FUSION · Functional UltraSound Integrated with Optical imaging in Neonates

Premature birth disrupts the crucial perinatal period, significantly increasing the risk of lifelong neurodevelopmental disabilities (NDDs) such as cerebral palsy, attention deficit, and autism. Current brain imaging techniques, like cranial ultrasound and MRI fail to characterize subtle brain injuries and to predict long-term neurodevelopmental outcomes. Therefore, NDDs are often diagnosed years after birth, missing the crucial window for early intervention. Functional connectivity (FC), which quantifies how brain regions connect, holds promise as an early biomarker for neurodevelopmental outcomes as abnormal FC patterns are likely to precede later behavioural alterations. However, existing imaging methods, such as EEG and fMRI, are either limited in resolution or impractical for routine neonatal use.The FUSION project aims to address this gap by developing a novel neuroimaging device that monitors FC in the neonatal brain. FUSION proposes a ground-breaking solution by integrating High-Density Diffuse Optical Tomography (HD-DOT) and functional ultrasound (fUS) imaging into a single, high-resolution, bedside device. Both technologies have been used for proof-of-concept studies for neonatal imaging in the last few years, but have their own limitations: HD-DOT can only evaluate FC in cortical areas, missing deep structures, whereas fUS has a restricted access to cortical areas but can image deep structures.The project aims first to create and validate this dual-modality headset for use in neonates, then to define the interaction between HD-DOT and fUS signals and finally to assess whole-brain FC during different sleep states in both healthy term and preterm infants to demonstrate its capacity to give new biomarkers of brain maturation and sleep integrity, known to influence the outcome. By advancing neonatal neuroimaging, FUSION will go beyond the state of the art, offering the first cost-effective, high-resolution, cot-side device for whole-brain FC assessment.