Functional near-infrared spectroscopy: A novel tool for detecting consciousness after acute severe brain injury.

Recent advancements in functional neuroimaging have demonstrated that some unresponsive patients in the intensive care unit retain a level of consciousness that is inconsistent with their behavioral diagnosis of awareness. Functional near-infrared spectroscopy (fNIRS) is a portable optical neuroimaging method that can be used to measure neural activity with good temporal and spatial resolution. However, the reliability of fNIRS for detecting the neural correlates of consciousness remains to be established. In a series of studies, we evaluated whether fNIRS can record sensory, perceptual, and command-driven neural processing in healthy participants and in behaviorally nonresponsive patients. At the individual healthy subject level, we demonstrate that fNIRS can detect commonly studied resting state networks, sensorimotor processing, speech-specific auditory processing, and volitional command-driven brain activity to a motor imagery task. We then tested fNIRS with three acutely brain injured patients and found that one could willfully modulate their brain activity when instructed to imagine playing a game of tennis-providing evidence of preserved consciousness despite no observable behavioral signs of awareness. The successful application of fNIRS for detecting preserved awareness among behaviorally nonresponsive patients highlights its potential as a valuable tool for uncovering hidden cognitive states in critical care settings.

Hostile Attribution Bias Shapes Neural Synchrony in the Left Ventromedial Prefrontal Cortex during Ambiguous Social Narratives.

Hostile attribution bias refers to the tendency to interpret social situations as intentionally hostile. While previous research has focused on its developmental origins and behavioral consequences, the underlying neural mechanisms remain underexplored. Here, we employed functional near-infrared spectroscopy (fNIRS) to investigate the neural correlates of hostile attribution bias. While undergoing fNIRS, male and female participants listened to and provided attribution ratings for 21 hypothetical scenarios where a character's actions resulted in a negative outcome for the listener. Ratings of hostile intentions were averaged to measure hostile attribution bias. Using intersubject representational similarity analysis, we found that participants with similar levels of hostile attribution bias exhibited higher levels of neural synchrony during narrative listening, suggesting shared interpretations of the scenarios. This effect was localized to the left ventromedial prefrontal cortex (VMPFC) and was particularly prominent in scenarios where the character's intentions were highly ambiguous. We then grouped participants into high and low bias groups based on a median split of their hostile attribution bias scores. A similarity-based classifier trained on the neural data classified participants as having high or low bias with 75% accuracy, indicating that the neural time courses during narrative listening was systematically different between the two groups. Furthermore, hostile attribution bias correlated negatively with attributional complexity, a measure of one's tendency to consider multifaceted causes when explaining behavior. Our study sheds light on the neural mechanisms underlying hostile attribution bias and highlights the potential of using fNIRS to develop nonintrusive and cost-effective neural markers of this sociocognitive bias.

Volleyball training improves working memory in children aged 7 to 12 years old: an fNIRS study.

This study aimed to investigate the effect of a 12-wk extracurricular volleyball training on working memory from both behavioral and cerebral aspects. A total of 80 children were randomized assigned to (i) the experimental group, who engaged in extracurricular volleyball training for 60 min, thrice a week for 12 wk, and (ii) the control group, who maintained their regular daily routine. Working memory was evaluated in both groups using the N-back task before and after the intervention. Furthermore, functional near-infrared spectroscopy was employed to monitor the level of oxygenated hemoglobin in the prefrontal cortex. The experimental group performed better in the behavioral task than the control group, as evidenced by a shorter response time and a higher correct rate. The functional near-infrared spectroscopy results suggested that the activation of the left dorsolateral prefrontal cortex was significantly higher in the experimental group than in the control group. In addition, correlation analyses showed that the enhancement of left dorsolateral prefrontal cortex activation was significantly correlated with decreasing response time and improving response accuracy in the N-back task. These findings suggest that the left dorsolateral prefrontal cortex is likely the neural substrate for improved working memory performance elicited by 12-wk open skill exercise.

Cortical specialization associated with native speech category acquisition in early infancy.

This study investigates neural processes in infant speech processing, with a focus on left frontal brain regions and hemispheric lateralization in Mandarin-speaking infants' acquisition of native tonal categories. We tested 2- to 6-month-old Mandarin learners to explore age-related improvements in tone discrimination, the role of inferior frontal regions in abstract speech category representation, and left hemisphere lateralization during tone processing. Using a block design, we presented four Mandarin tones via [ta] and measured oxygenated hemoglobin concentration with functional near-infrared spectroscopy. Results showed age-related improvements in tone discrimination, greater involvement of frontal regions in older infants indicating abstract tonal representation development and increased bilateral activation mirroring native adult Mandarin speakers. These findings contribute to our broader understanding of the relationship between native speech acquisition and infant brain development during the critical period of early language learning.

Parenting links to parent-child interbrain synchrony: a real-time fNIRS hyperscanning study.

Parent-child interaction is crucial for children's cognitive and affective development. While bio-synchrony models propose that parenting influences interbrain synchrony during interpersonal interaction, the brain-to-brain mechanisms underlying real-time parent-child interactions remain largely understudied. Using functional near-infrared spectroscopy, we investigated interbrain synchrony in 88 parent-child dyads (Mage children = 8.07, 42.0% girls) during a collaborative task (the Etch-a-Sketch, a joint drawing task). Our findings revealed increased interbrain synchrony in the dorsolateral prefrontal cortex and temporo-parietal areas during interactive, collaborative sessions compared to non-interactive, resting sessions. Linear regression analysis demonstrated that interbrain synchrony in the left temporoparietal junction was associated with enhanced dyadic collaboration, shared positive affect, parental autonomy support, and parental emotional warmth. These associations remained significant after controlling for demographic variables including child age, child gender, and parent gender. Additionally, differences between fathers and mothers were observed. These results highlight the significant association between brain-to-brain synchrony in parent-child dyads, the quality of the parent-child relationship, and supportive parenting behaviors. Interbrain synchrony may serve as a neurobiological marker of real-time parent-child interaction, potentially underscoring the pivotal role of supportive parenting in shaping these interbrain synchrony mechanisms.

Virtual (Zoom) Interactions Alter Conversational Behavior and Interbrain Coherence.

A growing number of social interactions are taking place virtually on videoconferencing platforms. Here, we explore potential effects of virtual interactions on observed behavior, subjective experience, and neural "single-brain" and "interbrain" activity via functional near-infrared spectroscopy neuroimaging. We scanned a total of 36 human dyads (72 participants, 36 males, 36 females) who engaged in three naturalistic tasks (i.e., problem-solving, creative-innovation, socio-emotional task) in either an in-person or virtual (Zoom) condition. We also coded cooperative behavior from audio recordings. We observed reduced conversational turn-taking behavior during the virtual condition. Given that conversational turn-taking was associated with other metrics of positive social interaction (e.g., subjective cooperation and task performance), this measure may be an indicator of prosocial interaction. In addition, we observed altered patterns of averaged and dynamic interbrain coherence in virtual interactions. Interbrain coherence patterns that were characteristic of the virtual condition were associated with reduced conversational turn-taking. These insights can inform the design and engineering of the next generation of videoconferencing technology.SIGNIFICANCE STATEMENT Videoconferencing has become an integral part of our lives. Whether this technology impacts behavior and neurobiology is not well understood. We explored potential effects of virtual interaction on social behavior, brain activity, and interbrain coupling. We found that virtual interactions were characterized by patterns of interbrain coupling that were negatively implicated in cooperation. Our findings are consistent with the perspective that videoconferencing technology adversely affects individuals and dyads during social interaction. As virtual interactions become even more necessary, improving the design of videoconferencing technology will be crucial for supporting effective communication.

Preschoolers' deception related to prefrontal cortex activation: An fNIRS study.

Deception is an essential part of children's moral development. Previous developmental studies have shown that children start to deceive at the age of 3 years, and as age increased to 5 years, almost all children were able to deceive for their own benefit. Although behavioral studies have indicated that the emergence and development of deception are related to cognitive abilities, their neural correlates remain poorly understood. Therefore, the present study examined the neural correlates underlying deception in preschool-aged children (N = 89, 44 % boys, age 3.13 to 5.96 years, Han Chinese) using functional near-infrared spectroscopy. A modified hide-and-seek paradigm was applied to elicit deceptive and truth-telling behaviors. The results showed that activation of bilateral dorsolateral prefrontal cortex was positively associated with the tendency to deceive an opponent in a competitive game in the 3-year-olds. In addition, 3-year-olds who showed a high tendency to deceive showed the same brain activation in the frontopolar area as 5-year-olds did when engaged in deception, whereas no such effect was found in 3-year-olds who never engaged in deception. These findings underscore the link between preschoolers' deception and prefrontal cortex function.

Neural substrates of L2-L1 transfer effects on phonological awareness in young Chinese-English bilingual children.

The growing trend of bilingual education between Chinese and English has contributed to a rise in the number of early bilingual children, who were exposed to L2 prior to formal language instruction of L1. The L2-L1 transfer effect in an L1-dominant environment has been well established. However, the threshold of L2 proficiency at which such transfer manifests remains unclear. This study investigated the behavioral and neural processes involved when manipulating phonemes in an auditory phonological task to uncover the transfer effect in young bilingual children. Sixty-two first graders from elementary schools in Taiwan were recruited in this study (29 Chinese monolinguals, 33 Chinese-English bilinguals). The brain activity was measured using fNIRS (functional near-infrared spectroscopy). Bilingual children showed right lateralization to process Chinese and left lateralization to process English, which supports more on the accommodation effect within the framework of the assimilation-accommodation hypothesis. Also, compared to monolinguals, bilingual children showed more bilateral frontal activation in Chinese, potentially reflecting a mixed influence from L2-L1 transfer effects and increased cognitive load of bilingual exposure. These results elucidate the developmental adjustments in the neural substrates associated with early bilingual exposure in phonological processing, offering valuable insights into the bilingual learning process.

Exaggerated sensitivity to threat and reduced medial prefrontal engagement during threat generalization in reactive aggressive adolescents.

Aggressive adolescents tend to exhibit abnormal fear acquisition and extinction, and reactive aggressive adolescents are often more anxious. However, the relationship between fear generalization and reactive aggression (RA) remains unknown. According to Reactive-Proactive Aggression Questionnaire (RPQ) scores, 61 adolescents were divided into two groups, namely, a high RA group (N = 30) and a low aggression (LA) group (N = 31). All participants underwent three consecutive phases of the Pavlovian conditioning paradigm (i.e., habituation, acquisition, and generalization), and neural activation of the medial prefrontal cortex (mPFC) was assessed by functional near-infrared spectroscopy (fNIRS). The stimuli were ten circles with varying sizes, including two conditioned stimuli (CSs) and eight generalization stimuli (GSs). A scream at 85 dB served as the auditory unconditioned stimulus (US). The US expectancy ratings of both CSs and GSs were higher in the RA group than in the LA group. The fNIRS results showed that CSs and GSs evoked lower mPFC activation in the RA group compared to the LA group during fear generalization. These findings suggest that abnormalities in fear acquisition and generalization are prototypical dysregulations in adolescents with RA. They provide neurocognitive evidence for dysregulated fear learning in the mechanisms underlying adolescents with RA, highlighting the need to develop emotional regulation interventions for these individuals.

Mothers and fathers show different neural synchrony with their children during shared experiences.

Parent-child shared experiences has an important influence on social development in children although contributions of mothers and fathers may differ. Neural synchronicity occurs between mothers and fathers and their children during social interactions but it is unclear whether they differ in this respect. We used data from simultaneous fNIRS hyperscanning in mothers (n = 33) and fathers (n = 29) and their children (3-4 years) to determine different patterns and strengths of neural synchronization in the frontal cortex during co-viewing of videos or free-play. Mothers showed greater synchrony with child than fathers during passive viewing of videos and the synchronization was positively associated with video complexity and negatively associated with parental stress. During play interactions, mothers showed more controlling behaviors over their child and greater evidence for joint gaze and joint imitation play with child whereas fathers spent more time gazing at other things. In addition, different aspects of child communication promoted neural synchrony between mothers and fathers and child during active play interactions. Overall, our findings indicate greater neural and behavioral synchrony between mothers than fathers and young children during passive or active shared experiences, although for both it was weakened by parental distress and child difficulty.

Greater up-modulation of intra-individual brain signal variability makes a high-load cognitive task more arduous for older adults.

The extent to which brain responses are less distinctive across varying cognitive loads in older adults is referred to as neural dedifferentiation. Moment-to-moment brain signal variability, an emerging indicator, reveals not only the adaptability of an individual's brain as an inter-individual trait, but also the allocation of neural resources within an individual due to ever-changing task demands, thus shedding novel insight into the process of neural dedifferentiation. However, how the modulation of intra-individual brain signal variability reflects behavioral differences related to cognitively demanding tasks remains unclear. In this study, we employed functional near-infrared spectroscopy (fNIRS) imaging to capture the variability of brain signals, which was quantified by the standard deviation, during both the resting state and an n-back task (n = 1, 2, 3) in 57 healthy older adults. Using multivariate Partial Least Squares (PLS) analysis, we found that fNIRS signal variability increased from the resting state to the task and increased with working memory load in older adults. We further confirmed that greater fNIRS signal variability generally supported faster and more stable response time in the 2- and 3-back conditions. However, the intra-individual level analysis showed that the greater the up-modulation in fNIRS signal variability with cognitive loads, the more its accuracy decreases and mean response time increases, suggesting that a greater intra-individual brain signal variability up-modulation may reflect decreased efficiency in neural information processing. Taken together, our findings offer new insights into the nature of brain signal variability, suggesting that inter- and intra-individual brain signal variability may index distinct theoretical constructs.

Influence of interpersonal distance on collaborative performance in the joint Simon task-An fNIRS-based hyperscanning study.

Collaboration is a critical skill in everyday life. It has been suggested that collaborative performance may be influenced by social factors such as interpersonal distance, which is defined as the perceived psychological distance between individuals. Previous literature has reported that close interpersonal distance may promote the level of self-other integration between interacting members, and in turn, enhance collaborative performance. These studies mainly focused on interdependent collaboration, which requires high levels of shared representations and self-other integration. However, little is known about the effect of interpersonal distance on independent collaboration (e.g., the joint Simon task), in which individuals perform the task independently while the final outcome is determined by the parties. To address this issue, we simultaneously measured the frontal activations of ninety-four pairs of participants using a functional near-infrared spectroscopy (fNIRS)-based hyperscanning technique while they performed a joint Simon task. Behavioral results showed that the Joint Simon Effect (JSE), defined as the RT difference between incongruent and congruent conditions indicating the level of self-other integration between collaborators, was larger in the friend group than in the stranger group. Consistently, the inter-brain neural synchronization (INS) across the dorsolateral and medial parts of the prefrontal cortex was also stronger in the friend group. In addition, INS in the left dorsolateral prefrontal cortex negatively predicted JSE only in the friend group. These results suggest that close interpersonal distance may enhance the shared mental representation among collaborators, which in turn influences their collaborative performance.

Teach a man to fish: Hyper-brain evidence on scaffolding strategy enhancing creativity acquisition and transfer.

Creativity is an indispensable competency in today's innovation-driven society. Yet, the influences of instructional strategy, a key determinant of educational outcomes, on the creativity-fostering process remains an unresolved mystery. We proposed that instructional strategy affects creativity cultivation and further investigated the intricate neural mechanisms underlying this relationship. In a naturalistic laboratory setting, 66 instructor-learner dyads were randomized into three groups (scaffolding, explanation, and control), with divergent thinking instructions separately. Functional near-infrared spectroscopy (fNIRS) hyperscanning simultaneously collected brain signals in the prefrontal cortex and temporal-parietal junction regions. Results indicated that learners instructed with a scaffolding strategy demonstrated superior creative performance both in acquisition (direct learning) and transfer (use in a novel context) of creativity skills, compared to pretest levels. In contrast, the control and explanation groups did not exhibit such effects. Notably, we also observed remarkable interbrain neural synchronization (INS) between instructors and learners in the left superior frontal cortex in the scaffolding group, but not in the explanation or control groups. Furthermore, INS positively predicted enhancements in creativity performance (acquisition and transfer), indicating that it is a crucial neural mechanism in the creativity-fostering process. These findings reveal that scaffolding facilitates the acquisition and transfer of creativity and deepen our understanding of the neural mechanisms underlying the process of creativity-fostering. The current study provides valuable insights for implementing teaching strategies to fostering creativity.

Cardiac vagal activity changes moderated the association of cognitive and cerebral hemodynamic variations in the prefrontal cortex.

Phasic cardiac vagal activity (CVA), reflecting ongoing, moment-to-moment psychophysiological adaptations to environmental changes, can serve as a predictor of individual difference in executive function, particularly executive performance. However, the relationship between phasic CVA and executive function demands requires further validation because of previous inconsistent findings. Moreover, it remains unclear what types of phasic changes of CVA may be adaptive in response to heightened executive demands. This study used the standard N-back task to induce different levels of working memory (WM) load and combined functional Near-Infrared Spectroscopy (fNIRS) with a multipurpose polygraph to investigate the variations of CVA and its interactions with cognitive and prefrontal responses as executive demands increased in fifty-two healthy young subjects. Our results showed phasic decreases in CVA as WM load increased (t (51) = -3.758, p < 0.001, Cohen's d = 0.526). Furthermore, phasic changes of CVA elicited by increased executive demands moderated the association of cognitive and cerebral hemodynamic variations in the prefrontal cortex (B = 0.038, SE = 0.014, p < 0.05). Specifically, as executive demands increased, individuals with larger phasic CVA withdrawal showed a positive relationship between cognitive and hemodynamic variations in the prefrontal cortex (ß = 0.281, p = 0.031). No such significant relationship was observed in individuals with smaller phasic CVA withdrawal. The current findings demonstrate a decrease in CVA with increasing executive demands and provide empirical support for the notion that a larger phasic CVA withdrawal can be considered adaptive in situations requiring high executive function demands.

Children's oppositional defiant disorder symptoms and neural synchrony in mother-child interactions: An fNIRS study.

Interpersonal neural synchrony (INS) between mothers and children responds to the temporal similarity of brain signals in joint behavior between dyadic partners and is considered an important neural indicator of the formation of adaptive social interaction bonds. Parent-child interactions are particularly important for the development and maintenance of oppositional defiant disorder (ODD) in children, but the underlying neurocognitive mechanisms are unknown. Therefore, in the current study we measured INS between mothers and children in interactions by using simultaneous functional Near-infrared Spectroscopy (fNIRS), and explored its association with ODD symptoms in children. Seventy-two mother-child dyads were recruited to participate in the study, including 35 children with ODD and 37 healthy children to be used as a control. Each mother-child dyad was measured for neural activity in frontal, parietal, and temporal lobe regions while completing free-play as well as positive, and negative topic discussion tasks. We used Phase-locked value to calculate the synchrony strength and then used the K-means algorithm and k-space based alignment tests to confirm the specific patterns of parent-child synchrony in different brain areas. The results showed that, in free-play (right MFG and bilateral SFG), positive (left TPJ and bilateral SFGdor), and negative (bilateral SFGmed, right ANG, and left MFG) topic discussions, the mother-child pairs showed different patterns of INS. These specific INS patterns were significantly lower in the ODD group compared to the control group and were negatively associated with ODD symptoms in children. Network analyses showed that these INS patterns were connected to different nodes in the ODD symptom network. Our findings suggest that ODD mother-child dyads exhibit lower neural synchrony across a wide range of parent-child interactions. Neural synchrony in the context of interpersonal interactions provides new insights into understanding the neural mechanisms of ODD and can be used as an indicator of neural and socio-environmental factors in the network of psychological disorder symptoms.

Spatial correspondence of cortical activity measured with whole head fNIRS and fMRI: Toward clinical use within subject.

Functional near infrared spectroscopy (fNIRS) and functional magnetic resonance imaging (fMRI) both measure the hemodynamic response, and so both imaging modalities are expected to have a strong correspondence in regions of cortex adjacent to the scalp. To assess whether fNIRS can be used clinically in a manner similar to fMRI, 22 healthy adult participants underwent same-day fMRI and whole-head fNIRS testing while they performed separate motor (finger tapping) and visual (flashing checkerboard) tasks. Analyses were conducted within and across subjects for each imaging approach, and regions of significant task-related activity were compared on the cortical surface. The spatial correspondence between fNIRS and fMRI detection of task-related activity was good in terms of true positive rate, with fNIRS overlap of up to 68 % of the fMRI for analyses across subjects (group analysis) and an average overlap of up to 47.25 % for individual analyses within subject. At the group level, the positive predictive value of fNIRS was 51 % relative to fMRI. The positive predictive value for within subject analyses was lower (41.5 %), reflecting the presence of significant fNIRS activity in regions without significant fMRI activity. This could reflect task-correlated sources of physiologic noise and/or differences in the sensitivity of fNIRS and fMRI measures to changes in separate (vs. combined) measures of oxy and de-oxyhemoglobin. The results suggest whole-head fNIRS as a noninvasive imaging modality with promising clinical utility for the functional assessment of brain activity in superficial regions of cortex physically adjacent to the skull.

The efficacy and methodology of using near-infrared spectroscopy to determine resting-state brain networks.

Functional connectivity is a critical aspect of brain function and is essential for understanding, diagnosing, and treating neurological and psychiatric disorders. It refers to the synchronous activity between different regions of the brain, which gives rise to communication and information processing. Resting-state functional connectivity is a subarea of study that allows researchers to examine brain activity in the absence of a task or stimulus. This can provide insight into the brain's intrinsic functional architecture and help identify neural networks that are active during rest. Thus, determining functional connectivity topography is valuable both clinically and in research. Traditional methods using functional magnetic resonance imaging have proven to be effective, however, they have their limitations. In this review, we investigate the feasibility of using functional near-infrared spectroscopy (fNIRS) as a low-cost, portable alternative for measuring functional connectivity. We first establish fNIRS' ability to detect localized brain activity during task-based experiments. Next, we verify its use in resting-state studies with results showing a high degree of correspondence with resting-state functional magnetic resonance imaging (rs-fMRI). Also discussed are various data-processing methods and the validity of filtering the global signal, which is the current standard for analysis. We consider the possible origins of the global signal, if it contains pertinent neuronal information that could be of importance in better understanding neuronal networks, and what we believe is the best method of approaching signal analysis and regression.

Connecting the dots: Sensory cueing enhances functional connectivity between pre-motor and supplementary motor areas in Parkinson's disease.

People with Parkinson's disease often exhibit improvements in motor tasks when exposed to external sensory cues. While the effects of different types of sensory cues on motor functions in Parkinson's disease have been widely studied, the underlying neural mechanism of these effects and the potential of sensory cues to alter the motor cortical activity patterns and functional connectivity of cortical motor areas are still unclear. This study aims to compare changes in oxygenated haemoglobin, deoxygenated haemoglobin and correlations among different cortical regions of interest during wrist movement under different external stimulus conditions between people with Parkinson's disease and controls. Ten Parkinson's disease patients and 10 age- and sex-matched neurologically healthy individuals participated, performing repetitive wrist flexion and extension tasks under auditory and visual cues. Changes in oxygenated and deoxygenated haemoglobin in motor areas were measured using functional near-infrared spectroscopy, along with electromyograms from wrist muscles and wrist movement kinematics. The functional near-infrared spectroscopy data revealed significantly higher neural activity changes in the Parkinson's disease group's pre-motor area compared to controls (p = 0.006), and functional connectivity between the supplementary motor area and pre-motor area was also significantly higher in the Parkinson's disease group when external sensory cues were present (p = 0.016). These results indicate that external sensory cues' beneficial effects on motor tasks are linked to changes in the functional connectivity between motor areas responsible for planning and preparation of movements.

Fronto-parietal activity changes associated with changes in working memory load: Evidence from simultaneous electroencephalography and functional near-infrared spectroscopy analysis.

Working memory (WM) involves the capacity to maintain and manipulate information over short periods. Previous research has suggested that fronto-parietal activities play a crucial role in WM. However, there remains no agreement on the effect of working memory load (WML) on neural activities and haemodynamic responses. Here, our study seeks to examine the effect of WML through simultaneous electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). In this study, a delay change detection task was conducted on 23 healthy volunteers. The task included three levels: one item, three items and five items. The EEG and fNIRS were simultaneously recorded during the task. Neural activities and haemodynamic responses at prefrontal and parietal regions were analysed using time-frequency analysis and weighted phase-lag index (wPLI). We observed a significant enhancement in prefrontal and parietal ß suppression as WML increased. Furthermore, as WML increased, there was a notable enhancement in fronto-parietal connectivity (FPC), as evidenced by both EEG and fNIRS. Correlation analysis indicated that as WML increased, there was a potential for enhancement of neurovascular coupling (NVC) of FPC.

Prefrontal cortex hemodynamic activity during a test of lower extremity functional muscle strength in children with cerebral palsy: A functional near-infrared spectroscopy study.

Children with cerebral palsy (CP) exhibit impaired motor control and significant muscle weakness due to a brain lesion. However, studies that assess the relationship between brain activity and performance on dynamic functional muscle strength assessments in CP are needed. The aim of this study was to determine the effect of a progressive lateral step-up test on prefrontal cortex (PFC) hemodynamic activity in children with CP. Fourteen ambulatory children with spastic CP (Gross Motor Function Classification System level I; 5-11 y) and 14 age- and sex-matched typically developing control children completed a progressive lateral step-up test at incremental step heights (0, 10, 15 and 20 cm) using their non-dominant lower limb. Hemodynamic activity in the PFC was assessed using non-invasive, portable functional neuroimaging (functional near-infrared spectroscopy). Children with CP completed fewer repetitions at each step height and exhibited lower PFC hemodynamic activity across step heights compared to controls. Lower PFC activation in CP was maintained after statistically controlling for the number of repetitions completed at each step height. PFC hemodynamic activity was not associated with LSUT task performance in children with CP, but a positive relationship was observed in controls at the most challenging 20 cm step height. The results suggest there is an altered PFC recruitment pattern in children with CP during a highly dynamic test of functional strength. Further studies are needed to explore the mechanisms underlying the suppressed PFC activation observed in children with CP compared to typically developing children.