Near-infrared Diffuse Optical Imaging for Noninvasive Monitoring of Cortical Spreading Depression

Cortical spreading depression (CSD) is a region of transient electrical and metabolic failure that propagates through peri-lesional brain tissue. Although characteristics of CSD have been shown to be relevant to injury outcome, subdural electrode measurements, currently in use, restrict monitoring only to patients requiring craniotomy. A portable, noninvasive monitoring device applicable to all patients experiencing CSD would therefore be of great clinical utility from the standpoint of furthering our basic understanding as well as guiding treatment strategies. Physical Sciences Inc. and Massachusetts General Hospital have developed under DOD funding a time-domain near-infrared device to monitor CSD noninvasively. Phase I studies have demonstrated the capability of this instrument for monitoring CSD in a piglet model. Phase II research will focus on the engineering aspects that will allow for device miniaturization, as well as for enhanced temporal and spatial resolution. This new system will be validated in human patients by conducting a clinical pilot study at the Massachusetts General Hospital on a population affected by stroke and/or TBI. The new compact prototype device will have a low-profile probe that will not interfere with normal patient care. This device will also be robust and suitable for field deployment.