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REVIEW article

Front. Neurol.
Sec. Applied Neuroimaging
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1524806
This article is part of the Research Topic Advanced fNIRS Applications in Neuroscience and Neurological Disorders View all 11 articles

Functional Near-Infrared Spectroscopy for the Assessment and Treatment of Patients with Disorders of Consciousness

Provisionally accepted
Nan Wang Nan Wang 1Yifang He Yifang He 2Sipeng Zhu Sipeng Zhu 1Dongsheng Liu Dongsheng Liu 3Xiaoke Chai Xiaoke Chai 1Qiheng He Qiheng He 1Tianqing Cao Tianqing Cao 1Jianghong He Jianghong He 1Jingqi Li Jingqi Li 4Juanning Si Juanning Si 2*YI YANG YI YANG 1*Jizong Zhao Jizong Zhao 1*
  • 1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  • 2 School of Instrument Science and Optoelectronic Engineering, Beijing Information Science and Technology University, Beijing, Beijing Municipality, China
  • 3 Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
  • 4 Hangzhou Mingzhou Brain Rehabilitation Hospital, Hangzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    Introduction: Advances in neuroimaging have significantly enhanced our understanding of brain function, providing critical insights into the diagnosis and management of disorders of consciousness (DoC). Functional near-infrared spectroscopy (fNIRS), with its real-time, portable, and noninvasive imaging capabilities, has emerged as a promising tool for evaluating functional brain activity and nonrecovery potential in DoC patients. This review explores the current applications of fNIRS in DoC research, identifies its limitations, and proposes future directions to optimize its clinical utility.Aim: This review examines the clinical application of fNIRS in monitoring DoC. Specifically, it investigates the potential value of combining fNIRS with brain-computer interfaces (BCIs) and closed-loop neuromodulation systems for patients with DoC, aiming to elucidate mechanisms that promote neurological recovery.Approach: A systematic analysis was conducted on 155 studies published between January 1993 and October 2024, retrieved from the Web of Science Core Collection database. Results: Analysis of 21 eligible studies on neurological diseases involving 262 DoC patients revealed significant findings. The prefrontal cortex was the most frequently targeted brain region. fNIRS has proven crucial in assessing brain functional connectivity and activation, facilitating the diagnosis of DoC. Furthermore, fNIRS plays a pivotal role in diagnosis and treatment through its application in neuromodulation techniques such as deep brain stimulation (DBS) and spinal cord stimulation (SCS). Conclusions: As a noninvasive, portable, and real-time neuroimaging tool, fNIRS holds significant promise for advancing the assessment and treatment of DoC. Despite limitations such as low spatial resolution and the need for standardized protocols, fNIRS has demonstrated its utility in evaluating residual brain activity, detecting covert consciousness, and monitoring therapeutic interventions. In addition to assessing consciousness levels, fNIRS offers unique advantages in tracking hemodynamic changes associated with neuroregulatory treatments, including DBS and SCS. By providing real-time feedback on cortical activation, fNIRS facilitates optimizing therapeutic strategies and supports individualized treatment planning. Continued research addressing its technical and methodological challenges will further establish fNIRS as an indispensable tool in the diagnosis, prognosis, and treatment monitoring of DoC patients.

    Keywords: functional near-infrared spectroscopy, disorders of consciousness, Neuromodulation, Brain-computer interface, Monitoring and assessment

    Received: 08 Nov 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Wang, He, Zhu, Liu, Chai, He, Cao, He, Li, Si, YANG and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Juanning Si, School of Instrument Science and Optoelectronic Engineering, Beijing Information Science and Technology University, Beijing, 100192, Beijing Municipality, China
    YI YANG, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    Jizong Zhao, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.