Simultaneous functional near infrared spectroscopy (fNIRS) and electroencephalography (EEG) is a neuroimaging device used to record hemodynamic and electrical responses to stimulus. While this imaging system is used amongst many populations, it is used for the first time in epithelial ovarian cancer patients to assess chemotherapy induced cognitive impairment. Before imaging, cognitive side effects were only qualitative in that subjects would report memory loss, brain fog, and general slowness; however, using fNIRS-EEG has quantified the chemotherapy-related changes in neurological function.

Upon successful clinical outcomes from fNIRS-EEG, further treatment applications were perused. Thus, fNIRS-EEG was integrated with transcranial magnetic stimulation (TMS) for the first time into a simultaneous neuroimaging and modulating device (fNET). From one successful pilot study, fNET is pioneering the way of many other disease therapies: including depression and glioma treatment. Specifically, fNET is developed to synchronize TMS to alpha phase in real time, which is to be used in new depression therapies. fNET is also developed to aid in brain tumor surgical planning and set healthy baseline connectivity data using working memory paradigms.

In this thesis, each of the three experiments are discussed in chronological order to illustrate how multimodal fNET has been developed. By integrating TMS with previously established fNIRS-EEG, neuroimaging possibilities are being engineered into the next standard of clinical care.