms the results obtained using traditional homogeneous reconstruction algorithms, providing much more accurate results for both, the extra- and the cerebral tissues. We also compare the analytical layered reconstruction with MC-based reconstructions, achieving similar degrees of accuracy, especially in the gray matter layer, but much faster (between 4 and 5 orders of magnitude).

Conclusions

We have successfully developed, implemented, and validated a method for retrieving chromophore concentration changes in the human brain, combining the simplicity and speed of the traditional homogeneous reconstruction algorithms with robustness and accuracy much more similar to those provided by MC simulations.

Hemodynamic signal changes during volitional swallowing in dysphagia patients with different unilateral hemispheric stroke and brainstem stroke: A near-infrared spectroscopy study

BACKGROUND AND OBJECTIVES

Strokes will result in decreased in cortical excitability and changed in the balance between the affected and unaffected hemispheres. Previous studies have focused on cortical changes in healthy subjects during swallowing, while they remain unknown in patients with stroke at different locations. Thus, the purpose of this study was to research cortical activation patterns of swallowing in patients with dysphagia and healthy subjects by the functional near-infrared spectroscopy (fNIRS). We also focus on the comparability of brain activation areas associated with swallowing between patients with different stroke locations and healthy subjects.

METHODS

total of 104 participants were invited to our study, involving 86 patients with dysphagic unilateral hemispheric stroke and 18 age and sex matched healthy controls. The stroke patients were categorized into patients with left unilateral stroke lesions (n = 30), patients with right unilateral stroke lesions (n = 32) and patients with brainstem injury (n = 24) according to different stroke sites. All patients underwent a series of clinical swallowing function assessments, such as the Fiberoptic endoscopic dysphagia severity scale (FEDSS), penetration-aspiration scale (PAS) of Rosenbek, the gugging swallowing screen (GUSS) and the functional oral Intake scale (FOIS) after informed consent has been signed. All participants received the fNIRS system assessment.

RESULTS

The results showed that extensive areas of the cerebral cortex activated during the swallowing tasks in healthy participants (P < FDR 0.05). For patients with left unilateral stroke lesions, the HbO concentration were strongest over the right hemisphere (P < FDR 0.05). In addition, a less severe activation was also observed in the left hemisphere. Comparable to patients with left unilateral stroke lesions, the strongest activation during swallowing task were found in the left hemisphere in patients with right unilateral stroke lesions (P < FDR 0.05). Similarly, the right hemisphere also has activated less. In contrast, patients with brain stem injury showed more bilaterally activation patterns.

CONCLUSION

Our finding states that cortical activation areas differ between patients with different stroke locations and healthy subjects during swallowing. There was a more bilateral activation in healthy participants and patients with lesions in the brainstem while more cortical activation in unaffected hemisphere in patients with unilateral hemispheric stroke. It also provides a basis for the future treatment of dysphagia after stroke.

Applications of functional near-infrared spectroscopy in non-drug therapy of traditional Chinese medicine: a review

Non-drug therapies of traditional Chinese medicine (TCM), including acupuncture, massage, tai chi chuan, and Baduanjin, have emerged as widespread interventions for the treatment of various diseases in clinical practice. In recent years, preliminary studies on the mechanisms of non-drug therapies of TCM have been mostly based on functional near-infrared spectroscopy (fNIRS) technology. FNIRS is an innovative, non-invasive tool to monitor hemodynamic changes in the cerebral cortex. Our review included clinical research conducted over the last 10 years, establishing fNIRS as a reliable and stable neuroimaging technique. This review explores new applications of this technology in the field of neuroscience. First, we summarize the working principles of fNIRS. We then present preventive research on the use of fNIRS in healthy individuals and therapeutic research on patients undergoing non-drug therapies of TCM. Finally, we emphasize the potential for encouraging future advancements in fNIRS studies to establish a theoretical framework for research in related fields.

Activation changes in patients with post-stroke cognitive impairment receiving intermittent theta burst stimulation: A functional near-infrared spectroscopy study

BACKGROUND

Intermittent theta burst stimulation (iTBS) has demonstrated efficacy in patients with cognitive impairment. However, activation patterns and mechanisms of iTBS for post-stroke cognitive impairment (PSCI) remain insufficiently understood.

OBJECTIVE

To investigate the activation patterns and potential benefits of using iTBS in patients with PSCI.

METHODS

A total of forty-four patients with PSCI were enrolled and divided into an iTBS group (iTBS and cognitive training) or a control group (cognitive training alone). Outcomes were assessed based on the activation in functional near-infrared spectroscopy (fNIRS), as well as Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel Index (MBI).

RESULTS

Thirty-eight patients completed the interventions and assessments. Increased cortical activation was observed in the iTBS group after the interventions, including the right superior temporal gyrus (STG), left frontopolar cortex (FPC) and left orbitofrontal cortex (OFC). Both groups showed significant improvements in LOTCA and MBI after the interventions (p < 0.05). Furthermore, the iTBS group augmented superior improvement in the total score of MBI and LOTCA compared to the control group, especially in visuomotor organization and thinking operations (p < 0.05).

CONCLUSION

iTBS altered activation patterns and improved cognitive function in patients with PSCI. The activation induced by iTBS may contribute to the improvement of cognitive function.

MamoRef: an optical mammography device using whole-field CW diffuse reflectance. Presentation, validation and preliminary clinical results

Objective.MamoRef is an mammography device that uses near-infrared light, designed to provide clinically relevant information for the screening of diseases of the breast. Using low power continuous wave lasers and a high sensitivity CCD (Charge-coupled device) that captures a diffusely reflected image of the tissue, MamoRef results in a versatile diagnostic tool that aims to fulfill a complementary role in the diagnosis of breast cancer providing information about the relative hemoglobin concentrations as well as oxygen saturation.Approach.We present the design and development of an initial prototype of MamoRef. To ensure its effectiveness, we conducted validation tests on both the theoretical basis of the reconstruction algorithm and the hardware design. Furthermore, we initiated a clinical feasibility study involving patients diagnosed with breast disease, thus evaluating the practical application and potential benefits of MamoRef in a real-world setting.Main results.Our study demonstrates the effectiveness of the reconstruction algorithm in recovering relative concentration differences among various chromophores, as confirmed by Monte Carlo simulations. These simulations show that the recovered data correlates well with the ground truth, with SSIMs of 0.8 or more. Additionally, the phantom experiments validate the hardware implementation. The initial clinical findings exhibit highly promising outcomes regarding MamoRef's ability to differentiate between lesions.Significance.MamoRef aims to be an advancement in the field of breast pathology screening and diagnostics, providing complementary information to standard diagnostic techniques. One of its main advantages is the ability of determining oxy/deoxyhemoglobin concentrations and oxygen saturation; this constitutes valuable complementary information to standard diagnostic techniques. Besides, MamoRef is a portable and relatively inexpensive device, intended to be not only used in specific medical imaging facilities. Finally, its use does not require external compression of the breast. The findings of this study underscore the potential of MamoRef in fulfilling this crucial role.

Application Research of Visible Near-Infrared Spectroscopy Technology for Detecting Intracerebral Hematoma

OBJECTIVE

To explore the visible near-infrared spectroscopic (VNIRS) characteristics of intracerebral hematoma, and provide experimental basis for hematoma localization and residual detection in hypertensive intracerebral hemorrhage (HICH) surgery.

METHODS

Using VNIRS, spectral data of cerebral hematoma and cortex were collected during HICH craniotomy, and characteristic spectra were matched with paired-sample T-test. A partial least squares (PLS) quantitative model for cerebral hematoma spectra was established.

RESULTS

The reflectance of cerebral hematoma spectra in the 500-800 nm band was lower than that of the cortex, and there were statistically significant differences in the 510, 565, and 630 nm bands (P < 0.05). The calibration correlation coefficient of the PLS quantitative model for cerebral hematoma spectra was R2 = 0.988, the cross-validation correlation coefficient was R2cv = 0.982, the root mean square error of calibration was RMSEC = 0.101, the root mean square error of cross-validation was RMSEV = 0.122, the external validation correlation coefficient was CORRELATION = 0.902, and the root mean square error of prediction was RMSEP = 0.426, indicating that the model had high fitting degree and good predictive ability.

CONCLUSIONS

VNIRS as a noninvasive, real-time and portable analysis technology, can be used for real-time detection of hematoma during HICH surgery, and provide reliable basis for hematoma localization and residual detection.

Near-Infrared Spectroscopy: A Free-Living Neuroscience Tool to Better Understand Diabetes and Obesity

The human brain is the least accessible of all organs and attempts to study it in vivo rely predominantly on neuroimaging. Functional near-infrared spectroscopy (fNIRS) allows for the study of cortical neural activity in a non-invasive manner that may resemble free-living conditions. Moreover, compared to other neuroimaging tools, fNIRS is less expensive, it does not require the use of ionizing radiation, and can be applied to all study populations (patients suffering from claustrophobia, or neonates). In this narrative review, we provide an overview of the available research performed using fNIRS in patients with diabetes and obesity. The few studies conducted to date have presented controversial results regarding patients with diabetes, some reporting a greater hemodynamic response and others reporting a reduced hemodynamic response compared to the controls, with an unclear distinction between types 1 and 2. Subjects with obesity or a binge eating disorder have reduced prefrontal activation in response to inhibitory food or non-food stimuli; however, following an intervention, such as cognitive treatment, prefrontal activation is restored. Moreover, we discuss the potential of future applications of fNIRS for a better understanding of cortical neural activity in the context of metabolic disorders.

A case for hybrid BCIs: combining optical and electrical modalities improves accuracy

Near-infrared spectroscopy (NIRS) is a promising research tool that found its way into the field of brain-computer interfacing (BCI). BCI is crucially dependent on maximized usability thus demanding lightweight, compact, and low-cost hardware. We designed, built, and validated a hybrid BCI system incorporating one optical and two electrical modalities ameliorating usability issues. The novel hardware consisted of a NIRS device integrated with an electroencephalography (EEG) system that used two different types of electrodes: Regular gelled gold disk electrodes and tri-polar concentric ring electrodes (TCRE). BCI experiments with 16 volunteers implemented a two-dimensional motor imagery paradigm in off- and online sessions. Various non-canonical signal processing methods were used to extract and classify useful features from EEG, tEEG (EEG through TCRE electrodes), and NIRS. Our analysis demonstrated evidence of improvement in classification accuracy when using the TCRE electrodes compared to disk electrodes and the NIRS system. Based on our synchronous hybrid recording system, we could show that the combination of NIRS-EEG-tEEG performed significantly better than either single modality only.

Using preregistration as a tool for transparent fNIRS study design

Significance

The expansion of functional near-infrared spectroscopy (fNIRS) methodology and analysis tools gives rise to various design and analytical decisions that researchers have to make. Several recent efforts have developed guidelines for preprocessing, analyzing, and reporting practices. For the planning stage of fNIRS studies, similar guidance is desirable. Study preregistration helps researchers to transparently document study protocols before conducting the study, including materials, methods, and analyses, and thus, others to verify, understand, and reproduce a study. Preregistration can thus serve as a useful tool for transparent, careful, and comprehensive fNIRS study design.

Aim

We aim to create a guide on the design and analysis steps involved in fNIRS studies and to provide a preregistration template specified for fNIRS studies.

Approach

The presented preregistration guide has a strong focus on fNIRS specific requirements, and the associated template provides examples based on continuous-wave (CW) fNIRS studies conducted in humans. These can, however, be extended to other types of fNIRS studies.

Results

On a step-by-step basis, we walk the fNIRS user through key methodological and analysis-related aspects central to a comprehensive fNIRS study design. These include items specific to the design of CW, task-based fNIRS studies, but also sections that are of general importance, including an in-depth elaboration on sample size planning.

Conclusions

Our guide introduces these open science tools to the fNIRS community, providing researchers with an overview of key design aspects and specification recommendations for comprehensive study planning. As such it can be used as a template to preregister fNIRS studies or merely as a tool for transparent fNIRS study design.

Reconstruction of light absorption changes in the human head using analytically computed photon partial pathlengths in layered media

Functional near infrared spectroscopy has been used in recent decades to sense and quantify changes in hemoglobin concentrations in the human brain. This noninvasive technique can deliver useful information concerning brain cortex activation associated with different motor/cognitive tasks or external stimuli. This is usually accomplished by considering the human head as a homogeneous medium; however, this approach does not explicitly take into account the detailed layered structure of the head, and thus, extracerebral signals can mask those arising at the cortex level. This work improves this situation by considering layered models of the human head during reconstruction of the absorption changes in layered media. To this end, analytically calculated mean partial pathlengths of photons are used, which guarantees fast and simple implementation in real-time applications. Results obtained from synthetic data generated by Monte Carlo simulations in two- and four-layered turbid media suggest that a layered description of the human head greatly outperforms typical homogeneous reconstructions, with errors, in the first case, bounded up to ∼20% maximum, while in the second case, the error is usually larger than 75%. Experimental measurements on dynamic phantoms support this conclusion.

Estimation of Respiratory Rate during Biking with a Single Sensor Functional Near-Infrared Spectroscopy (fNIRS) System

OBJECTIVE

The employment of wearable systems for continuous monitoring of vital signs is increasing. However, due to substantial susceptibility of conventional bio-signals recorded by wearable systems to motion artifacts, estimation of the respiratory rate (RR) during physical activities is a challenging task. Alternatively, functional Near-Infrared Spectroscopy (fNIRS) can be used, which has been proven less vulnerable to the subject's movements. This paper proposes a fusion-based method for estimating RR during bicycling from fNIRS signals recorded by a wearable system.

METHODS

Firstly, five respiratory modulations are extracted, based on amplitude, frequency, and intensity of the oxygenated hemoglobin concentration (O2Hb) signal. Secondly, the dominant frequency of each modulation is computed using the fast Fourier transform. Finally, dominant frequencies of all modulations are fused, based on averaging, to estimate RR. The performance of the proposed method was validated on 22 young healthy subjects, whose respiratory and fNIRS signals were simultaneously recorded during a bicycling task, and compared against a zero delay Fourier domain band-pass filter.

RESULTS

The comparison between results obtained by the proposed method and band-pass filtering indicated the superiority of the former, with a lower mean absolute error (3.66 vs. 11.06 breaths per minute, p<0.05). The proposed fusion strategy also outperformed RR estimations based on the analysis of individual modulation.

SIGNIFICANCE

This study orients towards the practical limitations of traditional bio-signals for RR estimation during physical activities.

Interdisciplinary views of fNIRS: Current advancements, equity challenges, and an agenda for future needs of a diverse fNIRS research community

Functional Near-Infrared Spectroscopy (fNIRS) is an innovative and promising neuroimaging modality for studying brain activity in real-world environments. While fNIRS has seen rapid advancements in hardware, software, and research applications since its emergence nearly 30 years ago, limitations still exist regarding all three areas, where existing practices contribute to greater bias within the neuroscience research community. We spotlight fNIRS through the lens of different end-application users, including the unique perspective of a fNIRS manufacturer, and report the challenges of using this technology across several research disciplines and populations. Through the review of different research domains where fNIRS is utilized, we identify and address the presence of bias, specifically due to the restraints of current fNIRS technology, limited diversity among sample populations, and the societal prejudice that infiltrates today's research. Finally, we provide resources for minimizing bias in neuroscience research and an application agenda for the future use of fNIRS that is equitable, diverse, and inclusive.

Shining a light on cultural neuroscience: Recommendations on the use of fNIRS to study how sociocultural contexts shape the brain

Functional near-infrared spectroscopy (fNIRS) is a portable neuroimaging technique that may serve as a methodological tool for studying how sociocultural contexts can shape the human brain and impact cognition and behavior. The use of fNIRS in community-based research may (a) advance theoretical knowledge in psychology and neuroscience, particularly regarding underrepresented ethnic-racial communities; (b) increase diversity in samples; and (c) provide neurobiological evidence of sociocultural factors supporting human development. The review aims to introduce the use of fNIRS, including its practicalities and limitations, to new adopters inquiring how sociocultural inputs affect the brain. The review begins with an introduction to cultural neuroscience, and a review on the use of fNIRS follows. Next, benefits and guidelines to the design of fNIRS research in naturalistic environments (in the community or in the field) using a cultural lens are discussed. Strengths-based and community-based approaches in cultural neuroscience are recommended throughout. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Estimation of Respiratory Rate from Functional Near-Infrared Spectroscopy (fNIRS): A New Perspective on Respiratory Interference

OBJECTIVE

Respiration is recognized as a systematic physiological interference in functional near-infrared spectroscopy (fNIRS). However, it remains unanswered as to whether it is possible to estimate the respiratory rate (RR) from such interference. Undoubtedly, RR estimation from fNIRS can provide complementary information that can be used alongside the cerebral activity analysis, e.g., sport studies. Thus, the objective of this paper is to propose a method for RR estimation from fNIRS. Our primary presumption is that changes in the baseline wander of oxygenated hemoglobin concentration (O2Hb) signal are related to RR.

METHODS

fNIRS and respiratory signals were concurrently collected from subjects during controlled breathing tasks at a constant rate from 0.1 Hz to 0.4 Hz. Firstly, the signal quality index algorithm is employed to select the best O2Hb signal, and then a band-pass filter with cut-off frequencies from 0.05 to 2 Hz is used to remove very low- and high-frequency artifacts. Secondly, troughs of the filtered O2Hb signal are localized for synthesizing the baseline wander (S1) using cubic spline interpolation. Finally, the fast Fourier transform of the S1 signal is computed, and its dominant frequency is considered as RR. In this paper, two different datasets were employed, where the first one was used for the parameter adjustment of the proposed method, and the second one was solely used for testing.

RESULTS

The low mean absolute error between the reference and estimated RRs for the first and second datasets (2.6 and 1.3 breaths per minute, respectively) indicates the feasibility of the proposed method for RR estimation from fNIRS.

SIGNIFICANCE

This paper provides a novel view on the respiration interference as a source of complementary information in fNIRS.

Dataset of parent-child hyperscanning functional near-infrared spectroscopy recordings

The term “hyperscanning” refers to the simultaneous recording of multiple individuals’ brain activity. As a methodology, hyperscanning allows the investigation of brain-to-brain synchrony. Despite being a promising technique, there is a limited number of publicly available functional Near-infrared Spectroscopy (fNIRS) hyperscanning recordings. In this paper, we report a dataset of fNIRS recordings from the prefrontal cortical (PFC) activity of 33 mother-child dyads and 29 father-child dyads. Data was recorded while the parent-child dyads participated in an experiment with two sessions: a passive video attention task and a free play session. Dyadic metadata, parental psychological traits, behavioural annotations of the play sessions and information about the video stimuli complementing the dataset of fNIRS signals are described. The dataset presented here can be used to design, implement, and test novel fNIRS analysis techniques, new hyperscanning analysis tools, as well as investigate the PFC activity in participants of different ages when they engage in passive viewing tasks and active interactive tasks.

Measurement(s)	Blood Oxygen Level-Dependent Response
Technology Type(s)	Functional Near-Infrared Spectroscopy
Factor Type(s)	Parenting Stress • Parental Bonding • Attachment Style
Sample Characteristic - Organism	Homo sapiens
Sample Characteristic - Location	Singapore

Reconstructing a Deblurred 3D Structure in a Turbid Medium from a Single Blurred 2D Image—For Near-Infrared Transillumination Imaging of a Human Body

To provide another modality for three-dimensional (3D) medical imaging, new techniques were developed to reconstruct a 3D structure in a turbid medium from a single blurred 2D image obtained using near-infrared transillumination imaging. One technique uses 1D information of a curvilinear absorber, or the intensity profile across the absorber image. Profiles in different conditions are calculated by convolution with the depth-dependent point spread function (PSF) of the transillumination image. In databanks, profiles are stored as lookup tables to connect the contrast and spread of the profile to the absorber depth. One-to-one correspondence from the contrast and spread to the absorber depth and thickness were newly found. Another technique uses 2D information of the transillumination image of a volumetric absorber. A blurred 2D image is deconvolved with the depth-dependent PSF, thereby producing many images with points of focus on different parts. The depth of the image part can be estimated by searching the deconvolved images for the image part in the best focus. To suppress difficulties of high-spatial-frequency noise, we applied a noise-robust focus stacking method. Experimentation verified the feasibility of the proposed techniques, and suggested their applicability to curvilinear and volumetric absorbers such as blood vessel networks and cancerous lesions in tissues.

Searching for the Mechanism of Action of Extremely Low Frequency Electromagnetic Field-The Pilot fNIRS Research

There is an ongoing debate on the benefits of magnetic stimulation in neurological disorders. Objectives: We aimed to evaluate the influence of magnetic stimulation on blood oxygenation of the motor cortex using functional near-infrared spectroscopy (fNIRS). Methods: A total of 16 healthy volunteer participants were subjected to four protocols. In the first two protocols, the participants remained at rest without (and then with) magnetic stimulation. In the next two protocols, motor cortex stimulation was achieved using a finger-tapping task, with and without magnetic stimulation. Changes in blood oxygenation levels within the motor cortex were recorded and analysed. Results: No characteristic changes in the blood oxygenation level-dependent responses were observed in resting participants after magnetic stimulation. No statistically significant difference was observed in the amplitude of the fNIRS signal before and after magnetic stimulation. We observed characteristic blood oxygenation level-dependent responses after the finger-tapping task in the second protocol, but not after magnetic stimulation. Conclusions: Although we did not observe any measurable effect of the magnetic field on the haemodynamic response of the motor cortex, understanding the mechanism(s) of magnetic stimulation may be important. Additional, detailed studies are needed to prove or negate the potential of this medical procedure.

Treatment of Persistent Post-Concussion Syndrome with Repetitive Transcranial Magnetic Stimulation Using Functional Near-Infrared Spectroscopy as a Biomarker of Response: A Randomized Sham-Controlled Clinical Trial Protocol (Preprint)

Background

Approximately one-third of all concussions lead to persistent postconcussion syndrome (PPCS). Repetitive transcranial magnetic stimulation (rTMS) is a form of noninvasive brain stimulation that has been extensively used to treat refractory major depressive disorder and has a strong potential to be used as a treatment for patients with PPCS. Functional near-infrared spectroscopy (fNIRS) has already been used as a tool to assess patients with PPCS and may provide insight into the pathophysiology of rTMS treatment in patients with PPCS.

Objective

The primary objective of this research is to determine whether rTMS treatment improves symptom burden in patients with PPCS compared to sham treatment using the Rivermead postconcussion symptom questionnaire. The secondary objective is to explore the neuropathophysiological changes that occur following rTMS in participants with PPCS using fNIRS. Exploratory objectives include determining whether rTMS treatment in participants with PPCS will also improve quality of life, anxiety, depressive symptoms, cognition, posttraumatic stress, and function secondary to headaches.

Methods

A total of 44 adults (18-65 years old) with PPCS (>3 months to 5 years) will participate in a double-blind, sham-controlled, concealed allocation, randomized clinical trial. The participants will engage in either a 4-week rTMS treatment protocol or sham rTMS protocol (20 treatments). The left dorsolateral prefrontal cortex will be located through Montreal Neurologic Institute coordinates. The intensity of the rTMS treatment over the left dorsolateral prefrontal cortex will be 120% of resting motor threshold, with a frequency of 10 Hz, 10 trains of 60 pulses per train (total of 600 pulses), and intertrain interval of 45 seconds. Prior to starting the rTMS treatment, participant and injury characteristics, questionnaires (symptom burden, quality of life, depression, anxiety, cognition, and headache), and fNIRS assessment will be collected. Repeat questionnaires and fNIRS will occur immediately after rTMS treatment and at 1 month and 3 months post rTMS. Outcome parameters will be analyzed by a 2-way (treatment × time) mixed analysis of variance.

Results

As of May 6, 2021, 5 participants have been recruited for the study, and 3 have completed the rTMS protocol. The estimated completion date of the trial is May 2022.

Conclusions

This trial will expand our knowledge of how rTMS can be used as a treatment option of PPCS and will explore the neuropathophysiological response of rTMS through fNIRS analysis.

Trial Registration

ClinicalTrials.gov NCT04568369; https://clinicaltrials.gov/ct2/show/NCT04568369

International Registered Report Identifier (IRRID)

DERR1-10.2196/31308

Effects of Transcranial Direct Current Stimulation (tDCS) on Cognitive Performance and Cerebral Oxygen Hemodynamics: A Systematic Review

Background: There is increasing evidence to support the efficacy of transcranial direct current stimulation (tDCS) applications in cognitive augmentation and rehabilitation. Neuromodulation achieved with tDCS may further regulate regional cerebral perfusion affiliated through the neurovascular unit; however, components of cerebral perfusion decrease across aging. A novel neuroimaging approach, functional near-infrared spectroscopy (fNIRS), can aid in quantifying these regional perfusional changes. To date, the interaction of the effects of tDCS on cognitive performance across the lifespan and obtained fNIRS hemodynamic responses remain unknown.

Objective: This review aims to examine the effects of tDCS on cognitive performance and fNIRS hemodynamic responses within the context of cognitive aging.

Methods: Six databases were searched for studies. Quality appraisal and data extraction were conducted by two independent reviewers. Meta-analysis was carried out to determine overall and subgroup effect sizes.

Results: Eight studies met inclusion criteria. The overall effect size demonstrates that tDCS can alter cognitive performance and fNIRS signals, with aging being a potential intermediary in tDCS efficacy.

Conclusion: From the studies included, the effects of tDCS on cognitive performance and fNIRS metrics are most prominent in young healthy adults and appear to become less robust with increasing age. Given the small number of studies included in this review further investigation is recommended.

Trends and Challenges of Wearable Multimodal Technologies for Stroke Risk Prediction

We review in this paper the wearable-based technologies intended for real-time monitoring of stroke-related physiological parameters. These measurements are undertaken to prevent death and disability due to stroke. We compare the various characteristics, such as weight, accessibility, frequency of use, data continuity, and response time of these wearables. It was found that the most user-friendly wearables can have limitations in reporting high-precision prediction outcomes. Therefore, we report also the trend of integrating these wearables into the internet of things (IoT) and combining electronic health records (EHRs) and machine learning (ML) algorithms to establish a stroke risk prediction system. Due to different characteristics, such as accessibility, time, and spatial resolution of various wearable-based technologies, strategies of applying different types of wearables to maximize the efficacy of stroke risk prediction are also reported. In addition, based on the various applications of multimodal electroencephalography-functional near-infrared spectroscopy (EEG-fNIRS) on stroke patients, the perspective of using this technique to improve the prediction performance is elaborated. Expected prediction has to be dynamically delivered with high-precision outcomes. There is a need for stroke risk stratification and management to reduce the resulting social and economic burden.

A consensus guide to using functional near-infrared spectroscopy in posture and gait research

BACKGROUND

Functional near-infrared spectroscopy (fNIRS) is increasingly used in the field of posture and gait to investigate patterns of cortical brain activation while people move freely. fNIRS methods, analysis and reporting of data vary greatly across studies which in turn can limit the replication of research, interpretation of findings and comparison across works.

RESEARCH QUESTION AND METHODS

Considering these issues, we propose a set of practical recommendations for the conduct and reporting of fNIRS studies in posture and gait, acknowledging specific challenges related to clinical groups with posture and gait disorders.

RESULTS

Our paper is organized around three main sections: 1) hardware set up and study protocols, 2) artefact removal and data processing and, 3) outcome measures, validity and reliability; it is supplemented with a detailed checklist.

SIGNIFICANCE

This paper was written by a core group of members of the International Society for Posture and Gait Research and posture and gait researchers, all experienced in fNIRS research, with the intent of assisting the research community to lead innovative and impactful fNIRS studies in the field of posture and gait, whilst ensuring standardization of research.

New Directions in Exercise Prescription: Is There a Role for Brain-Derived Parameters Obtained by Functional Near-Infrared Spectroscopy?

In the literature, it is well established that regular physical exercise is a powerful strategy to promote brain health and to improve cognitive performance. However, exact knowledge about which exercise prescription would be optimal in the setting of exercise–cognition science is lacking. While there is a strong theoretical rationale for using indicators of internal load (e.g., heart rate) in exercise prescription, the most suitable parameters have yet to be determined. In this perspective article, we discuss the role of brain-derived parameters (e.g., brain activity) as valuable indicators of internal load which can be beneficial for individualizing the exercise prescription in exercise–cognition research. Therefore, we focus on the application of functional near-infrared spectroscopy (fNIRS), since this neuroimaging modality provides specific advantages, making it well suited for monitoring cortical hemodynamics as a proxy of brain activity during physical exercise.