JoWUA

Abstract

Transcranial Focused Ultrasound Stimulation (tFUS) and Transcranial Magnetic Stimulation (TMS) are two noninvasive brain stimulation methods that show promise for precisely altering neuronal activity. Particularly promising are these approaches for use in pediatric anaesthesia, where avoiding cognitive impairment, delayed recovery, and negative neurodevelopmental outcomes depends on preserving normal neural reactivity. Children are at increased risk for developing perioperative neurocognitive problems because, despite improvements in anaesthetic, present techniques often do not address decreased brain reactivity during operations. There is a dearth of tailored, real-time therapies for monitoring and improving brain function when under anaesthesia. Improving surgical outcomes for young patients and protecting neurodevelopment depends on filling this gap. This study provides the Pediatric Neural Responsiveness Enhancement Framework (PNREF) to address these issues; it combines transcranial magnetic stimulation (TMS) with transcutaneous ultrasound (tFUS) to provide real-time neural stimulation to children undergoing pediatric anaesthesia. The five-step process follows this architecture: first, pre-anesthesia brain activity mapping identifies areas of interest. Secondly, the procedure's cerebral activity is tracked via EEG-based real-time monitoring. Third, brain areas are targeted using transcranial magnetic stimulation (TMS) pulses to maintain activity. As a fourth benefit, transcranial ultrasound (tFUS) allows for more thorough manipulation of the brain's cortex and subcortical regions. The safety and effectiveness of the stimulation are guaranteed by a feedback loop that modifies the settings based on real-time EEG input. With a decrease in recovery time and an increase in post-anesthesia cognitive function scores, initial simulations and pilot clinical investigations demonstrate the efficacy of PNREF. The proposed method achieves the cognitive recovery time by 30%, neurodevelopmental outcome scores by 96.34%, neural reactivity during anesthesia by 97.85%, EEG-based real-time monitoring accuracy by 98.05% and surgical outcomes by 97.42%.