Cortical Region Reporting Patterns in Neurodevelopmental Disorders: A Systematic Review of fNIRS Studies

Abstract

Functional near-infrared spectroscopy (fNIRS) is a portable, non-invasive tool for studying cortical function in children with neurodevelopmental and neurological disorders. Although fNIRS use is increasing, heterogeneous study paradigms and cortical targets have limited cross-condition comparisons and the identification of shared research priorities. This systematic review maps cortical regions and reporting patterns in five key conditions—autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), cerebral palsy (CP), hypoxic–ischemic encephalopathy (HIE), and epilepsy (Ep)—from January 2015 to December 2025. A systematic search across five databases identified 72 relevant studies meeting PRISMA 2020 criteria, revealing both similarities and differences across disorders. The prefrontal cortex (PFC) was studied in all five conditions (5/5: 100%), making it the most consistently investigated cortical region. The parietal and temporal cortices were studied in 4 of 5 conditions (80%). The frontal cortex had the most regions investigated, while the temporal cortex showed the most consistent coverage across conditions (2.25 conditions per region). Beyond regional preferences, condition-specific patterns were aligned with their disorder phenotypes: social brain networks in ASD, prefrontal executive systems in ADHD, sensorimotor changes in CP, cerebrovascular monitoring in HIE, and state-dependent changes in Ep. Across conditions, researchers found altered prefrontal activity, disrupted connectivity, and compensatory brain responses, supporting broader frameworks. Collectively, these findings identify the PFC as a shared target for transdiagnostic fNIRS investigations while highlighting important gaps in regional coverage and methodological consistency. Despite methodological differences, fNIRS shows promise for identifying both shared and unique brain patterns in pediatric neurodevelopmental and neurological disorders. This review provides a framework for prioritizing cortical targets and guiding future standardized fNIRS research in pediatric populations.