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(f)USIng technologies to image the newborn brain
Electroencephalography (EEG) and functional neuroimaging enable us to better understand brain functions and to detect abnormalities. However, it is challenging to use these technologies at the bedside because of their size, lack of portability, and cost. Demene et al. have developed a portable customized and noninvasive system, called fUSI (functional ultrasound imaging), that is capable of continuous video-EEG recording and fast ultrasound imaging of the brain microvasculature in newborn babies. They applied fUSI to monitor brain activity and neurovascular changes in two neonates with abnormal cortical development, demonstrating the value of fUSI for the bedside monitoring of cerebral activity in neonates.
Abstract
Functional neuroimaging modalities are crucial for understanding brain function, but their clinical use is challenging. Recently, the use of ultrasonic plane waves transmitted at ultrafast frame rates was shown to allow for the spatiotemporal identification of brain activation through neurovascular coupling in rodents. Using a customized flexible and noninvasive headmount, we demonstrate in human neonates that real-time functional ultrasound imaging (fUSI) is feasible by combining simultaneous continuous video–electroencephalography (EEG) recording and ultrafast Doppler (UfD) imaging of the brain microvasculature. fUSI detected very small cerebral blood volume variations in the brains of neonates that closely correlated with two different sleep states defined by EEG recordings. fUSI was also used to assess brain activity in two neonates with congenital abnormal cortical development enabling elucidation of the dynamics of neonatal seizures with high spatiotemporal resolution (200 μm for UfD and 1 ms for EEG). fUSI was then applied to track how waves of vascular changes were propagated during interictal periods and to determine the ictal foci of the seizures. Imaging the human brain with fUSI enables high-resolution identification of brain activation through neurovascular coupling and may provide new insights into seizure analysis and the monitoring of brain function.
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