# A whole-cortex fNIRS system to shine light on the problem of post-operative delirium

> **NIH NIH R21** · VANDERBILT UNIVERSITY · 2021 · $197,960

## Abstract

PROJECT SUMMARY: For individuals > 60 years of age, the dangers of surgery include more than surgical
complications: postoperative delirium (POD) is an established concern with reported incidence rates that
exceed 50% for certain surgeries, including cardiac surgery. Nearly 3.9 million elderly patients are at risk for
POD due to cardiac surgery alone. The dangerous sequelae associated with POD include increased
perioperative morbidity, increased duration of hospitalization and increased risk of dementia, the additional
costs of which amount to ~$152 billion. Despite the large number of investigations related to POD, no
satisfactory intraoperative biomarkers or preoperative predictors have emerged that can prevent or curtail the
dysfunction, exposing a critical gap in our understanding of signs and contributors to the condition. New
methods of assessment are needed to guide changes and interventions in surgical procedures that
can reduce the incidence of POD.
 A common shortcoming in research studies on delirium has been the lack of awareness and
understanding of neurocognitive changes during surgery. Consequently, such studies are inadequate to
identify what aspects of surgery contribute to delirium and to guide changes to surgical procedures that can
possibly prevent it. Neuromonitoring during surgery has been largely limited to inconclusive cerebral oximetry
and electroencephalography (EEG) studies. Cerebral oximetry lacks perspective of the whole cortex during
surgery – missing potentially critical landmarks for delirium biomarkers; EEG studies suffer from low spatial
resolution and high susceptibility to signal artifacts. Moreover, current tools are bulky and have unreliable
adhesive attachments that imbue susceptibility to motion, mobility limitations, setup difficulty and inconsistency
in data quality due to changes in sensor positioning expected during the perioperative workflow.
 In contrast, functional near infrared spectroscopy (fNIRS)-based perioperative monitoring of the whole
cortex would offer better spatial resolution, lower susceptibility to artifacts, and a better view of the brain
before, during and after surgery. We propose a novel fNIRS cap for perioperative monitoring to overcome
the usability and sensing limitations of current neuroimaging technologies. This cap will improve on our
first-generation wireless fNIRS system (Bowden) and leverage the immobilizing features of our novel granular
jamming technology (Webster). In Aim 1 we will develop the fNIRS electronics, integrate them with granular
jamming and perform mechanical and electrical testing. In Aim 2 we will perform i) a human pilot study to
confirm the physiological validity of the results in a mock operating room and ii) a nested intraoperative pilot
study (Shah) to confirm the feasibility to detect changes in fNIRS data correlated with the anesthesia care
record. If successful, our novel cap will enable more comprehensive study of intraoperative contributors to and
...

## Key facts

- **NIH application ID:** 10373814
- **Project number:** 1R21AG072188-01A1
- **Recipient organization:** VANDERBILT UNIVERSITY
- **Principal Investigator:** Audrey Kynsella Bowden
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $197,960
- **Award type:** 1
- **Project period:** 2021-09-30 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10373814

## Citation

> US National Institutes of Health, RePORTER application 10373814, A whole-cortex fNIRS system to shine light on the problem of post-operative delirium (1R21AG072188-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10373814. Licensed CC0.

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