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Analysis of photon transit time for low-power light passing into the head, and through both skull and brain, of human subjects allowed for tomographic imaging of cerebral hemoglobin oxygenation based on photon diffusion theory. In healthy adults, imaging of changes in hemoglobin saturation during hand movement revealed focal, contralateral increases in motor cortex oxygenation with spatial agreement to activation maps determined by functional magnetic resonance imaging; in ill neonates, imaging of hemoglobin saturation revealed focal regions of low oxygenation after acute stroke, with spatial overlap to injury location determined by computed tomography scan. Because such slow optical changes occur over seconds and co-localize with magnetic resonance imaging vascular signals whereas fast activation-related optical changes occur over milliseconds and co-localize with EEG electrical signals, optical methods offer a single modality for exploring the spatio-temporal relationship between electrical and vascular responses in the brain in vivo, as well as for mapping cortical activation and oxygenation at the bedside in real-time for clinical monitoring.

Prolonged and/or fractionated depolarization due to tissue degeneration of the ventricular myocardium is a feature of cardiomyopathy. Signal averaged electrocardiography uses high-pass filters of the Butterworth type to quantify, noninvasively, fractionated high-frequency components at the end of the QRS complex. In this study a finite impulse response high-pass filter of the 90th order (cutoff at 37 Hz) was applied to magnetocardiograms (MCGs) and high-resolution electrocardiograms (ECGs) order to quantify high-frequency components throughout the myocardial depolarization. Additionally, late-potential analysis on the signal-averaged ECG was performed. A prospective investigation was made of 23 cardiologically asymptomatic patients, 11 females and 12 males, with type I diabetes mellitus. Their mean age was 21.7 years (range, 13-34 years). The mean duration of diabetes was 14 years (range, 1-27 years). Data were compared with those of 22 control subjects (12 females, 10 males) of mean age, 23.2 years (range, 11-35 years). The ECGs and MCGs were simultaneously recorded and signal-averaged, digitally filtered, and quantified by a score obtained by multiplying the amplitude variation of the signal by the number of maximal/minimal in the QRS complex. Echocardiograms were used to calculate the left ventricular mass and to document the presence of cardiomyopathy. Scores were higher in the MCGs of with type I diabetes mellitus than in the control subjects (P < .001). High scores correlated with an increased left ventricular muscular mass index (P < .05) and duration of the diabetes (P < .05). The high-resolution ECG, processed analogously, showed similar results in relation to left ventricular mass (P = .06) and duration of diabetes (P = .07), respectively (nonsignificant). No late potentials were found. These findings suggest that using a linear-phase high-pass finite impulse response filter may be useful for the noninvasive identification of patients with cardiomyopathy who exhibit possible disturbances of intraventricular depolarization. Our findings also suggest that analysis using the total QRS complex, rather than the final part of the QRS complex only, may improve identification of patients at risk.

In the present study we evaluated a new 50 MHz single wavelength multi-source detector imaging system for noninvasive optical imaging of human brain function. The system is based on phase resolved technology and allows measurements in remission mode of changes in phase shift and light intensity in the phased array approach and the conventional phase modulation approach. To evaluate the potentials and limitations of the system with respect to functional brain imaging we assessed the sensitivity of imaging based on photon migration pattern and absorption changes in the two different approaches as a function of object depth in a homogeneous brian model under controlled conditions. Furthermore first results using this technique for noninvasive optical imaging of functional brain activation in human subjects are presented and discussed with respect to potentials and limitations of the respective parameter.

During performance of a sequential finger opposition task we measured changes in regional cerebral blood oxygenation (rCBO) over the motor cortex and blood flow velocity changes (CBFV) in the middle cerebral artery in a combined near-infrared spectroscopy (NIRS) and transcranial Doppler Sonography (TCD) study. Stimulus duration was 60 s followed by a 90 s rest period. During performance of the motor task we observed an increase in [oxy-Hb] a decrease in [deoxy-Hb] and an increase in MCA flow velocity. These changes were significantly more pronounced contralaterally than ipsilaterally to the moving hand. The time course of changes in [oxy-Hb] and CBFV were strikingly similar, showing a pronounced initial over-shoot.

Neuronal activation is coupled to localised changes in regional cerebral blood flow, blood oxygenation and metabolism (Leninger-Follert et al. 1979, Frostig et al. 1990). On this basis it is possible to detect and localise activated brain areas by the use of functional imaging methods like PET and fMRI (Phelps et al. 1985, Fox et al. 1986, Belliveau et al. 1991). The high spatial resolution of these imaging methods allows to characterise and localise hemodynamic and metabolic changes of activated brain areas on an anatomical basis. Near infrared spectroscopy noninvasively detects changes in the concentration of oxy-Hb, deoxy-Hb and Cyt-O2 by measuring changes in absorption at specific wavelength of light in the near infrared region. The technique in the first instance was used to detect global changes in cerebral hemodynamics (Jobsis 1977, Elwell 1994) and was recently introduced to assess hemodynamic response induced by functional brain activation (Hoshi et al. 1993, Villringer et al. 1993, Obrig et al. 1995, Kato et al. 1993, Meek et al. 1995), The high temporal resolution and the ability to assess several oxygenation parameters simultaneously provides information about temporal dynamics of oxygenation changes in response to functional stimulation. Reasons for using this technique to investigate functional brain activation lie in some advantages compared to traditionally used functional imaging methods. Near infrared spectroscopy is completely non-invasive low expensive and can be used with high flexibility. NIRS allows repeated measures and administration of exogenous tracers is not required. The technique is therefore suited for assessment of brain function in clinical settings as a bedside technique.

The influence of different lengths of the pre-stimulation resting period on the magnitude of a hemodynamic response evoked by motor stimulation was examined in 10 subjects by means of near-infrared spectroscopy (NIRS). A motor stimulus was used which has been previously established as a model for functional activation studies with NIRS. Subjects performed a 20 s finger opposition task in the hand contralateral to NIRS probe localization over left sensorimotor area (C3′, according to the 10–20 system). The duration of the pre-stimulation resting period was varied from 10s to 50s and response magnitude was assessed for each of the interstimulus intervals (10 s, 20 s, 30 s, 40 s and 50 s). Data analysis showed that response magnitude in oxygenated and deoxygenated haemoglobin concentration changed with different interstimulation intervals. Interestingly the greatest NIRS response was obtained with a resting period of 30 s prior to stimulation; shorter and longer resting periods resulted in smaller responses. The time course and the dependence of response magnitude on interstimulus interval differed between [oxy-Hb] and [deoxy-Hb] changes. For [oxy-Hb] the previously described fast initial increase (‘overshoot’) and the post-stimulation undershoot was more clearly seen with long prestimulation resting periods. Cytochromeoxidase oxygenation changes did not change significantly with different interstimulus intervals.

We applied non-invasive multisite near-infrared spectroscopy (NIRS) to assess oxygenation changes during performance of a sequential finger opposition task in five healthy human adults. Oxygenation response was localized anatomically using three-dimensional high-resolution magnetic resonance imaging (3D MRI). NIRS measurements showed a localized increase in [oxy-Hb] and a decrease in [deoxy-Hb] in all subjects. The largest response was obtained when the measurement position was over the primary motor and sensory cortex hand area. Interestingly, changes in [deoxy-Hb] seemed to be more localized than changes in [oxy-Hb]. We conclude that this simple, non-invasive and flexible optical bedside method may be used for functional brain mapping.

We studied cerebral hemodynamic response to a sequential motor task in 56 subjects to investigate the time course and distribution of blood oxygenation changes as monitored by near-infrared spectroscopy (NIRS). To address whether response is modulated by different performance velocities, a group of subjects (n = 12) was examined while performing the motor task at 1, 2, and 3 Hz. The results demonstrate that 1) the NIRS response reflects localized changes in cerebral hemodynamics, 2) the response, consisting of an increase in oxygenated hemoglobin concentration [oxy-Hb] and a decrease in deoxygenated hemoglobin concentration ([deoxy-Hb]), is lateralized and increases in amplitude with higher performance rates, and 3) changes in [oxy-Hb] and [deoxy-Hb] differ in time course. Changes in [oxy-Hb] are biphasic, with a fast initial increase and a pronounced poststimulus undershoot. The stimulus-associated decrease in [deoxy-Hb] is monophasic, and response latency is greater. We conclude that NIRS is able to detect even small changes in cerebral hemodynamic response to functional stimulation.