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Oral frailty associated with oral hypokinesia may cause dementia. Functional near-infrared spectroscopy (fNIRS) can be used while the participants are in seating position with few restrictions. Thus, it is useful for assessing brain function, particularly oral motor activity. However, methods for identifying oral motor cortex (OMC) activation via the scalp have not been established. The current study aimed to detect OMC activation, an indicator of activity phase ratio (APR), which reflects increased oxygen consumption (0 < [deoxyhemoglobin (ΔDeoxyHb) or 0 < {[ΔDeoxyHb- oxyhemoglobin (ΔOxyHb)/√2]}, via fNIRS to accurately identify local brain activity. The APR, calculated via zero-set vector analysis, is a novel index for quantifying brain function both temporally and spatially at rest and during tasks. In total, 14 healthy participants performed bite tasks for 3 s per side for 10 times while in the sitting position. Then, time-series data on concentration changes in ΔOxyHb and ΔDeoxyHb were obtained via fNIRS. The anatomical location of the OMC was determined using a pooled data set of three-dimensional magnetic resonance images collected in advance from 40 healthy adults. In the zero-set vector analysis, the average change in ΔOxyHb and ΔDeoxyHb concentrations was utilized to calculate the APR percentage in 140 trials. The significant regions (z-score of ≥2.0) of the APR and ΔOxyHb in the task were compared. During the bite task, the APR significantly increased within the estimated OMC region (56–84 mm lateral to Cz and 4–20 mm anterior to Cz) in both the right and left hemispheres. By contrast, the ΔOxyHb concentrations increased on the bite side alone beyond the OMC region. The mean APR at rest for 2 s before the task showed 59.5%–62.2% in the left and right OMCs. The average APR for 3 s during the task showed 75.3% for the left OMC and 75.7% for the right OMC during the left bite task, and 65.9% for the left OMC and 80.9% for the right OMC during the right bite task. Interestingly, the average increase in APR for the left and right OMCs for the left bite task and the right bite task was 13.9% and 13.7%, respectively, showing almost a close match. The time course of the APR was more limited to the bite task segment than that of ΔOxyHb or ΔDexyHb concentration, and it increased in the OMC. Hence, the APR can quantitatively monitor both the resting and active states of the OMC in the left and right hemispheres. Using the zero-set vector-based fNIRS, the APR can be a valid indicator of oral motor function and bite force.

ObjectiveTo observe the effect of dexmedetomidine-assisted intravenous inhalation combined anesthesia on cerebral oxygen metabolism and serum Th1/Th2 levels in elderly patients with colorectal cancer.MethodFrom April 2018 to May 2020,100 elderly patients undergoing elective laparoscopic radical resection of colorectal cancer were prospectively selected and randomly divided into observation group and control group. Before induction of anesthesia, the loading dose of dexmedetomidine was given at 0.5 μg/kg, and the infusion time was 15 min. After tracheal intubation, 0.4 μg/kg/h dexmedetomidine was continuously pumped, and the infusion was stopped 40 min before the end of the operation. In the control group, the same amount of 0.9% sodium chloride was injected intravenously in the same way. 30 min before induction of anesthesia (T0), immediately before induction of anesthesia (T1), immediately after tracheal intubation (T2), 40 min before operation (T3), and immediately after operation (T4), record the blood oxygen content of the artery and internal jugular vein Difference (D(a-jv)O2), brain oxygen uptake rate (COER%), brain oxygen saturation (rSO2) mean. VAS scale, Ramsay scale, MoCA scale were taken at 6, 12, 24, and 48 h postoperatively to evaluate analgesia, sedation, and cognitive function. And monitor the levels of interferon-γ (IFN-γ), interleukin-4 (IL-4), myelin basic protein (MBP), neuron-specific enolase (NSE) and S100β. The occurrence of restlessness and adverse reactions during the recovery period of the two groups were compared.ResultThe levels of D(a-jv)O2, COER%, and rSO2 in the control group and observation group were higher than the preoperative basic values at T2, T3, and T4 (P < 0.05); The levels of D(a-jv)O2, COER%, and rSO2 in the observation group were lower than those in the control group at T2, T3, and T4 (P < 0.05). The VAS score and Ramsay score of the observation group were lower than those of the control group at 6, 12, 24, and 48 h after surgery, while the MoCA score was higher than that of the control group (P < 0.05). In addition, the serum IFN-γ, MBP, NSE and S100β levels of the observation group were lower than those of the control group (P < 0.05), and the ratio of IFN-γ/IL-4 was higher than that of the control group (P < 0.05). The overall incidence of adverse reactions in the observation group was lower than that in the control group [32.0% (16/50) vs. 12.0% (6/50), P < 0.05].ConclusionDexmedetomidine-assisted combined intravenous and inhalation anesthesia is beneficial to reduce perioperative cerebral oxygen metabolism and improve postoperative immunosuppression in elderly patients with colorectal cancer. It has a certain protective effect on nerve injury after operation, thus improving the cognitive function of patients and reducing the occurrence of adverse reactions.

Infant hydrocephalus poses a severe global health burden; 80% of cases occur in the developing world where patients have limited access to neurosurgical care. Surgical treatment combining endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC), first practiced at CURE Children’s Hospital of Uganda (CCHU), is as effective as standard ventriculoperitoneal shunt (VPS) placement while requiring fewer resources and less post-operative care. Although treatment focuses on controlling ventricle size, this has little association with treatment failure or long-term outcome. This study aims to monitor the progression of hydrocephalus and treatment response, and investigate the association between cerebral physiology, brain growth, and neurodevelopmental outcomes following surgery. We will enroll 300 infants admitted to CCHU for treatment. All patients will receive pre/post-operative measurements of cerebral tissue oxygenation (SO2), cerebral blood flow (CBF), and cerebral metabolic rate of oxygen consumption (CMRO2) using frequency-domain near-infrared combined with diffuse correlation spectroscopies (FDNIRS-DCS). Infants will also receive brain imaging, to monitor tissue/ventricle volume, and neurodevelopmental assessments until two years of age. This study will provide a foundation for implementing cerebral physiological monitoring to establish evidence-based guidelines for hydrocephalus treatment. This paper outlines the protocol, clinical workflow, data management, and analysis plan of this international, multi-center trial.

Background: We aimed to explore the effect of comprehensive cerebral protection on cerebral oxygen metabolism and vascular endothelial function in elderly patients with acute cerebral infarction. Methods: A total of 168 elderly patients with acute cerebral infarction treated in The First Affiliated Hospital of Nanchang University, China from January 2016 to January 2018 were selected. The patients were divided into a control group and an observation group using random number method, n=84. Patients in the observation group were given comprehensive cerebral protection treatment, and patients in the control group were treated with conventional standardized treatments. The changes of cerebral oxygen metabolism, hemorheology and vascular endothelial function before and after treatment were compared between the two groups. Results: After treatment, oxygen content in arteries and internal jugular veins (Da-vO2), ofoxygen uptake fraction (OEF), Oxygen saturation (SpO2), nitric oxide (NO) were increased in both groups in comparison to before treatment, jugular venous oxygen saturation (SjvO2), brain oxygen uptake rate (ERO2), endothelin (ET), intracranial pressure (ICP), whole blood viscosity, plasma viscosity, reduced viscosity of whole blood, and hematocrit were decreased. However, the changes in the observation group were larger than those in the control group, the difference was statistically significant (P

Background: To investigate the effect of edaravone on the postoperative cognitive function and cerebral oxygen metabolism in elderly patients with spinal surgery. Methods: One hundred and twenty patients undergoing elective thoracolumbar surgery, aged 65–75 years, were randomly divided into two groups: edaravone group (Group E, n=60) and control group (Group C, n=60). At 30 minutes before anesthesia, the patients in Group E received 0.5 mg/kg edaravone, while the patients in Group C received the same volume of normal saline. Mini-mental state examination (MMSE) was performed at 1 day before the operation, and 1 day and 4 days after the operation. Results: A total of 26 patients in both groups had postoperative cognitive dysfunction. Compared with the preoperative MMSE scores, postoperative MMSE scores decreased significantly in both groups (p