Visual working memory load-related changes in neural activity and functional connectivity

Background

Visual working memory (VWM) helps us store visual information to prepare for subsequent behavior. The neuronal mechanisms for sustaining coherent visual information and the mechanisms for limited VWM capacity have remained uncharacterized. Although numerous studies have utilized behavioral accuracy, neural activity, and connectivity to explore the mechanism of VWM retention, little is known about the load-related changes in functional connectivity for hemi-field VWM retention.

Methodology/Principal Findings

In this study, we recorded electroencephalography (EEG) from 14 normal young adults while they performed a bilateral visual field memory task. Subjects had more rapid and accurate responses to the left visual field (LVF) memory condition. The difference in mean amplitude between the ipsilateral and contralateral event-related potential (ERP) at parietal-occipital electrodes in retention interval period was obtained with six different memory loads. Functional connectivity between 128 scalp regions was measured by EEG phase synchronization in the theta- (4–8 Hz), alpha- (8–12 Hz), beta- (12–32 Hz), and gamma- (32–40 Hz) frequency bands. The resulting matrices were converted to graphs, and mean degree, clustering coefficient and shortest path length was computed as a function of memory load. The results showed that brain networks of theta-, alpha-, beta-, and gamma- frequency bands were load-dependent and visual-field dependent. The networks of theta- and alpha- bands phase synchrony were most predominant in retention period for right visual field (RVF) WM than for LVF WM. Furthermore, only for RVF memory condition, brain network density of theta-band during the retention interval were linked to the delay of behavior reaction time, and the topological property of alpha-band network was negative correlation with behavior accuracy.

Conclusions/Significance

We suggest that the differences in theta- and alpha- bands between LVF and RVF conditions in functional connectivity and topological properties during retention period may result in the decline of behavioral performance in RVF task.     

Sex differences in EEG power changes in retention of dichotically and monaurally presented verbal stimuli

EEG power mapping was used to study gender differences in hemispheric functional organization during memorizing dichotically and monaurally presented verbal information. Right-handed students (12 men and 14 women) participated in experiments. The EEG was recorded from 16 electrodes placed at homologous sites of the left and right brain hemispheres. Task-related changes in the thetal power in men differentiated between monaural presentations to different ears, i.e., situations of oppositely directed attention. In women the thetal power reactivity (the difference between the band power logarithms under baseline conditions and in task interval) differentiated between dichotic and monaural presentations of words, i.e., situations with different memory loads. Gender differences were also found in the alpha frequency band. Power changes in the alpha 1 band in all memory tasks and power changes in the alpha 2 were more evident in the right hemisphere in men but in the left hemisphere in women. In contrast, in the posterior temporal lead the alpha 2 power reactivity in men was higher in the right hemisphere, whereas in women the lateral differences were absent. As compared to men, the alpha 2 desynchronization in women was also more pronounced in posterior regions of both hemispheres. There were no gender differences in efficacy of memorizing. It is suggested that different processing strategies rather than different behavioral performance may be responsible for the revealed specific spatiotemporal EEG patterns.     

Frequency-spatial organization of brain electrical activity in creative verbal thinking: role of the gender factor

Gender differences in EEG patterns associated with verbal creativity were studied by EEG mapping. The EEGs of 18 males and 21 females (right-handed university students) were recorded during a performance of Remote Associates Task (RAT) compared with the letter-fluency and simple associate's tasks. Gender differences were found in a factor structure of the indices of verbal thinking and a score of generating words was greater in women than men. No significant gender differences in originality of associations were revealed, however, gender-related differences in the EEG-patterns were found at the final and initial stages of RAT. In men, the beta2-power was increased in both hemispheres at the beginning of test. To the end of testing, the power of oscillations in the beta2 band increased only in the central part of the cortex. In women, the beta2-power was increased to a greater extent in the right than in the left hemisphere at the initial stage of task performance, whereas the final stage was characterized by a relative decrease in beta-activity in parietotemporal cortical regions and increase in the left prefrontal region. It is suggested that the verbal creative thinking in men is based mostly on "insight" strategy whereas women additionally involve the "intellectual" strategy.     

Investigation of brain functional connectivity in patients with mild cognitive impairment: A functional near‐infrared spectroscopy (fNIRS) study

This study examines brain functional connectivity in both cognitively normal seniors and patients with mild cognitive impairment (MCI) to elucidate prospective markers of MCI. A homemade four‐channel functional near‐infrared spectroscopy (fNIRS) system was employed to measure hemodynamic responses in the subjects' prefrontal cortex during a resting state, an oddball task, a 1‐back task, and a verbal fluency task. Brain functional connectivity was calculated as the Pearson correlation coefficients between fNIRS channels. The results show that during the verbal fluency task, while the healthy control (HC) group presents a significantly stronger inter‐hemispheric connectivity compared to intra‐hemispheric connectivity, there is no difference between the inter‐ and intra‐hemispheric connectivity in the MCI group. In addition, a comparison between the MCI and HC connectivity reveals that the MCI group has a statistically higher right and inter‐hemispheric connectivity during the resting state, but a significantly lower left and inter‐hemispheric connectivity during the verbal fluency test. These findings demonstrate the potential of fNIRS to study brain functional connectivity in neurodegenerative diseases.     

The Default Mode Network and the Working Memory Network Are Not Anti-Correlated during All Phases of a Working Memory Task

Introduction

The default mode network and the working memory network are known to be anti-correlated during sustained cognitive processing, in a load-dependent manner. We hypothesized that functional connectivity among nodes of the two networks could be dynamically modulated by task phases across time.

Methods

To address the dynamic links between default mode network and the working memory network, we used a delayed visuo-spatial working memory paradigm, which allowed us to separate three different phases of working memory (encoding, maintenance, and retrieval), and analyzed the functional connectivity during each phase within and between the default mode network and the working memory network networks.

Results

We found that the two networks are anti-correlated only during the maintenance phase of working memory, i.e. when attention is focused on a memorized stimulus in the absence of external input. Conversely, during the encoding and retrieval phases, when the external stimulation is present, the default mode network is positively coupled with the working memory network, suggesting the existence of a dynamically switching of functional connectivity between “task-positive” and “task-negative” brain networks.

Conclusions

Our results demonstrate that the well-established dichotomy of the human brain (anti-correlated networks during rest and balanced activation-deactivation during cognition) has a more nuanced organization than previously thought and engages in different patterns of correlation and anti-correlation during specific sub-phases of a cognitive task. This nuanced organization reinforces the hypothesis of a direct involvement of the default mode network in cognitive functions, as represented by a dynamic rather than static interaction with specific task-positive networks, such as the working memory network.     

Visual Search Elicits the Electrophysiological Marker of Visual Working Memory

Background

Although limited in capacity, visual working memory (VWM) plays an important role in many aspects of visually-guided behavior. Recent experiments have demonstrated an electrophysiological marker of VWM encoding and maintenance, the contralateral delay activity (CDA), which has been shown in multiple tasks that have both explicit and implicit memory demands. Here, we investigate whether the CDA is evident during visual search, a thoroughly-researched task that is a hallmark of visual attention but has no explicit memory requirements.

Methodology/Principal Findings

The results demonstrate that the CDA is present during a lateralized search task, and that it is similar in amplitude to the CDA observed in a change-detection task, but peaks slightly later. The changes in CDA amplitude during search were strongly correlated with VWM capacity, as well as with search efficiency. These results were paralleled by behavioral findings showing a strong correlation between VWM capacity and search efficiency.

Conclusions/Significance

We conclude that the activity observed during visual search was generated by the same neural resources that subserve VWM, and that this activity reflects the maintenance of previously searched distractors.     

Quantifying the Reconfiguration of Intrinsic Networks during Working Memory

Rapid, flexible reconfiguration of connections across brain regions is thought to underlie successful cognitive control. Two intrinsic networks in particular, the cingulo-opercular (CO) and fronto-parietal (FP), are thought to underlie two operations critical for cognitive control: task-set maintenance/tonic alertness and adaptive, trial-by-trial updating. Using functional magnetic resonance imaging, we directly tested whether the functional connectivity of the CO and FP networks was related to cognitive demands and behavior. We focused on working memory because of evidence that during working memory tasks the entire brain becomes more integrated. When specifically probing the CO and FP cognitive control networks, we found that individual regions of both intrinsic networks were active during working memory and, as expected, integration across the two networks increased during task blocks that required cognitive control. Crucially, increased integration between each of the cognitive control networks and a task-related, non-cognitive control network (the hand somatosensory-motor network; SM) was related to increased accuracy. This implies that dynamic reconfiguration of the CO and FP networks so as to increase their inter-network communication underlies successful working memory.     

Increased memory load-related frontal activation after estradiol treatment in postmenopausal women

Prior research shows that menopause is associated with changes in cognition in some older women. However, how estrogen loss and subsequent estrogen treatment affects cognition and particularly the underlying brain processes responsible for any cognitive changes is less well understood. We examined the ability of estradiol to modulate the manipulation of information in working memory and related brain activation in postmenopausal women. Twenty healthy postmenopausal women (mean age (SD) = 59.13 (5.5)) were randomly assigned to three months of 1 mg oral 17-β estradiol or placebo. At baseline and three months later each woman completed a visual verbal N-back sequential letter test of working memory during functional magnetic resonance imaging (fMRI). The fMRI data showed that women who were treated with estradiol for three months had increased frontal activation during the more difficult working memory load conditions compared to women treated with placebo. Performance on the verbal working memory task showed no difference between estradiol and placebo treated subjects. These data are consistent with prior work showing increases in frontal activation on memory tasks after estrogen treatment. However, this is the first study to show that estrogen-induced increases in brain activity were tied to cognitive load during a verbal working memory task. These data suggest that estradiol treatment effects on cognition may be in part produced through modulation of frontal lobe functioning under difficult task conditions.     

Evidence for Anomalous Network Connectivity during Working Memory Encoding in Schizophrenia: An ICA Based Analysis

Background

Numerous neuroimaging studies report abnormal regional brain activity during working memory performance in schizophrenia, but few have examined brain network integration as determined by “functional connectivity” analyses.

Methodology/Principal Findings

We used independent component analysis (ICA) to identify and characterize dysfunctional spatiotemporal networks in schizophrenia engaged during the different stages (encoding and recognition) of a Sternberg working memory fMRI paradigm. 37 chronic schizophrenia and 54 healthy age/gender-matched participants performed a modified Sternberg Item Recognition fMRI task. Time series images preprocessed with SPM2 were analyzed using ICA. Schizophrenia patients showed relatively less engagement of several distinct “normal” encoding-related working memory networks compared to controls. These encoding networks comprised 1) left posterior parietal-left dorsal/ventrolateral prefrontal cortex, cingulate, basal ganglia, 2) right posterior parietal, right dorsolateral prefrontal cortex and 3) default mode network. In addition, the left fronto-parietal network demonstrated a load-dependent functional response during encoding. Network engagement that differed between groups during recognition comprised the posterior cingulate, cuneus and hippocampus/parahippocampus. As expected, working memory task accuracy differed between groups (p<0.0001) and was associated with degree of network engagement. Functional connectivity within all three encoding-associated functional networks correlated significantly with task accuracy, which further underscores the relevance of abnormal network integration to well-described schizophrenia working memory impairment. No network was significantly associated with task accuracy during the recognition phase.

Conclusions/Significance

This study extends the results of numerous previous schizophrenia studies that identified isolated dysfunctional brain regions by providing evidence of disrupted schizophrenia functional connectivity using ICA within widely-distributed neural networks engaged for working memory cognition.     

Visual working memory capacity and proactive interference

Background

Visual working memory capacity is extremely limited and appears to be relatively immune to practice effects or the use of explicit strategies. The recent discovery that visual working memory tasks, like verbal working memory tasks, are subject to proactive interference, coupled with the fact that typical visual working memory tasks are particularly conducive to proactive interference, suggests that visual working memory capacity may be systematically under-estimated.

Methodology/Principal Findings

Working memory capacity was probed behaviorally in adult humans both in laboratory settings and via the Internet. Several experiments show that although the effect of proactive interference on visual working memory is significant and can last over several trials, it only changes the capacity estimate by about 15%.

Conclusions/Significance

This study further confirms the sharp limitations on visual working memory capacity, both in absolute terms and relative to verbal working memory. It is suggested that future research take these limitations into account in understanding differences across a variety of tasks between human adults, prelinguistic infants and nonlinguistic animals.     

Increased memory load-related frontal activation after estradiol treatment in postmenopausal women

Prior research shows that menopause is associated with changes in cognition in some older women. However, how estrogen loss and subsequent estrogen treatment affects cognition and particularly the underlying brain processes responsible for any cognitive changes is less well understood. We examined the ability of estradiol to modulate the manipulation of information in working memory and related brain activation in postmenopausal women. Twenty healthy postmenopausal women (mean age (SD) = 59.13 (5.5)) were randomly assigned to three months of 1 mg oral 17-β estradiol or placebo. At baseline and three months later each woman completed a visual verbal N-back sequential letter test of working memory during functional magnetic resonance imaging (fMRI). The fMRI data showed that women who were treated with estradiol for three months had increased frontal activation during the more difficult working memory load conditions compared to women treated with placebo. Performance on the verbal working memory task showed no difference between estradiol and placebo treated subjects. These data are consistent with prior work showing increases in frontal activation on memory tasks after estrogen treatment. However, this is the first study to show that estrogen-induced increases in brain activity were tied to cognitive load during a verbal working memory task. These data suggest that estradiol treatment effects on cognition may be in part produced through modulation of frontal lobe functioning under difficult task conditions.     

Is the Link from Working Memory to Analogy Causal? No Analogy Improvements following Working Memory Training Gains

Analogical reasoning has been hypothesized to critically depend upon working memory through correlational data [1], but less work has tested this relationship through experimental manipulation [2]. An opportunity for examining the connection between working memory and analogical reasoning has emerged from the growing, although somewhat controversial, body of literature suggests complex working memory training can sometimes lead to working memory improvements that transfer to novel working memory tasks. This study investigated whether working memory improvements, if replicated, would increase analogical reasoning ability. We assessed participants’ performance on verbal and visual analogy tasks after a complex working memory training program incorporating verbal and spatial tasks [3], [4]. Participants’ improvements on the working memory training tasks transferred to other short-term and working memory tasks, supporting the possibility of broad effects of working memory training. However, we found no effects on analogical reasoning. We propose several possible explanations for the lack of an impact of working memory improvements on analogical reasoning.     

Proteomics‐level analysis of myelin formation and regeneration in a mouse model for Vanishing White Matter disease

Vanishing white matter (VWM) is a recessive neurodegenerative disease caused by mutations in translation initiation factor eIF2B and leading to progressive brain myelin deterioration, secondary axonal damage, and death in early adolescence. Eif2b5^R132H/R132H mice exhibit delayed developmental myelination, mild early neurodegeneration and a robust remyelination defect in response to cuprizone‐induced demyelination. In the current study we used Eif2b5^R132H/R132H mice for mass‐spectrometry analyses, to follow the changes in brain protein abundance in normal‐ versus cuprizone‐diet fed mice during the remyelination recovery phase. Analysis of proteome profiles suggested that dysregulation of mitochondrial functions, altered proteasomal activity and impaired balance between protein synthesis and degradation play a role in VWM pathology. Consistent with these findings, we detected elevated levels of reactive oxygen species in mutant‐derived primary fibroblasts and reduced 20S proteasome activity in mutant brain homogenates. These observations highlight the importance of tight translational control to precise coordination of processes involved in myelin formation and regeneration and point at cellular functions that may contribute to VWM pathology.

     

Ecstasy Exposure & Gender: Examining Components of Verbal Memory Functioning

Objective

Studies have demonstrated verbal memory deficits associated with past year ecstasy use, although specific underlying components of these deficits are less understood. Further, prior research suggests potential gender differences in ecstasy-induced serotonergic changes. Therefore, the current study investigated whether gender moderated the relationship between ecstasy exposure and components of verbal memory after controlling for polydrug use and confounding variables.

Method

Data were collected from 65 polydrug users with a wide range of ecstasy exposure (ages 18–35; 48 ecstasy and 17 marijuana users; 0–2310 ecstasy tablets). Participants completed a verbal learning and memory task, psychological questionnaires, and a drug use interview.

Results

Increased past year ecstasy exposure predicted poorer short and long delayed free and cued recalls, retention, and recall discrimination. Male ecstasy users were more susceptible to dose-dependent deficits in retention than female users.

Conclusion

Past year ecstasy consumption was associated with verbal memory retrieval, retention, and discrimination deficits in a dose-dependent manner in a sample of healthy young adult polydrug users. Male ecstasy users were at particular risk for deficits in retention following a long delay. Gender difference may be reflective of different patterns of polydrug use as well as increased hippocampal sensitivity. Future research examining neuronal correlates of verbal memory deficits in ecstasy users are needed.     

Gender Differences in Hemispheric Spatiotemporal EEG Patterns upon Reproduction of Verbal Information

Changes in EEG power and coherence were studied in ten men and ten women during mental reproduction of dichotically presented lists of words. The EEG was recorded with 14 electrodes located over symmetric points of the left and right hemispheres. In all subjects, the mental reproduction was accompanied by an increase in the power of the ₁ rhythm in the frontal regions and a decrease in the power of the ₁ and ₂ rhythms in the caudal regions of the hemispheres. A decrease in the power of the ₂ rhythm in the caudal regions of the hemispheres was greater in women than in men. Gender differences were also observed in the left- and right-hemispheric coherence reactivity. During word reproduction, men showed a higher EEG coherence in the ₂ band in the right hemisphere, while women displayed a greater increase in the coherence of the ₁ and ₂ rhythms in the left hemisphere. Lateral differences in reactivity of the intrahemispheric coherence in these frequency bands were observed only in women and were caused by a decrease in coherent interactions in the right hemisphere and their increase in the left hemisphere. These gender differences can be associated with different strategies of information memorization: men involve predominantly episodic memory, and women use semantic polymodal encoding.     

Gender Differences in Shame in Patients with Binge‐Eating Disorder

Objective: To examine the relationship between shame and the behavioral and attitudinal features of eating disorders in men and women diagnosed with binge‐eating disorder (BED). Research Methods and Procedures: Participants were 188 consecutively evaluated adults (38 men and 150 women) who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for BED. Participants were interviewed and completed a battery of measures assessing shame, behavioral and attitudinal features of eating disorders, and general psychological functioning. Results: Shame did not differ significantly by gender and was not associated with BMI or binge‐eating frequency. Shame was significantly associated with the attitudinal features of eating disorders, even after controlling for levels of depression and self‐esteem. When considered separately by gender and controlling for depression and self‐esteem, shame was associated with body dissatisfaction in men and with weight concern in women. Discussion: Men and women with BED, who presented for treatment, reported similar levels of shame. Overall, while shame was related to attitudinal features, the specific associations differed by gender. For men, shame was related to how dissatisfied they felt with their bodies, whereas for women, shame was associated with concerns about weight. Interestingly, shame was not related to BMI or binge‐eating frequency in men or women. These results provide preliminary support for self‐conscious emotions playing different roles in men and women with BED.     

Investigation of the source‐detector separation in near infrared spectroscopy for healthy and clinical applications

Understanding near infrared light propagation in tissue is vital for designing next generation optical brain imaging devices. Monte Carlo (MC) simulations provide a controlled mechanism to characterize and evaluate contributions of diverse near infrared spectroscopy (NIRS) sensor configurations and parameters. In this study, we developed a multilayer adult digital head model under both healthy and clinical settings and assessed light‐tissue interaction through MC simulations in terms of partial differential pathlength, mean total optical pathlength, diffuse reflectance, detector light intensity and spatial sensitivity profile of optical measurements. The model incorporated four layers: scalp, skull, cerebrospinal‐fluid and cerebral cortex with and without a customizable lesion for modeling hematoma of different sizes and depths. The effect of source‐detector separation (SDS) on optical measurements' sensitivity to brain tissue was investigated. Results from 1330 separate simulations [(4 lesion volumes × 4 lesion depths for clinical +3 healthy settings) × 7 SDS × 10 simulation = 1330)] each with 100 million photons indicated that selection of SDS is critical to acquire optimal measurements from the brain and recommended SDS to be 25 to 35 mm depending on the wavelengths to obtain optical monitoring of the adult brain function. The findings here can guide the design of future NIRS probes for functional neuroimaging and clinical diagnostic systems.      

Gender-Dependent Frequency–Spatial Organization of the Brain Cortex Activity during Convergent and Divergent Thinking: I. Analysis of the EEG Power

The frequency–spatial organization of the brain cortex activity of men and women was studied during convergent (CTh) and divergent (DTh) thinking by means of EEG power mapping in a broad frequency band. Right-handed 17- to 23-year-old students (36 men and 30 women) participated in the study. Mental arithmetic was used as a model of CTh. Functional changes in the EEG patterns in the ₁ and ₁ frequency bands were distinct in CTh: the activation of the frontal cortical regions with a predominant involvement of right-hemispheric mechanisms of sustained attention was characteristic of the men, whereas, in the women, desynchronization of the ₁ rhythm was shifted to the caudal part of the cortex with a stronger left-hemispheric control over the calculating operations. This difference may be indicative of the involvement of different attention mechanisms and, consequently, the predominant use of the verbal or visuospatial strategies of CTh in men and women. Regardless of the gender, DTh was accompanied by an increase in the EEG power in the ₂ band. The successful performance of a divergent task was determined by different frequency components of the brain activation in men and women. In men, successful performance was associated with a substantial increase in the power of the ₂ rhythm and weak EEG desynchronization in the ₁ band; in women, successful performance was characterized by a lower increase in the amplitude of the ₂ oscillations as compared to noncreative persons and stronger EEG desynchronization in the ₁ band. The reciprocal changes in the power of the ₁ and ₂ rhythms in men and women during successful DTh may reflect the difference in interactions between cortical and subcortical structures in the regulation of voluntary, involuntary, and differential attention.     

Functional neuronal network activity differs with cognitive dysfunction in childhood-onset systemic lupus erythematosus

Introduction

Neuropsychiatric manifestations are common in childhood-onset systemic lupus erythematosus (cSLE) and often include neurocognitive dysfunction (NCD). Functional magnetic resonance imaging (fMRI) can measure brain activation during tasks that invoke domains of cognitive function impaired by cSLE. This study investigates specific changes in brain function attributable to NCD in cSLE that have potential to serve as imaging biomarkers.

Methods

Formal neuropsychological testing was done to measure cognitive ability and to identify NCD. Participants performed fMRI tasks probing three cognitive domains impacted by cSLE: visuoconstructional ability (VCA), working memory, and attention. Imaging data, collected on 3-Tesla scanners, included a high-resolution T1-weighted anatomic reference image followed by a T2*-weighted whole-brain echo planar image series for each fMRI task. Brain activation using blood oxygenation level-dependent contrast was compared between cSLE patients with NCD (NCD-group, n = 7) vs. without NCD (noNCD-group, n = 14) using voxel-wise and region of interest-based analyses. The relationship of brain activation during fMRI tasks and performance in formal neuropsychological testing was assessed.

Results

Greater brain activation was observed in the noNCD-group vs. NCD-group during VCA and working memory fMRI tasks. Conversely, compared to the noNCD-group, the NCD-group showed more brain activation during the attention fMRI task. In region of interest analysis, brain activity during VCA and working memory fMRI tasks was positively associated with the participants'' neuropsychological test performance. In contrast, brain activation during the attention fMRI task was negatively correlated with neuropsychological test performance. While the NCD group performed worse than the noNCD group during VCA and working memory tasks, the attention task was performed equally well by both groups.

Conclusions

NCD in patients with cSLE is characterized by differential activation of functional neuronal networks during fMRI tasks probing working memory, VCA, and attention. Results suggest a compensatory mechanism allows maintenance of attentional performance under NCD. This mechanism appears to break down for the VCA and working memory challenges presented in this study. The observation that neuronal network activation is related to the formal neuropsychological testing performance makes fMRI a candidate imaging biomarker for cSLE-associated NCD.     

Noninvasive and sensitive optical assessment of brain death

Brain death is an irreversible loss of all brain functions, and the assessment is crucial for organ supply for transplantation. The noninvasive, sensitive, universally available and timely ancillary method to assess brain death has not been established. Here, we attempted to explore a noninvasive way in brain death assessment. Eighteen brain‐dead patients and 20 healthy subjects were measured by near‐infrared spectroscopy (NIRS), with a multiple‐phase protocol at varied fraction of inspired O₂ (FIO₂). We found that the concentration changes ratios of oxyhemoglobin to deoxyhemoglobin (Δ[HbO₂]/Δ[Hb]) in the cerebral cortex of brain‐dead patients were significantly higher than those of healthy subjects. And, the Δ[HbO₂]/Δ[Hb] in low‐to‐high FIO₂ phase was most sensitive to distinguish brain‐dead patients from healthy subjects, with a recommended threshold ranged in 1.40~1.50. The innovative incorporation of NIRS and a varied FIO₂ protocol was shown to be a noninvasive and reliable way in assessing brain death. This successful attempt of NIRS application is a help for fast and accurate evaluation of brain death, promptly offering quality‐assured donor organs and indicate us a protocol‐aided way to expand the use of NIRS.