Evaluating Brain Flow Index from a temple-worn wearable against depth-resolved time-domain NIRS during head-down tilt and postural transitions in healthy young men

Authors

Gulati, D., Rudaeva, A., Dutta, A., Rogers, D., Prajapat, R., Kumar, N., Gupta, S., Goyal, D., Boas, D. A.

Abstract

Significance: Wearable optical sensors could make continuous cerebral hemodynamic monitoring practical in daily life. Because any surface head sensor also samples extracerebral tissue, demonstrating cerebral relevance requires a reference that separates deep from superficial hemodynamics. Aim: We evaluated whether the Temple Brain Flow Index (Temple-BF), derived from a temple-worn photoplethysmographic wearable, covaried more strongly with the deeper (brain-assigned) than the superficial (scalp-assigned) hemodynamics recovered from time-domain near-infrared spectroscopy (TD-NIRS) during controlled postural challenges. Approach: Sixty sessions from 44 healthy young adult men were analyzed across three physiological challenges: 30{degrees} head-down tilt, stand-to-squat, and stand-to-supine transitions. Optical density and mean time of flight from a three-module TD-NIRS system were inverted with a Monte Carlo-derived two-layer model to obtain scalp- and brain-layer hemoglobin time series. Temple-BF was compared with these model-derived signals using lag-adjusted and zero-lag correlations, paired brain-versus-scalp comparisons, heart rate and short-separation-HbO adjusted partial correlations. Results: Median lag-adjusted correlations between Temple-BF and brain-layer {Delta}HbO traces were 0.912, 0.843, and 0.839 for head-down tilt, stand-to-squat, and stand-to-supine transitions, respectively; corresponding scalp-layer medians were 0.494, 0.700, and 0.767. Paired brain-minus-scalp differences were significant for head-down tilt (median 0.333, p < 0.001) and stand-to-squat (0.110, p < 0.001) but not for stand-to-supine (0.036, p = 0.082) transitions. Zero-lag brain-layer medians were 0.826, 0.701, and 0.796, and the association persisted after adjustment for heart rate (partial r = 0.832, 0.850, 0.654) and for short-separation superficial HbO (0.649, 0.570, 0.438). Transition-window correlations had medians of 0.878, 0.861, and 0.876, with directionally concordant transition responses in 59 of 60 sessions. Conclusions: Temple-BF tracked model-derived brain-layer TD-NIRS {Delta}HbO across all three postural challenges, with larger median correlations against the brain-layer than the scalp compartment in all three protocols, and transition responses in the same direction for almost all sessions. These results support Temple-BF as a relative marker of cerebral hemodynamic change during postural perturbations. Establishing cerebral specificity at the temple, and excluding residual systemic and superficial contributions, will require flow-sensitive references and fuller systemic monitoring.

Preprint server: bioRxiv
The authors list and abstract were imported from bioRxiv on 25 Sep 2026.

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