Measures of vascular dysfunction may serve as valuable clinical markers for the early detection of dementia, and for monitoring its progression. Near-Infrared Spectroscopy (NIRS) can non-invasively measure brain oxygenation by quantifying concentration changes of oxygenated (HbO) and deoxygenated haemoglobin (HbR). NIRS shows much promise for clinical translation: it has few contraindications, it can be performed at the bedside, and it is low-cost. High-Density Diffuse Optical Tomography (HD-DOT) extends this method by combining high-density NIRS with anatomical information to produce volumetric or topographical maps of brain oxygenation. Here we present an observational cohort study for Alzheimer's disease, dementia with Lewy bodies or mild cognitive impairment (n=32), which for the first time evaluates the possibility of using HD-DOT to develop biomarkers for dementia. Our early findings show that visual stimulation elicits a reduction in the magnitude of concentration changes of both HbO and HbR in Alzheimer’s Disease compared to healthy controls.
KEYWORDS: Near infrared spectroscopy, Dementia, Brain, Design and modelling, Data modeling, Neuroimaging, Neurodegeneration, Image classification, Head, Magnetic resonance imaging
SignificanceDementia presents a global healthcare crisis, and neuroimaging is the main method for developing effective diagnoses and treatments. Yet currently, there is a lack of sensitive, portable, and low-cost neuroimaging tools. As dementia is associated with vascular and metabolic dysfunction, near-infrared spectroscopy (NIRS) has the potential to fill this gap.AimThis future perspective aims to briefly review the use of NIRS in dementia to date and identify the challenges involved in realizing the full impact of NIRS for dementia research, including device development, study design, and data analysis approaches.ApproachWe briefly appraised the current literature to assess the challenges, giving a critical analysis of the methods used. To assess the sensitivity of different NIRS device configurations to the brain with atrophy (as is common in most forms of dementia), we performed an optical modeling analysis to compare their cortical sensitivity.ResultsThe first NIRS dementia study was published in 1996, and the number of studies has increased over time. In general, these studies identified diminished hemodynamic responses in the frontal lobe and altered functional connectivity in dementia. Our analysis showed that traditional (low-density) NIRS arrays are sensitive to the brain with atrophy (although we see a mean decrease of 22% in the relative brain sensitivity with respect to the healthy brain), but there is a significant improvement (a factor of 50 sensitivity increase) with high-density arrays.ConclusionsNIRS has a bright future in dementia research. Advances in technology – high-density devices and intelligent data analysis—will allow new, naturalistic task designs that may have more clinical relevance and increased reproducibility for longitudinal studies. The portable and low-cost nature of NIRS provides the potential for use in clinical and screening tests.
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