Functional near-infrared spectroscopy in non-invasive neuromodulation

Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks,which have been widely applied in the field of central neurological diseases,such as stroke,Parkinson’s disease,and mental disorders.Although significant advances have been made in neuromodulation technologies,the identification of optimal neurostimulation paramete rs including the co rtical target,duration,and inhibition or excitation pattern is still limited due to the lack of guidance for neural circuits.Moreove r,the neural mechanism unde rlying neuromodulation for improved behavioral performance remains poorly understood.Recently,advancements in neuroimaging have provided insight into neuromodulation techniques.Functional near-infrared spectroscopy,as a novel non-invasive optical brain imaging method,can detect brain activity by measuring cerebral hemodynamics with the advantages of portability,high motion tole rance,and anti-electromagnetic interference.Coupling functional near-infra red spectroscopy with neuromodulation technologies offe rs an opportunity to monitor the cortical response,provide realtime feedbac k,and establish a closed-loop strategy integrating evaluation,feedbac k,and intervention for neurostimulation,which provides a theoretical basis for development of individualized precise neuro rehabilitation.We aimed to summarize the advantages of functional near-infra red spectroscopy and provide an ove rview of the current research on functional near-infrared spectroscopy in transcranial magnetic stimulation,transcranial electrical stimulation,neurofeedback,and braincomputer interfaces.Furthermore,the future perspectives and directions for the application of functional near-infrared spectroscopy in neuromodulation are summarized.In conclusion,functional near-infrared spectroscopy combined with neuromodulation may promote the optimization of central pellral reorganization to achieve better functional recovery form central nervous system diseases.

Cortical activity in patients with high-functioning ischemic stroke during the Purdue Pegboard Test:insights into bimanual coordinated fine motor skills with functional near-infrared spectroscopy

After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promising intervention to address these deficits.However,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted interventions.To address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination.Twenty-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand dexterity.We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly subtask.Importantly,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks.Notably,the observed neural response patterns varied depending on the specific subtask.In the unaffected hand task,the differences were primarily observed in the ipsilesional hemisphere.In contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,respectively.While significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual tasks.This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural responses.The findings also suggest that patients who exhibit better bimanual performance demonstrate more efficient cortical activation.Therefore,incorporating bilateral arm training in post-stroke rehabilitation is important for better outcomes.The combination of functional near-infrared spectroscopy with functional motor paradigms is valuable for assessing skills and developing targeted interventions in stroke rehabilitation.

Synchronous measurements of prefrontal activity and pulse rate variability during online video game playing with functional near-infrared spectroscopy

Interactions between the central nervous system(CNS)and autonomic nervous system(ANS)play a crucial role in modulating perception,cognition,and emotion production.Previous studies on CNS–ANS interactions,or heart–brain coupling,have often used heart rate variability(HRV)metrics derived from electrocardiography(ECG)recordings as empirical measurements of sympathetic and parasympathetic activities.Functional near-infrared spectroscopy(fNIRS)is a functional brain imaging modality that is increasingly used in brain and cognition studies.The fNIRS signals contain frequency bands representing both neural activity oscillations and heartbeat rhythms.Therefore,fNIRS data acquired in neuroimaging studies can potentially provide a single-modality approach to measure task-induced responses in the brain and ANS synchronously,allowing analysis of CNS–ANS interactions.In this proof-of-concept study,fNIRS was used to record hemodynamic changes from the foreheads of 20 university students as they each played a round of multiplayer online battle arena(MOBA)game.From the fNIRS recordings,neural and heartbeat frequency bands were extracted to assess prefrontal activities and shortterm pulse rate variability(PRV),an approximation for short-term HRV,respectively.Under the experimental conditions used,fNIRS-derived PRV metrics showed good correlations with ECG-derived HRV golden standards,in terms of absolute measurements and video game playing(VGP)-related changes.It was also observed that,similar to previous studies on physical activity and exercise,the PRV metrics closely related to parasympathetic activities recovered slower than the PRV indicators of sympathetic activities after VGP.It is concluded that it is feasible to use fNIRS to monitor concurrent brain and ANS activations during online VGP,facilitating the understanding of VGP-related heart–brain coupling.

Spatial sensitivity to absorption changes for various near-infrared spectroscopy methods:A compendium review

This compendium review focuses on the spatial distribution of sensitivity to localized absorption changes in optically diffuse media,particularly for measurements relevant to near-infrared spectroscopy.The three temporal domains,continuous wave,frequency domain,and time domain,each obtain different optical data types whose changes may be related to effective homogeneous changes in the absorption coefficient.Sensitivity is the relationship between a localized perturbation and the recovered effective homogeneous absorption change.Therefore,spatial sensitivity maps representing the perturbation location can be generated for the numerous optical data types in the three temporal domains.The review first presents a history of the past 30 years of work investigating this sensitivity in optically diffuse media.These works are experimental and theoretical,presenting one-,two-,and three-dimensional sensitivity maps for different Near-Infrared Spectroscopy methods,domains,and data types.Following this history,we present a compendium of sensitivity maps organized by temporal domain and then data type.This compendium provides a valuable tool to compare the spatial sensitivity of various measurement methods and parameters in one document.Methods for one to generate these maps are provided in Appendix A,including the code.This historical review and comprehensive sensitivity map compendium provides a single source researchers may use to visualize,investigate,compare,and generate sensitivity to localized absorption change maps.

Near-infrared spectroscopy in schizophrenia:A bibliometric perspective

BACKGROUND Compared with current methods used to assess schizophrenia,near-infrared spectroscopy(NIRS)has the advantages of providing noninvasive and real-time monitoring of functional activities of the brain and providing direct and objective assessment information.AIM To explore the research field of NIRS in schizophrenia from the perspective of bibliometrics.METHODS The Web of Science Core Collection was used as the search tool,and the last search date was April 21,2024.Bibliometric indicators,such as the numbers of publications and citations,were recorded.Bibliometrix and VOS viewer were used for visualization analysis.RESULTS A total of 355 articles from 105 journals were included in the analysis.The overall trend of the number of research publications increased.Schizophrenia Research was identified as an influential journal in the field.Kasai K was one of the most influential and productive authors in this area of research.The University of Tokyo and Japan had the highest scientific output for an institution and a country,respectively.The top ten keywords were“schizophrenia”,“activation”,“near-infrared spectroscopy”,“verbal fluency task”,“cortex”,“brain,performance”,“workingmemory”,“brain activation”,and“prefrontal cortex”.CONCLUSION Our study reveals the evolution of knowledge and emerging trends in the field of NIRS in schizophrenia.the research focus is shifting from underlying disease characteristics to more in-depth studies of brain function and physiological mechanisms.

Correlation between LIFG and Autonomic Activation during Stressful Tasks:A Functional Near-infrared Spectroscopy (fNIRS) Study

It remains unclear whether language tasks in one＇s first （L1） or second （L2） language can cause stress responses and whether frontal, autonomic and behavioral responses to stressful tasks are correlated. In this study, we studied 22 Chinese subjects whose L2 was English and measured the cerebral blood oxygenation in their frontal lobe by using functional near-infrared spectroscopy （fNIRS） as par- ticipants engaged in a mental arithmetic task （MAT） and verbal fluency tasks （VFTs） in L1 （Chinese） and L2 （English）. To examine the activated cortical areas, we estimated the channel location based on Montreal Neurological Institute （MNI） standard brain space by using a-probabilistic estimation method. We evaluated heart rate （HR） changes to analyze autonomic nervous system （ANS） functioning. We found that the MAT and VFTs induced greater increases in HR than did the control （Ctrl） task. Further- more, subjects developed greater increases in HR in the MAT and VFTt~ than they did in the VFTL1. Compared with the Ctrl task, the MAT and both VFTLland VFTL2 produced robust and widespread bi- lateral activation of the frontal cortex. Interestingly, partial correlation analysis indicated that the activity in the left inferior frontal gyrus （LIFG） [Brodmarm＇s area （BA） 47] was consistently correlated with the increases in HR across the three tasks （MAT, VFTL2, and VFTL1）, after controlling for the performance data. The present results suggested that a VFT in L2 may be more stressful than in L1. The LIFG may affect the activation of the sympathetic system induced by stressful tasks, includin~ MATs and VFTs.

DISCRIMINATION OF MENTAL WORKLOAD LEVELS IN HUMAN SUBJECTS WITH FUNCTIONAL NEAR-INFRARED SPECTROSCOPY

We have applied functional near-infrared spectroscopy(fNIRS)to the human forehead to distinguish different levels of mental workload on the basis of hemodynamic changes occurring in the prefrontal cortex.We report data on 3 subjects from a protocol involving 3 mental workload levels based on to working memory tasks.To quantify the potential of fNIRS for mental workload discrimination,we have applied a 3-nearest neighbor classification algorithm based on the amplitude of oxyhemoglobin(HbO2)and deoxyhemoglobin(HbR)concentration changes associated with the working memory tasks.We have found classification success rates in the range of 44%-72%,which are significantly higher than the corresponding chance level(for random data)of 19.1%.This work shows the potential of fNIRS for mental workload classification,especially when more parameters(rather than just the amplitude of concentration changes used here)and more sophisticated classification algorithms(rather than the simple 3-nearest neighbor algorithm used here)are considered and optimized for this application.

Extracting heartrate from optical signal of functional near-infrared spectroscopy based on mathematical morphology

Functional near-infrared spectroscopy(fNIRS),as a new optical functional neuroimaging method,has been widely used in neuroscience research.In some research fields with NIRS,heartrate(HR)(or heartbeat)is needed as useful information to evaluate its influence,or to know the state ofsubject,or to remove its artifact.If HR(or heartbeat)can be detected with high accuracy from theoptical intensity,this will undoubtedly benefit a lot to many NIRS studies.Previous studies haveused the moving time window method or mathematical morphology method(MMM)to detectheartbeats in the optical intensity.However,there are some disadvantages in these methods.In thisstudy,we proposed a method combining the periodic information of heartbeats and the operator ofmathematical morphology to automatically detect heartbeats in the optical intensity.First theoptical intensity is smoothed using a moving average flter.Then,the opening operator of math-ematical morphology extracts peaks in the smoothed optical intensity.Finally,one peak is iden-tified as a heartbeat peak if this peak is the maximum in a predefined point range.Throughvalidation on experimental data,our method can overcome the disadvantages of previous methods,and detet heartbeats in the optical signal of fNIRS with nearly 100%accuracy.

DETECTING BILATERAL FUNCTIONAL CONNECTIVITY IN THE PREFRONTAL CORTEX DURING A STROOP TASK BY NEAR-INFRARED SPECTROSCOPY

Near infrared spectroscopy(NIRS)is generally accepted as a functional brain imaging technology for brain activation study.With multichannel highly sensitive NIRS instruments,it has become possible to assess functional connectivity of different brain negions by NIRS.However,the feasibility needs to be validated in complex cognitive activities.In this study,we recorded the hemodynamic activity of the bilateral prefrontal cortex(PFC)during a color-word matching Stroop task.Wavelet transform coberence(WTC)analysis was applied to ascss the functional conectivity of all homologous channel pairs within the left/right PFC.Both the behavioral and brain activ ation results showed signifcant Stroop effects.The results of WTC analysis revealed that,bilateral functional connectivity was significantly stronger during both the incongruent stimuli and neutral stimuli compared to that of the rest period.It also showed significant Stroop effect.Our findings demonstrate that,NIRS bcomes a valuable tool to elucidate the functional conectivity of brain cortex in complex cognitive activities.

ASSESSING WORKING MEMORY IN REAL-LIFE SITUATIONS WITH FUNCTIONAL NEAR-INFRARED SPECTROSCOPY

Working memory is one of the most important functions in our brain,which has been widely studied with unreal-life measured technologies.A functional near-infrared spectroscopy(fNIRS)instrument with a portable and low-cost design is developed,which is capable of providing hemodynamic measurement associated with brain function in real-life situations.Using this instrument,we performed working memory studies involved in Chinese words encoding,verbal,and spatial stem recognition,which are mainly studied with other technologies.Our results show that fNIRS can well assess working memory activities,in comparison with the reported results mainly using other methodologies.Furthermore,we find that hemodynamic change in the prefrontal cortex during all working memory tasks is highly associated with subjects’behavioral data.fNIRS is shown to be a promising alternative to the current methodologies for studying or assessing functional brain activities in natural condition.

Effect of head model on Monte Carlo modeling of spatial sensitivity distribution for functional near-infrared spectroscopy

Modeling Light propagation within human head to deduce spatial sensitivity distribution(SSD)is important for Near-infrared spectroscopy(NIRS)/imaging(NIRI)and diffuse correlation tomography.Lots of head models have been used on this issue,including layered head model,artificial simplified head model,MRI slices described head model,and visible human head model.Hereinto,visible Chinese human(VCH)head model is considered to be a most faithful presentation of anatomical structure,and has been highlighted to be employed in modeling light propagation.However,it is not practical for all researchers to use VCH head models and actually increasing number of people are using magnet resonance imaging(MRI)head models.Here,all the above head models were simulated and compared,and we focused on the effect of using di®erent head models on predictions of SSD.Our results were in line with the previous reports on the effect of cerebral cortex folding geometry.Moreover,the in fluence on SSD increases with thefidelity of head models.And surprisingly,the SSD percentages in scalp and gray matter(region of interest)in MRI head model were found to be 80%and 125%higher than in VCH head model.MRI head models induced nonignorable discrepancy in SSD estimation when compared with VCH head model.This study,as we believe,is the first to focus on comparison among full serials of head model on estimating SSD,and provided quantitative evidence for MRI head model users to calibrate their SSD estimation.

Functional near-infrared spectroscopy can detect low-frequency hemodynamic oscillations in the prefrontal cortex during steady-state visual evoked potentialinducing periodic facial expression stimuli presentation

Brain oscillations are vital to cognitive functions,while disrupted oscillatory activity is linked to various brain disorders.Although high-frequency neural oscillations(>1 Hz)have been extensively studied in cognition,the neural mechanisms underlying low-frequency hemodynamic oscillations(LFHO)<1 Hz have not yet been fully explored.One way to examine oscillatory neural dynamics is to use a facial expression(FE)paradigm to induce steady-state visual evoked potentials(SSVEPs),which has been used in electroencephalography studies of high-frequency brain oscillation activity.In this study,LFHO during SSVEP-inducing periodic flickering stimuli presentation were inspected using functional near-infrared spectroscopy(fNIRS),in which hemodynamic responses in the prefrontal cortex were recorded while participants were passively viewing dynamic FEs flickering at 0.2 Hz.The fast Fourier analysis results demonstrated that the power exhibited monochronic peaks at 0.2 Hz across all channels,indicating that the periodic events successfully elicited LFHO in the prefrontal cortex.More importantly,measurement of LFHO can effectively distinguish the brain activation difference between different cognitive conditions,with happy FE presentation showing greater LFHO power than neutral FE presentation.These results demonstrate that stimuli flashing at a given frequency can induce LFHO in the prefrontal cortex,which provides new insights into the cognitive mechanisms involved in slow oscillation.

DISCRIMINATIVE ANALYSIS OF FUNCTIONAL NEAR-INFRARED SPECTROSCOPY SIGNALS FOR DEVELOPMENT OF NEUROIMAGING BIOMARKERS OF ELDERLY DEPRESSION

Functional near-infrared spectroscopy(fNIRS)is a neuroimaging technology which is suitable for psychiatric patients.Several fNIRS studies have found abnormal brain activations during cognitive tasks in elderly depression.In this paper,we proposed a discriminative model of multivariate pattern classification based on fNIRS signals to distinguish elderly depressed patients from healthy controls.This model used the brain activation patterns during a verbal fluency task as features of classification.Then Pseudo-Fisher Linear Discriminant Analysis was performed on the feature space to generate discriminative model.Using leave-one-out(LOO)cross-validation,our results showed a correct classification rate of 88%.The discriminative model showed its ability to identify people with elderly depression and suggested that fNIRS may be an efficient clinical tool for diagnosis of depression.This study may provide the first step for the development of neuroimaging biomarkers based on fNIRS in psychiatric disorders.

Odorant discrimination using functional near-infrared spectroscopy of the main olfactory bulb in rats

We characterize the hemodynamic response changes near-infrared spectroscopy （NIRS） during the presentation of in the main olfactory bulb （MOB） of anesthetized rats with three different odorants： （i） plain air as a reference （Blank）, （ii） 2-heptanone （HEP）, and （iii） isopropylbenzene （Ib）. Odorants generate different changes in the concentrations of oxy- hemoglobin. Our results suggest that NIRS technology might be useful in discriminating various odorants in a non-invasive manner using animals with a superb olfactory system.

Right prefrontal cortex is activated for perceiving postural limits: a functional near-infrared spectroscopy study

The purpose of this study was to investigate neuronal mechanisms active during the percep-tion of forward postural limits in a standing po-sition and to specify fall-related brain activity using optical functional near-infrared spectros-copy. The study group included six right-handed, healthy female volunteers (range: 19, 20 years). The optical imaging device comprised 16 opto-des designed to provide 24-channel recording of changes in hemoglobin oxygenation. We meas-ured the changes of oxygenated hemoglobin levels in the frontal region when subjects per-ceived reachability in a standing position. Com- pared with those in other regions, the oxygen-ated hemoglobin levels in the right frontal region compatible with the right prefrontal cortex sig-nificantly increased. This result suggests that brain activities in the right prefrontal cortex are related to perception of reachability. Overesti-mation of postural limits has been reported as one of the risk factor for falling. This overesti-mation might be induced by dysfunction in the prefrontal cortex, resulting in a failure to inhibit a motor program that would have caused a loss of balance in reaching. Activation of the right prefrontal cortex may be a key factor for pre-venting accidental falls in the elderly and in pa-tients with neurological disorders.

Near-infrared spectroscopy method for rapid proximate quantitative analysis of nutrient composition in Pacific oyster Crassostrea gigas

Glycogen,amino acids,fatty acids,and other nutrient components affect the flavor and nutritional quality of oysters.Methods based on near-infrared reflectance spectroscopy(NIRS)were developed to rapidly and proximately determine the nutrient content of the Pacific oyster Crassostreagigas.Samples of C.gigas from 19 costal sites were freeze-dried,ground,and scanned for spectral data collection using a Fourier transform NIR spectrometer(Thermo Fisher Scientific).NIRS models of glycogen and other nutrients were established using partial least squares,multiplication scattering correction first-order derivation,and Norris smoothing.The R_(C) values of the glycogen,fatty acids,amino acids,and taurine NIRS models were 0.9678,0.9312,0.9132,and 0.8928,respectively,and the residual prediction deviation(RPD)values of these components were 3.15,2.16,3.11,and 1.59,respectively,indicating a high correlation between the predicted and observed values,and that the models can be used in practice.The models were used to evaluate the nutrient compositions of 1278 oyster samples.Glycogen content was found to be positively correlated with fatty acids and negatively correlated with amino acids.The glycogen,amino acid,and taurine levels of C.gigas cultured in the subtidal and intertidal zones were also significantly different.This study suggests that C.gigas NIRS models can be a cost-effective alternative to traditional methods for the rapid and proximate analysis of various slaughter traits and may also contribute to future genetic and breeding-related studies in Pacific oysters.

Application of principal component-radial basis function neural networks (PC-RBFNN) for the detection of water-adulterated bayberry juice by near-infrared spectroscopy

Near-infrared (NIR) spectroscopy combined with chemometrics techniques was used to classify the pure bayberry juice and the one adulterated with 10% (w/w) and 20% (w/w) water. Principal component analysis (PCA) was applied to reduce the dimensions of spectral data, give information regarding a potential capability of separation of objects, and provide principal component (PC) scores for radial basis function neural networks (RBFNN). RBFNN was used to detect bayberry juice adulterant. Multiplicative scatter correction (MSC) and standard normal variate (SNV) transformation were used to preprocess spectra. The results demonstrate that PC-RBFNN with optimum parameters can separate pure bayberry juice samples from water-adulterated bayberry at a recognition rate of 97.62%, but cannot clearly detect water levels in the adulterated bayberry juice. We conclude that NIR technology can be successfully applied to detect water-adulterated bayberry juice.

Working Memory Function in Chinese Dyslexic Children:A Near-Infrared Spectroscopy Study

The deficiency theories of dyslexia are quite contradictory and the cross-cultural studies in recent years mainly focused on whether the dyslexics among cultures shared the same cognitive profile or just based on the language.This study used Near-Infrared Spectroscopy (NIRS) imaging to measure the regional cerebral blood volume (BV) and the changes of cerebral activation in the left prefrontal cortex of 12 Chinese dyslexic children and their 12 age-matched normal controls during the Paced Vis-ual Serial Addition Test (PVSAT).Results showed that the scores of PVSAT of dyslexic children were significantly lower than those of the normal children (t=3.33,P<0.01).The activations of the left pre-frontal cortex in the normal group were significantly greater than those of dyslexic children (all P<0.01).Our results indicated that Chinese dyslexia had a general deficiency in working memory and this may be caused by the abnormal metabolic activity of brain blood volume in the left prefrontal cortex and the deficits in brain function might be the basis of neuropathology of Chinese dyslexia.Present study sup-ports the difference on brain activation of dyslexics from different languages may be caused by the same cognitive system related to reading.

Evaluation of Expression Recognition Function in Autism Spectrum Disorder Using Near-Infrared Spectroscopy

One of the characteristics of Autism Spectrum Disorder (ASD) is social disorder. The specificity of facial and expression recognition for people with ASD is gathering attention as a factor of this social disorder. The study examined the hemodynamic activities in the prefrontal cortex using near-infrared spectroscopy (NIRS) when a person with ASD performed an expression recognition task. The subjects were twenty males (18 - 22 years old) with ASD and without intellectual disabilities. Forty-five healthy males matched for age and sex were included as a control group. In both groups, the degree of autistic tendencies was evaluated using the Autism-Spectrum Quotient (AQ). Using eight standard emotional expressions of Japanese people, two expression recognition tasks were set. An NIRS was used to measure the prefrontal cortex blood mobilization during the expression-processing process. The AQ was significantly higher in the ASD group, while the rate of overall correct expression response was significantly lower (p &rho;= &minus;0.40 p < 0.001). In the automatic expression-processing task, no activation in the prefrontal cortex was found in either the ASD or the control group. In the conscious expression-processing task, the activation of the left and right lateral prefrontal cortex was weaker in the ASD group compared to the control group. Unlike in the control group, a mild activation of posterior prefrontal cortex was found in the ASD group. The expression-processing process of the ASD group was found to be different from that of the control group. NIRS was effective in detecting a brain function disorder in people with ASD during an expression-processing process.

Association of low non-invasive near-infrared spectroscopic measurements during initial trauma resuscitation with future development of multiple organ dysfunction

BACKGROUND: Near-infrared spectroscopy(NIRS) non-invasively monitors muscle tissue oxygen saturation(St O2). It may provide a continuous noninvasive measurement to identify occult hypoperfusion, guide resuscitation, and predict the development of multiple organ dysfunction(MOD) after severe trauma. We evaluated the correlation between initial St O2 and the development of MOD in multi-trauma patients.METHODS: Patients presenting to our urban, academic, Level I Trauma Center/Emergency Department and meeting standardized trauma-team activation criteria were enrolled in this prospective trial. NIRS monitoring was initiated immediately on arrival with collection of St O2 at the thenar eminence and continued up to 24 hours for those admitted to the Trauma Intensive Care Unit(TICU). Standardized resuscitation laboratory measures and clinical evaluation tools were collected. The primary outcome was the association between initial St O2 and the development of MOD within the f irst 24 hours based on a MOD score of 6 or greater. Descriptive statistical analyses were performed; numeric means, multivariate regression and rank sum comparisons were utilized. Clinicians were blinded from the StO 2 values.RESULTS: Over a 14 month period, 78 patients were enrolled. Mean age was 40.9 years(SD 18.2), 84.4% were male, 76.9% had a blunt trauma mechanism and mean injury severity score(ISS) was 18.5(SD 12.9). Of the 78 patients, 26(33.3%) developed MOD within the first 24 hours. The MOD patients had mean initial St O2 values of 53.3(SD 10.3), signifi cantly lower than those of nonMOD patients 61.1(SD 10.0); P=0.002. The mean ISS among MOD patients was 29.9(SD 11.5), significantly higher than that of non-MODS patients, 12.1(SD 9.1)(P<0.0001). The mean shock index(SI) among MOD patients was 0.92(SD 0.28), also signifi cantly higher than that of non-MODS patients, 0.73(SD 0.19)(P=0.0007). Lactate values were not signifi cantly different between groups.CONCLUSION: Non-invasive, continuous St O2 near-infrared spectroscopy values during initial trauma resuscitation correlate with the later development of multiple organ dysfunction in this patient population.