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Cerebral hemodynamics in newborn infants exposed to speech sounds: a whole-head optical topography study.

ABSTRACT: Considerable knowledge on neural development related to speech perception has been obtained by functional imaging studies using near-infrared spectroscopy (optical topography). In particular, a pioneering study showed stronger left-dominant activation in the temporal lobe for (normal) forward speech (FW) than for (reversed) backward speech (BW) in neonates. However, it is unclear whether this stronger left-dominant activation for FW is equally observed for any language or is clearer for the mother tongue. We hypothesized that the maternal language elicits clearer activation than a foreign language in newborns because of their prenatal and/or few-day postnatal exposure to the maternal language. To test this hypothesis, we developed a whole-head optode cap for 72-channel optical topography and visualized the spatiotemporal hemodynamics in the brains of 17 Japanese newborns when they were exposed to FW and BW in their maternal language (Japanese) and in a foreign language (English). Statistical analysis showed that all sound stimuli together induced significant activation in the bilateral temporal regions and the frontal region. They also showed that the left temporal-parietal region was significantly more active for Japanese FW than Japanese BW or English FW, while no significant difference between FW and BW was shown for English. This supports our hypothesis and suggests that the few-day-old brain begins to become attuned to the maternal language. Together with a finding of equivalent activation for all sound stimuli in the adjacent measurement positions in the temporal region, these findings further clarify the functional organization of the neonatal brain.

SUBMITTER: Sato H

PROVIDER: S-EPMC6870359 | biostudies-literature | 2012 Sep

REPOSITORIES: biostudies-literature

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Cerebral hemodynamics in newborn infants exposed to speech sounds: a whole-head optical topography study.

Sato Hiroki H Hirabayashi Yukiko Y Tsubokura Hifumi H Kanai Makoto M Ashida Takashi T Konishi Ikuo I Uchida-Ota Mariko M Konishi Yukuo Y Maki Atsushi A

Human brain mapping 20110628 9

Considerable knowledge on neural development related to speech perception has been obtained by functional imaging studies using near-infrared spectroscopy (optical topography). In particular, a pioneering study showed stronger left-dominant activation in the temporal lobe for (normal) forward speech (FW) than for (reversed) backward speech (BW) in neonates. However, it is unclear whether this stronger left-dominant activation for FW is equally observed for any language or is clearer for the moth ...[more]

PMID: 21714036

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Project description:Objective: Cerebral autoregulation limits the variability of cerebral blood flow (CBF) in the presence of systemic arterial blood pressure (ABP) changes. Monitoring cerebral autoregulation is important in the Neurocritical Care Unit (NCCU) to assess cerebral health. Here, our goal is to identify optimal frequency-domain near-infrared spectroscopy (FD-NIRS) parameters and apply a hemodynamic model of coherent hemodynamics spectroscopy (CHS) to assess cerebral autoregulation in healthy adult subjects and NCCU patients. Methods: In five healthy subjects and three NCCU patients, ABP oscillations at a frequency around 0.065 Hz were induced by cyclic inflation-deflation of pneumatic thigh cuffs. Transfer function analysis based on wavelet transform was performed to measure dynamic relationships between ABP and oscillations in oxy- (O), deoxy- (D), and total- (T) hemoglobin concentrations measured with different FD-NIRS methods. In healthy subjects, we also obtained the dynamic CBF-ABP relationship by using FD-NIRS measurements and the CHS model. In healthy subjects, an interval of hypercapnia was performed to induce cerebral autoregulation impairment. In NCCU patients, the optical measurements of autoregulation were linked to individual clinical diagnoses. Results: In healthy subjects, hypercapnia leads to a more negative phase difference of both O and D oscillations vs. ABP oscillations, which are consistent across different FD-NIRS methods and are highly correlated with a more negative phase difference CBF vs. ABP. In the NCCU, a less negative phase difference of D vs. ABP was observed in one patient as compared to two others, indicating a better autoregulation in that patient. Conclusions: Non-invasive optical measurements of induced phase difference between D and ABP show the strongest sensitivity to cerebral autoregulation. The results from healthy subjects also show that the CHS model, in combination with FD-NIRS, can be applied to measure the CBF-ABP dynamics for a better direct measurement of cerebral autoregulation.

Project description:BackgroundExtra-corporeal membrane oxygenation (ECMO) is a life-saving intervention for severe respiratory and cardiac diseases. However, 50% of survivors have abnormal neurologic exams. Current ECMO management is guided by systemic metrics, which may poorly predict cerebral perfusion. Continuous optical monitoring of cerebral hemodynamics during ECMO holds potential to detect risk factors of brain injury such as impaired cerebrovascular autoregulation (CA).MethodsWe conducted daily measurements of microvascular cerebral blood flow (CBF), oxygen saturation, and total hemoglobin concentration using diffuse correlation spectroscopy (DCS) and frequency-domain diffuse optical spectroscopy in nine neonates. We characterize CA utilizing the correlation coefficient (DCSx) between CBF and mean arterial blood pressure (MAP) during ECMO pump flow changes.ResultsAverage MAP and pump flow levels were weakly correlated with CBF and were not correlated with cerebral oxygen saturation. CA integrity varied between individuals and with time. Systemic measurements of MAP, pulse pressure, and left cardiac dysfunction were not predictive of impaired CA.ConclusionsOur pilot results suggest that systemic measures alone cannot distinguish impaired CA from intact CA during ECMO. Furthermore, optical neuromonitoring could help determine patient-specific ECMO pump flows for optimal CA integrity, thereby reducing risk of secondary brain injury.ImpactCerebral blood flow and oxygenation are not well predicted by systemic proxies such as ECMO pump flow or blood pressure. Continuous, quantitative, bedside monitoring of cerebral blood flow and oxygenation with optical tools enables new insight into the adequacy of cerebral perfusion during ECMO. A demonstration of hybrid diffuse optical and correlation spectroscopies to continuously measure cerebral blood oxygen saturation and flow in patients on ECMO, enabling assessment of cerebral autoregulation. An observation of poor correlation of cerebral blood flow and oxygenation with systemic mean arterial pressure and ECMO pump flow, suggesting that clinical decision making guided by target values for these surrogates may not be neuroprotective. ~50% of ECMO survivors have long-term neurological deficiencies; continuous monitoring of brain health throughout therapy may reduce these tragically common sequelae through brain-focused adjustment of ECMO parameters.

Dataset Information

Cerebral hemodynamics in newborn infants exposed to speech sounds: a whole-head optical topography study.

Publications

Cerebral hemodynamics in newborn infants exposed to speech sounds: a whole-head optical topography study.

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