CoMind R1: a time-resolved interferometric optical neuromonitoring system for pulsatile cerebral blood flow measurement at late times-of-flight.

Significance: Continuous, noninvasive monitoring of cerebral blood flow (CBF) at the bedside is a critical unmet clinical need and a long-standing goal of biomedical optics. Despite extensive development, no optical measurement of CBF has achieved routine clinical use. Aim: We aim to demonstrate and validate CoMind R1, a time-resolved interferometric neuromonitoring system designed to noninvasively measure CBF at pulsatile rates. Approach: CoMind R1 integrates numerous advances, including a high-power, linearly swept 1064 nm laser, multimode collection, parallelized detection, and real-time processing. Performance is evaluated with homogeneous and dynamic bi-layer phantoms and Results: CoMind R1 achieves an instrument response function width of 120 ps and exhibits no significant drift over 24 h. Conclusions: CoMind R1 consistently achieves time-of-flight resolved measurements of pulsatile blood flow at the late times-of-flight necessary to ensure a brain-dominated signal in the typical adult. CoMind R1 thus provides cerebral sensitivity and tissue specificity in a scalable, cost-effective architecture and advances optical monitoring of CBF toward clinical translation.