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The aim of this study was to evaluate the potential use of wearable and fiberless fNIRS to monitor brain haemodynamic and oxygenation changes related to brain neuronal activity during real-world situations. A wearable and fiberless multichannel fNIRS system was used to measure brain activity over the prefrontal cortex during a prospective memory task performed outside the lab. The case study reported here explored whether brain changes in HbO2 and HHb on a freely moving participant in response to social and non-social PM cues in an experiment outside the lab can be monitored continuously and robustly.
The use of fNIRS on freely moving participants in life-based experiments represents a challenging situation. In fact, head movements can cause probe displacements with consequent motion artifacts that corrupt the optical identification of brain activity36. Moreover, optical sensors are sensitive to stray light (e.g., sunlight when experiments are performed outside), creating additional noise in fNIRS signals. The reported case study provides a preliminary demonstration of the feasibility of the fNIRS system in such real life applications. The absence of optical fibers in such devices prevents optical coupling between the scalp and the optodes resulting in more robust measurements against motion artifacts. In addition, the shading cap ensures a good shielding from the stray light which avoids detectors saturation and low Signal-to-Noise Ratio (SNR). Moreover, increases in HbO2 and decrease in HHb concentrations were found in correspondence of social and non-social PM hits (Figure 3D-E)11,37 further supporting its feasibility. In order to assess if the haemodynamic trends observed in Figure 3D-E are statistically significant and to locate activated regions within the prefrontal cortex (Figure 5, Video 1, Video 2, Figure 6, Figure 7), group-level analyses are required. In order to make inference and to identify functionally specialized prefrontal cortex regions38, 39, future works will present group data and statistical analyses based on Statistical Parametric Mapping (SPM) using a General Linear Model (GLM) approach.
Even though results have to be considered preliminary, it has been demonstrated that fiberless fNIRS can be effectively brought outside the traditional lab settings and used for real time monitoring of brain activity. This opens up new directions for neurological and neuroscience research. There are at least two obvious areas for application in this respect. The first relates to ecological validity. Cognitive neuroscience researchers investigate patterns of brain activity while people are performing cognitive tasks (using e.g., blood oxygen level dependent signal change as a proxy in functional MRI) in order to try to discover how the brain supports our mental abilities. In some cases, it is possible to create experimental situations in the scanner that match very closely the situation in everyday life where the process of interest is used. Consider, for example, reading. Reading words on a display while in a MRI scanner likely makes such similar demands to reading words in a book when at home that it is almost taken for granted that the results gleaned in the scanner can help explain how the brain implements reading in everyday life. However, for many forms of human behaviour and cognition, this assumption is more precarious. For instance, the cognitive processes that a participant uses when a social situation is presented in an MRI scanner (where the participant is immobile, on their own, and in a very unfamiliar and tightly controlled environment) may well be different in important regards to those engaged when the participant is socialising in real life40. This is particularly important in social neuroscience where the investigation of the neuronal correlates of inter-personal dynamics (termed hyperscanning, for review see Babiloni and Astolfi, 201441) requires a more naturalistic environment. NIRS-based hyperscanning42, 43 may thus represent a new tool to simultaneously monitor brain activity from two or more people in realistic situations. Indeed, there are some mental abilities that cannot be studied well in the highly artificial and physically constrained environment of a MRI, PET or MEG scanner. Those involving ambulation or large amounts of bodily movement as well as those involving social interactions are obvious candidates. For this reason, being able to study the brain activity of participants in naturalistic situations is highly desirable for researchers.
A second, related, broad area of application relates to the use of this technology in clinical situations. An obvious candidate may be neurorehabilitation, where one might wish to study the effects upon the brain of training procedures for activities of daily living (e.g., in a kitchen), or of medication upon particular neuronal populations in relation to these activities. But the technology might also perhaps be developed for educational settings as well, and e.g., for the use of “real-time” self-monitoring of brain activity. The portability, low risk, and ability to use it in situ in real-world environments with minimal constraint upon behaviour, makes this method very different from others that are currently available.
However, although wearable fNIRS systems show potential for real-world observations, there are other limitations that have to be addressed when using fNIRS during natural walking. Since the infrared light travels through the scalp, it is sensitive to processes that happen both at the cerebral and extra-cerebral compartments of the head. Previous studies demonstrated that a certain amount of the signals measured through fNIRS arises from systemic changes34, 39, 44 that are not directly related to brain activity (see Scholkmann et al.9 for a review). As intra and extra-cerebral hemodynamic are affected by systemic changes both task-evoked and spontaneous (e.g., heart rate, blood pressure, respiration, skin blood flow), physiological changes related to the walking activity should be considered. They originate from the autonomic nervous system (ANS) activity, which regulates heart rate, respiration, blood pressure and vessels diameter through its efferent fibers. More precisely, the sympathetic division of the ANS is hyper-activated during exercise leading to heart rate, blood pressure and respiration increments45. For example, previous studies have demonstrated that respiration induces changes in partial pressure of carbon dioxide in the arterial blood (PaCO2) which in turn influence cerebral blood flow and cerebral blood volume46, 47. In addition, Figure 3A shows an example of periodic HHb increases and HbO2 decreases that occur within walking periods that can be confused with brain deactivation. In order to make consistent comparisons between conditions (e.g., assess if significant changes in concentration occur respect to a baseline period), all the experimental phases should be measured under the same physical activity state. For this reason, a walked rest phase (Rest 2) was included in our life-based protocol. A proper interpretation of fNIRS data requires also a good SNR. This is usually achieved with conventional block and event-related designs where stimulations are repeated several times. Trial repetitions and structured designs are not always possible in life-based experiments. For this reason, additional sensors and appropriate analysis techniques to account for systemic changes48 and motion artifacts are necessary to improve the SNR and to correctly interpret brain signals. We plan to investigate the impact of such walk-related systemic changes through the use of portable devices to monitor breathing rate, heart rate and walking pace. Moreover, the problem of events recovery needs to be addressed, too. In cognitive neuroscience experiments, brain activity is investigated in relation to stimuli or environments encountered by participants’, and their behaviour in response to, or anticipation of them. Experimenters therefore need to (a) know what is currently available to the participant in their environment, and (b) have a moment-by-moment record of the participant’s behaviour. In a typical lab situation these factors can be readily controlled since the experimenter can constrain what participants encounter, and the form and number of behaviours that the participant can evince. However, this is not the case in “real-world” environments outside the lab, where many events and experiences that the research participant will have are beyond the strict control of the experimenter49. Accordingly, in “real-world” type tasks of the kind studied here, video records are used for analysis (e.g., Shallice and Burgess, 19913). This allows to recover both sustained (e.g., block-level) and transient (e.g., event-related) processes that support different aspects of performance (for review see Gonen-Yaacovi and Burgess, 201221). The events to be recovered from the video recordings will depend on the theoretical question being addressed in the experiment. In the reported case study, event onsets were recovered from the videos filmed by the 3 cameras. This procedure of determining the onset and termination of particular cues and behavioural responses is laborious and requires skill when carried out on life-based data. A central issue is that with “real life” type experiments there is usually not the same degree of a priori knowledge of events as with the lab-based ones, and participants usually have more scope in the way they can respond. Moreover, as participants are free to move in a natural and uncontrolled environment, they are faced with a variety of rapidly-changing stimuli and it is difficult to recover the haemodynamic response to the real event of interest. For example, in the case study, the haemodynamic trends observed for HbO2 and HHb (Figure 3D-E) are not phase-locked to the video-recovered onset like the typical event-related haemodynamic response38. HbO2 and HHb start respectively to rise and decrease 20 sec before the stimulus onset and reach a peak after it. Further analyses are thus needed to establish whether PM cues events are happening actually when the participant sees the target, when he approaches towards it or when he reaches it. Given the potential of fiberless fNIRS technologies for real life clinical applications, future work will address the video-coding problem by developing new algorithms to identify event onsets in a more objective way, as well as exploring the possibility of doing it directly from fNIRS data.