The Relationship between Depression Severity and Prefrontal Hemodynamic Changes in Adolescents with Major Depression Disorder: A Functional Near-infrared Spectroscopy Study.

Objective: : Numerous studies have identified hemodynamic changes in adults with major depressive disorder (MDD) by using functional near-infrared spectroscopy (fNIRS). However, studies on adolescents with MDD are limited. As adolescence is a stage of rapid brain development, differences may occur depending on age. This study used fNIRS as an objective tool to investigate hemodynamic changes in the frontal lobe according to depression severity and age in adolescents with MDD. Methods: : Thirty adolescents (12 aged 12-15 years and 18 aged 16-18 years) were retrospectively investigated. The Children's Depression Inventory was used as a psychiatric evaluation scale, fNIRS was used as an objective brain function evaluation tool, and the Verbal Fluency Test was performed. Results: : During the Verbal Fluency Test, in the younger MDD group, oxygenated-hemoglobin concentration increased in the right dorsolateral prefrontal cortex region as the severity of depression increased. In the older MDD group, the oxygenated-hemoglobin concentration decreased in the right dorsolateral prefrontal cortex region as the severity of depression increased. Conclusion: : These results suggest that fNIRS may be an objective tool for identifying age differences among adolescents with MDD. To generalize the results and verify fNIRS as a potential biomarker tool, follow-up studies with a larger sample group should be conducted.

A study on the functional near-infrared spectroscopy on impaired prefrontal activation and impulsivity during cognitive task in patients with major depressive disorder.

BACKGROUND: This study aimed to examine the association between prefrontal activation during a verbal fluency task (VFT) and impulsivity among patients with major depressive disorder (MDD), using functional near-infrared spectroscopy (fNIRS). METHODS: We enrolled a total of 119 participants, 60 with MDD patients and 59 with healthy controls (HCs), aged 18 to 34 years. The Barratt Impulsiveness Scale-11 (BIS-11) was used to assess impulsivity after completing baseline demographic, clinical, and physical assessments. A VFT was used to examine prefrontal activation during cognitive executions while fNIRS was monitored. The changing values of oxygenated hemoglobin (oxy-Hb) and their associations with the BIS-11 score were analyzed. RESULTS: The data analysis comprised 109 participants in total (54 MDD; 55 HCs). Spearman's correlation analysis of the MDD group showed a negative correlation between changes in oxy-Hb and BIS-11 values in the right prefrontal cortex, notably the right frontopolar cortex (FPC) and ventromedial prefrontal cortex (VMPFC). After adjusting for sex, age, years of education, and Hamilton Depression Rating Scale (HAMD), significance was maintained in the right FPC [ρ = -0.317, p = 0.027], and the right VMPFC [ρ = -0.327, p = 0.022]. Furthermore, multivariate linear regression suggested a significant association in the right prefrontal cortex with BIS-11 score [ß = -1.904, SE = 0.799, p = 0.0214]. CONCLUSIONS: Impaired prefrontal activation during a verbal fluency task, led to higher impulsivity in patients with MDD.

fNIRS Assessment during Cognitive Tasks in Elderly Patients with Depressive Symptoms.

This study aimed to investigate differences in prefrontal cortex activation between older adults with and without depressive symptoms during cognitive tasks using functional near-infrared spectroscopy (fNIRS). We examined 204 older participants without psychiatric or neurological disorders who completed the Geriatric Depression Scale, digit span, Verbal Fluency Test, and Stroop test. At the same time, prefrontal cortex activation was recorded using fNIRS. During the Stroop test, significantly reduced hemodynamics were observed in the depressive-symptom group. The mean accΔHbO2 of all channel averages was 0.14 µM in the control group and -0.75 µM in the depressive-symptom group (p = 0.03). The right hemisphere average was 0.13 µM and -0.96 µM, respectively (p = 0.02), and the left hemisphere average was 0.14 µM and -0.54 µM, respectively (p = 0.12). There was no significant difference in hemodynamic response (mean accΔHbO2) between the two groups during the digit span backward and VFT. In conclusion, reduced hemodynamics in the frontal cortex of the depressive-symptom group has been observed. The frontal fNIRS signal and the Stroop task may be used to measure depressive symptoms sensitively in the elderly.

Assessment of Functional Near-infrared Spectroscopy by Comparing Prefrontal Cortex Activity: A Cognitive Impairment Screening Tool.

Many studies have suggested the possibility of using functional near-infrared spectroscopy (fNIRS) devices as neuroimaging tools in various patients. We aimed to evaluate whether fNIRS to measure the prefrontal cortex (PFC fNIRS) is suitable as a screening tool for cognitive impairments. Sixty participants, divided into normal, mild cognitive impairment, and dementia groups, were instructed to wear an fNIRS device during cognitive assessments to assess whether there is a significant difference in the PFC activity between the groups. A significant difference in PFC activity between the groups was observed during the verbal fluency test. Moreover, the PFC activity during the verbal fluency test significantly correlated with the existing cognitive screening tool score. These results suggested that PFC fNIRS can be used as a cognitive impairment screening tool for mild cognitive impairment and dementia. A larger sample size is needed to validate the potential of PFC fNIRS as a cognitive impairment screening tool.

A new variant position of head-up CPR may be associated with improvement in the measurements of cranial near-infrared spectroscopy suggestive of an increase in cerebral blood flow in non-traumatic out-of-hospital cardiac arrest patients: A prospective interventional pilot study.

AIM OF THE STUDY: This study aimed to investigate the effect of the head-up position implemented during cardiopulmonary resuscitation (CPR) on cerebral blood flow (CBF) using near-infrared spectroscopy in out-of-hospital cardiac arrest patients. METHODS: Baseline characteristics (age, sex, cerebral performance category before cardiac arrest, witnessed cardiac arrest, bystander CPR, first monitored rhythm, no-flow time, prehospital low-flow time, CPR duration in the emergency department (ED), and reason for stopping CPR in the ED) were recorded. The changes of CBF were derived from the optical oscillation waveform measured by near-infrared spectroscopy in adult patients with out-of-hospital cardiac arrest by alternating head-up and supine positions at 4-minute intervals while performing CPR. The CBF velocity according to the head position was also evaluated using the time derivative of the oscillation waveform. RESULTS: During the study period, 28 patients were enrolled. The median increase in CBF in the prefrontal area in the head-up position was 14.6% (Interquartile range, 8.8-65.0), more than that in the supine position. An increase in CBF was observed in the head-up position compared with the supine position in 83.3% of the patients included in the analysis. CONCLUSION: CBF increased when the head-up position was used during CPR in non-traumatic out-of-hospital cardiac arrest patients.

The slope of cerebral oxyhemoglobin oscillation is associated with vascular reserve capacity in large artery steno-occlusion.

Inadequate cerebral perfusion is a risk factor for cerebral ischemia in patients with large artery steno-occlusion. We investigated whether prefrontal oxyhemoglobin oscillation (ΔHbO2, 0.6-2 Hz) was associated with decreased vascular reserve in patients with steno-occlusion in the large anterior circulation arteries. Thirty-six patients with steno-occlusion in the anterior circulation arteries (anterior cerebral artery, middle cerebral artery, and internal carotid artery) were included and compared to thirty-six control subjects. Patients were categorized into two groups (deteriorated vascular reserve vs. preserved vascular reserve) based on the results of Diamox single- photon emission computed tomography imaging. HbO2 data were collected using functional near-infrared spectroscopy. The slope of ΔHbO2 and the ipsilateral/contralateral slope ratio of ΔHbO2 were analyzed. Among the included patients (n = 36), 25 (69.4%) had deteriorated vascular reserve. Patients with deteriorated vascular reserve had a significantly higher average slope of ΔHbO2 on the ipsilateral side (5.01 ± 2.14) and a higher ipsilateral/contralateral ratio (1.44 ± 0.62) compared to those with preserved vascular reserve (3.17 ± 1.36, P = 0.014; 0.93 ± 0.33, P = 0.016, respectively) or the controls (3.82 ± 1.69, P = 0.019; 0.94 ± 0.29, P = 0.001). The ipsilateral/contralateral ΔHbO2 ratio could be used as a surrogate for vascular reserve in patients with severe steno-occlusion in the anterior circulation arteries.

Prognostication of neurological outcome after cardiac arrest using wavelet phase coherence analysis of cerebral oxygen.

BACKGROUND: The prognosis for cardiac arrest (CA) is associated with the degree of cerebral ischemia. We investigated the relationship between the wavelet coherence of cerebral oxyhemoglobin (HbO2) among different channels and outcomes after CA. Moreover, we aimed to develop a prognostication method after CA. METHODS: Eighty-three post-resuscitation patients were included. The HbO2 data were collected during the post-resuscitation period (median day, 1) using functional near-infrared spectroscopy. The coherence between sections of prefrontal HbO2 oscillations in five frequency intervals (I, 0.6-2 Hz; II, 0.15-0.6 Hz; III, 0.05-0.15 Hz; IV, 0.02-0.05 Hz; and V, 0.0095-0.02 Hz) were analyzed. We evaluated the outcomes using cerebral performance category (CPC) scores (good outcome, CPC ≤ 2 and poor outcome, CPC ≥ 3) at 3 months after CA. Additionally, the predictive method was developed using the biomarker and coherence value after CA. RESULTS: Among the included patients, 19 patients (22.9%) had a good outcome. Poor outcome group had significantly lower phase coherence in the myogenic frequency interval III compared to good outcome group (0.36 ±â€¯0.14 vs. 0.54 ±â€¯0.18, P < 0.001). The predictive method using neuron-specific enolase (NSE) and interval III value demonstrated good discrimination (area under the curve 0.919; 95% confidence interval, 0.850-0.989). CONCLUSIONS: The predictive method using NSE and phase coherence of HbO2 in the interval III from the vascular smooth muscle cells could be a useful tool for prognosticating after CA. This suggests that evaluating cerebral ischemia using phase coherence of HbO2 might be a helpful outcome predictor following CA.

Assessment of cerebral autoregulation using continuous-wave near-infrared spectroscopy during squat-stand maneuvers in subjects with symptoms of orthostatic intolerance.

Orthostatic lightheadedness in healthy young adults often leads to syncope in severe cases. One suggested underlying mechanism of orthostatic lightheadedness is a drop in transient blood pressure (BP); however, a decrease in BP does not always lead to a drop in cerebral blood flow (CBF) due to cerebral autoregulation (CA). We present a direct assessment method of CA using a multichannel continuous-wave near-infrared spectroscopy (CW-NIRS) device that measures the temporal changes in oxy- and deoxy-hemoglobin concentrations in the prefrontal cortex. Twenty healthy young adults were recruited. During the experiment, continuous beat-to-beat BP and heart rate were simultaneously measured during repetitive squat-stand maneuvers. We introduce a new metric termed 'time-derivative hemodynamic model (DHbT)', which is the time-derivative of total-hemoglobin concentration change that reflects the changes of cerebral blood volume and CBF. Although the absolute levels and the variations of systolic and diastolic BPs and mean arterial pressure showed no significant difference between the two groups, the proposed model showed a distinct difference in slope variation and response time of DHbT between the subjects with frequent symptom of orthostatic intolerance and the healthy control subjects. Thus, these results clearly demonstrate the feasibility of using CW-NIRS devices as a CA performance assessment tool.

Efficient data extraction method for near-infrared spectroscopy (NIRS) systems with high spatial and temporal resolution.

An hardware-efficient method for the extraction of hemodynamic responses in near-infrared spectroscopy systems is proposed to increase the spatial and temporal resolution. The performance improvement is attributed to high signal-to-noise ratio receivers, a modulation scheme, and a multi-input-multi-output based data extraction algorithm. The proposed system shows more than twofold improvement in the figure of merit compared to conventional designs. Experimental results support the validity of the proposed system.