Diffuse optical spectroscopy is advancing the non-invasive assessment of cerebral oxygenation, blood flow, oxygen metabolism, and hemodynamic regulation in neonates, infants, children, and adolescents. Established near-infrared spectroscopy (NIRS) methods are increasingly complemented by frequency-domain, time-domain, and broadband approaches, diffuse correlation spectroscopy (DCS), diffuse optical tomography (DOT), and hybrid optical technologies. Together, these techniques offer new opportunities to characterize pediatric brain physiology continuously and at the bedside, particularly in patients vulnerable to neurological injury, including those with prematurity, congenital heart disease, neonatal encephalopathy, traumatic brain injury, stroke, hydrocephalus, and critical illness. However, challenges related to motion artifacts, extracerebral signal contamination, measurement interpretation, device standardization, reproducibility, and validation against established clinical and imaging methods continue to limit widespread adoption. Further research is needed to determine how advanced diffuse optical measurements can improve diagnosis, prognostication, treatment monitoring, and neuroprotective care.

This Research Topic aims to bring together clinical, translational, and technological studies that advance the development, validation, and application of diffuse optical spectroscopy for pediatric brain monitoring. We particularly welcome contributions from the diffuse optics, biomedical engineering, neuroscience, and clinical communities that evaluate these technologies across diverse pediatric populations and healthcare settings. The Research Topic will highlight research addressing the clinical utility of optical measures of cerebral oxygenation, blood flow, oxygen metabolism, and autoregulation, as well as studies examining their role in detecting neurological compromise, guiding clinical decision-making, and supporting individualized neuromonitoring. Research focused on multimodal integration, reproducibility, implementation, and clinical translation is also encouraged.

To gather further insights into advanced diffuse optical spectroscopy for pediatric cerebral monitoring, we welcome articles addressing, but not limited to, the following themes:

•Clinical evaluation of diffuse optical monitoring technologies in neonates, infants, children, and adolescents
•Cerebral oxygenation, blood flow, oxygen metabolism, and cerebrovascular autoregulation
•Frequency-domain, time-domain, and broadband near-infrared spectroscopy
•Diffuse correlation spectroscopy and non-invasive cerebral blood-flow monitoring
•Diffuse optical tomography and spatial assessment of pediatric brain physiology
•Optical neuromonitoring in prematurity, congenital heart disease, and neonatal encephalopathy
•Applications in traumatic brain injury, stroke, hydrocephalus, and pediatric neurocritical care
•Perioperative, intensive-care, emergency, and bedside monitoring
•Validation against MRI, EEG, ultrasound, invasive monitoring, or other clinical standards
•Multimodal monitoring combining optical spectroscopy with EEG, MRI, ultrasound, or systemic physiological measurements
•Signal processing, motion correction, artifact reduction, computational modelling, and artificial intelligence
•Wearable, portable, and bedside diffuse optical technologies
•Reproducibility, standardization, regulatory considerations, and clinical implementation
•Strategies for translating diffuse optical spectroscopy into routine pediatric care

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Advanced Diffuse Optical Spectroscopy for Pediatric Brain Oxygenation and Hemodynamic Monitoring