Neural Noise

fNIRS biomarkers for stratifying poststroke cognitive impairment

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  • fNIRS biomarkers from frontal and temporal cortex activation help stratify poststroke cognitive impairment (American Heart Association Journals).1
  • Supports non-invasive neuroimaging in stroke rehabilitation and trial design; clear implementation path for fNIRS in clinical neurophysiology.1 1

Weekly enrichment (2026-07-20)

  • The underlying study was published in the American Heart Association journal Stroke (doi 10.1161/strokeaha.124.050269) as a cross-sectional study run at Nanchong Central Hospital between June 2023 and April 2024, using the Montreal Cognitive Assessment to grade cognition and fNIRS to measure task-evoked frontal and temporal oxygenated-hemoglobin responses.2 3
  • The cohort comprised 159 participants: 138 patients with poststroke cognitive impairment (mean age 53.7, SD 10.2 years, 78.3% men) and 21 age- and sex-matched healthy controls (mean age 52.8, SD 4.7 years), with patients in the subacute-to-chronic phase after stroke.3
  • Patients with poststroke cognitive impairment showed significantly reduced oxygenated-hemoglobin activation in the left dorsal prefrontal cortex (L-DPFC) relative to controls, identifying it as the key discriminating region.3
  • A multivariate model built on L-DPFC features separated impaired patients from healthy controls with an area under the ROC curve of 0.76.3
  • A model distinguishing mild from moderate impairment reached AUC 0.75 (95% CI 0.65–0.85) by combining age, education level, National Institutes of Health Stroke Scale score, recanalization therapy, and the L-DPFC centroid.3
  • A model distinguishing moderate from severe impairment reached AUC 0.84 (95% CI 0.75–0.92) using disease duration, lesion location, and the L-DPFC centroid, supporting fNIRS-based severity stratification for individualized rehabilitation.3
  • Poststroke cognitive impairment affects an estimated 30% to 50% of stroke survivors, underscoring the clinical need for objective, bedside-friendly stratification tools.3
  • Consistent with these findings, a separate working-memory fNIRS study found impaired patients rely on compensatory right prefrontal activation (frontopolar and orbitofrontal cortex) when left prefrontal activation is reduced, and a systematic review highlights declining functional connectivity as a promising fNIRS marker of poststroke cognitive dysfunction.4 5
  • fNIRS is being explored as a rapid, quantitative, real-time screening tool for post-stroke executive dysfunction (including pairing with transcranial magnetic stimulation), and lesion-side comparisons show distinct connectivity patterns for left-, right-, and bilateral-hemisphere strokes.6 7

Footnotes

  1. https://news.google.com/rss/articles/CBMingFBVV95cUxQMDZEMGdlQ2h1ck55cTlXZ2ZYT1phTWl5U2RlYUtqRTB3WGVFM09NdUlkLW5QME9VMTlSY19wX2ZmTmRkUTk4aWNUN0d6RGZacE1RbEFGX0M3VXU3cFNVbnN6NHFKamljSnF5YnVVQzdfbGpQRWtSeVpuTVJSc1MtY2hBT215ekF5a0JyS3V4cC13eTRFVVp4ajBNaHNmQQ?oc=5 ↩ ↩2 ↩3

  2. https://doi.org/10.1161/strokeaha.124.050269 ↩

  3. https://pubmed.ncbi.nlm.nih.gov/40927842/ ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7

  4. https://doi.org/10.3389/fneur.2024.1419128 ↩

  5. https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2025.1633142/full ↩

  6. https://pmc.ncbi.nlm.nih.gov/articles/PMC10173709/ ↩

  7. https://link.springer.com/article/10.1186/s12883-026-04827-3 ↩

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