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Lighting up babies' brains: development of a combined NIRS/EEG system for infants

A newborn infant has an extraordinarily vulnerable and immature central nervous system, which is undergoing rapid structural and functional development. As these infants are pre-verbal and their neurological systems are immature, assessing accurately and treating effectively procedure-related pain is a significant challenge. The nociceptive signals caused by the pain are accompanied by changes in regional blood oxygenation and neuronal activity in the infant’s brain. In this study, we developed a dual-mode Near-Infrared Spectroscopy (NIRS) and electroencephalography (EEG) monitor that can measure regional brain oxygenation and neuronal activity concurrently (safe and non-invasive). The neuronal activity is measured by an innovative low-noise EEG amplifier in both conventional and ultra-low frequency bandwidths. This multimodal recording allows us to investigate the coupling of neuronal activity and the neurovascular system as never before. NIRS and EEG electrodes are miniaturized and unified in one sensor. This modification facilitates the use of a NIRS/EEG device for recording from neonatal subjects. Ten infants, born between 27-35 weeks gestational age, are being recruited from the NICU at BCWH. They are monitored during a single, routine blood draw required for clinical care. In this experiment, we investigate the change of cerebral hemodynamic across 3 phases of blood collection, baseline, heel lance, recovery. Variation of blood flow accompanied with the slow shift of EEG has been detected during the pain stimulus phase. Additionally, the increase of gamma-band correlated to a rise in blood flow is also observed