Cerebral Hemodynamics and Microvasculature Changes in Relation to White Matter Microstructure After Pediatric Mild Traumatic Brain Injury: An A-CAP Pilot Study

Abstract

Advanced neuroimaging techniques show promise as a biomarker for mild traumatic brain injury (mTBI). However, little research has evaluated cerebral hemodynamics or its relation to white matter microstructure post-mTBI in children. This novel pilot study examined differences in cerebral hemodynamics, as measured using functional near-infrared spectroscopy (fNIRS), and its association with diffusion tensor imaging (DTI) metrics in children with mTBI or mild orthopedic injury (OI) to address these gaps. Children 8.00–16.99 years of age with mTBI ( n = 9) or OI ( n = 6) were recruited in a pediatric emergency department, where acute injury characteristics were assessed. Participants completed DTI twice, post-acutely (2–33 days) and chronically (3 or 6 months), and fNIRS ∼1 month post-injury. Automated deterministic tractography was used to compute DTI metrics. There was reduced absolute phase globally and coherence in the dorsolateral pre-frontal cortex (DLPFC) after mTBI compared to the OI group. Coherence in the DLPFC and absolute phase globally showed distinct associations with fractional anisotropy in interhemispheric white matter pathways. Two fNIRS metrics (coherence and absolute phase) differentiated mTBI from OI in children. Variability in cerebral hemodynamics related to white matter microstructure. The results provide initial evidence that fNIRS may have utility as a clinical biomarker of pediatric mTBI.

Skin-interfacing wearable biosensors for smart health monitoring of infants and neonates

“…Regional tissue oxygen saturation (rSO2) monitors discriminate light paths from different tissue depths, ergo measuring veinous as well as arterial hemoglobin oxygenation 54 . Therefore, NIRS can be more useful in measuring cerebral hemodynamics, which is helpful for seizure detection 55 , intraventricular hemorrhage 56 , and white matter injury 57 . Rwei et al developed a soft, flexible, wireless system for monitoring infant cerebral hemodynamics 58 .…”