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Chou PH, Liu WC, Lin WH, Hsu CW, Wang SC, Su KP. NIRS-aided differential diagnosis among patients with major depressive disorder, bipolar disorder, and schizophrenia. J Affect Disord 2023; 341:366-373. [PMID: 37634818 DOI: 10.1016/j.jad.2023.08.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND To establish a clinically applicable neuroimaging-guided diagnostic support system that uses near-infrared spectroscopy (NIRS) for differential diagnosis at the individual level among major depressive disorder (MDD), bipolar disorder (BPD), and schizophrenia (SZ). METHODS A total of 192 participants were recruited, including 40 patients with MDD, 38 patients with BPD, 65 patients with SZ, and 49 healthy individuals. We analyzed the spatiotemporal characteristics of hemodynamic responses in the frontotemporal cortex during a verbal fluency test (VFT) measured by NIRS to assess the accuracy of single-subject classification for differential diagnosis among the three psychiatric disorders. The optimal threshold of the frontal centroid value (54 seconds) was utilized on the basis of the findings of the Japanese study. RESULTS The application of the optimal threshold of the frontal centroid value (54 seconds) allowed for the accurate differentiation of patients with unipolar MDD (72.5%) from BPD (78.9%) or SZ (84.6%). CONCLUSION These results suggest that the NIRS-aided differential diagnosis of major psychiatric disorders can be a promising biomarker in Taiwan. Future multi-site studies are needed to validate our findings.
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Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, Hsinchu, Taiwan; Dr. Chou's Mental Health Clinic, Hsinchu, Taiwan
| | - Wen-Chun Liu
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Wei-Hao Lin
- Department of Psychiatry, Puli branch, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Wei Hsu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shao-Cheng Wang
- Department of Psychiatry, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan, Taiwan.
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Tainan, Taiwan; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
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2
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Chou PH, Wang SC, Wu CS, Ito M. Trauma-related guilt as a mediator between post-traumatic stress disorder and suicidal ideation. Front Psychiatry 2023; 14:1131733. [PMID: 37056401 PMCID: PMC10086326 DOI: 10.3389/fpsyt.2023.1131733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/13/2023] [Indexed: 04/15/2023] Open
Abstract
Background As a mental health issue, suicide is a growing global concern, with patients who have post-traumatic stress disorder (PTSD) being at particularly high risk. This study aimed to investigate whether the link between PTSD and suicidal ideation is mediated by trauma-related guilt. Methods Data were obtained from Wave 1, Time 1 (November 2016), and Time 2 (March 2017) of the National Survey for Stress and Health (NSSH) in Japan. The NSSH is an online longitudinal survey conducted on Japan's national population aged 18 years and older. The cumulative response rate of the survey was 66.7% at Time 2. A total of 1,005 patients with PTSD were included for analyses. The severity of PTSD symptoms was assessed with PTSD DSM-5 Checklist, and the trauma-related guilt were assessed using the two subscales (hindsight-bias/responsibility and global guilt scale) of the trauma-related guilt inventory (TRGI). Suicidal ideation was evaluated using the suicidal ideation attributes scale (SIDAS). Pearson's correlation was used to investigate the associations among PTSD symptoms, TRGI scores, and SIDAS scores. Causal mediation analysis was applied to evaluate the causal relationship between PTSD, trauma-related guilt, and suicidal ideation. Results Pearson's correlation did not show patients' age, gender, and household income significantly associated with SIDAS scores. On the other hand, severities of PTSD symptoms (r = 0.361, p < 0.001) and trauma-related guilt (r = 0.235, p < 0.001) were positively associated with SIDAS scores. After adjusting for age, gender, and household income, the mediation analysis revealed that trauma-related guilt significantly mediates the effects of PTSD symptoms on suicidal ideation. Conclusion Our results implied that trauma-related guilt may represent a critical link between PTSD and suicidal ideation, which may be a noteworthy target for therapeutic intervention.
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Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Taichung, Taiwan
- Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan
- *Correspondence: Po-Han Chou, ;
| | - Shao-Cheng Wang
- Department of Psychiatry, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan, Taiwan
- Department of Nurse-Midwifery and Women Health, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
- Chi-Shin Wu,
| | - Masaya Ito
- National Center for Cognitive-Behavior Therapy and Research, National Center of Neurology and Psychiatry, Hsinchu, Miaoli, Taiwan
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Palomo-Osuna J, Dueñas M, Naranjo C, De Sola H, Salazar A, Failde I. Factors related to cognitive function in type-2 diabetes and neuropathic pain patients, the role of mood and sleep disorders in this relationship. Sci Rep 2022; 12:15442. [PMID: 36104367 PMCID: PMC9472177 DOI: 10.1038/s41598-022-18949-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/22/2022] [Indexed: 11/09/2022] Open
Abstract
To compare cognitive function in patients with diabetes mellitus type-2 (T2DM) both with and without diabetic neuropathic pain (DNP). To analyse the relationship between mood and sleep disorders, quality of life and cognitive function in patients with DNP. Cross-sectional study conducted in patients with T2DM and neuropathy. The presence of DNP, cognitive function, mood status, sleep quality, health-related quality of life, pain intensity and phenotype of pain were measured. Descriptive, bivariate and multivariate analyses were performed. A total of 149 patients (71 with DNP) were included. Patients with and without DNP presented similar scores on the TYM (41.46; SD = 6.70 vs. 41.97; SD = 5.50) and those with DNP had a slightly higher frequency of cognitive impairment (TYM score ≤ 41: 40.8% vs. 43.6%). The patients without DNP performed better in the verbal fluency dimension (mean = 3.53; SD = 0.98 vs. mean = 3.82; SD = 0.66). Being older (B = − 0.258) and under treatment with insulin (B = − 2.919) were related with greater cognitive impairment. Obesity (OR = 17.277) and a longer duration of diabetes (OR = 1.317) were also related to greater risk of cognitive impairment. Impaired cognitive function in patients with DNP is more related to T2DM factors than pain factors. The presence of depression and a worse quality of life were related to a greater risk of cognitive impairment. Identifying and controlling these factors should be an essential intervention for maintaining the cognitive function in patients with T2DM and DNP.
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4
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Direct-Acting Antiviral Drugs Reduce Fibromyalgia Symptoms in Patients with Chronic Hepatitis C. J Clin Med 2022; 11:jcm11185327. [PMID: 36142974 PMCID: PMC9500682 DOI: 10.3390/jcm11185327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background Fibromyalgia (FM) is a complex disorder characterized by chronic widespread pain and significant patient burden. Patients with chronic hepatitis C are reportedly predisposed to the development of FM. Direct-acting antiviral drugs (DAA) achieved a remarkable therapeutic efficacy in CHC patients. We therefore investigated the impact of DAA on FM symptoms in CHC patients. Methods We enrolled consecutive CHC patients who received DAA. FM symptoms were evaluated based on the 2016 American College of Rheumatology (ACR) fibromyalgia scale at baseline and 12 and 24 weeks after cessation of DAA therapy. Logistic regression was performed to determine the influence of HCV on FM at baseline. We also recruited individuals who underwent a health checkup examination as the control group, and calculated the standardized prevalence ratio of FM in CHC patients. Comparisons of fibromyalgia in different time points were undertaken using the Wilcoxon signed-rank test. Results A total of 33 CHC patients (15 males and 18 females) and 402 controls were recruited. All CHC patients achieved sustained virological response. Two (6%) patients and two (0.5%) controls fulfilled the diagnostic criteria for FM, and the standardized prevalence ratio was 23.9 in CHC patients. Logistic regression also showed increased odds for FM in CHC patients after adjusting for age and sex (OR: 14.4; 95%CI: 1.6, 128.0). In addition, their fibromyalgianess scale decreased at 12 and 24 weeks after DAA therapy. In conclusion, CHC patients were more likely to develop FM. Implementation of DAA therapy might improve FM symptoms in these patients.
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Abstract
Pain is an unpleasant sensory and emotional experience. Understanding the neural mechanisms of acute and chronic pain and the brain changes affecting pain factors is important for finding pain treatment methods. The emergence and progress of non-invasive neuroimaging technology can help us better understand pain at the neural level. Recent developments in identifying brain-based biomarkers of pain through advances in advanced imaging can provide some foundations for predicting and detecting pain. For example, a neurologic pain signature (involving brain regions that receive nociceptive afferents) and a stimulus intensity-independent pain signature (involving brain regions that do not show increased activity in proportion to noxious stimulus intensity) were developed based on multivariate modeling to identify processes related to the pain experience. However, an accurate and comprehensive review of common neuroimaging techniques for evaluating pain is lacking. This paper reviews the mechanism, clinical application, reliability, strengths, and limitations of common neuroimaging techniques for assessing pain to promote our further understanding of pain.
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Affiliation(s)
- Jing Luo
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Hui-Qi Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
| | - Bo Gou
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China.
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
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Lee SY, Cha JY, Yoo JW, Nazareno M, Cho YS, Joo SY, Seo CH. Effect of the Application of Virtual Reality on Pain Reduction and Cerebral Blood Flow in Robot-Assisted Gait Training in Burn Patients. J Clin Med 2022; 11:jcm11133762. [PMID: 35807047 PMCID: PMC9267903 DOI: 10.3390/jcm11133762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 01/17/2023] Open
Abstract
Burn injuries and their treatment are extremely painful. This study aimed to determine whether virtual reality (VR) could reduce pain during robot-assisted gait training (RAGT) in burn patients by analyzing the cerebral blood flow (CBF) in the prefrontal cortex over time using functional near-infrared spectroscopy (fNIRS). The patients included in this study complained of a pain score ≥5 on a visual analog scale (VAS) during RAGT, which was performed 10 times for 2 weeks. Each session consisted of 15 min of VR application, with a 2-min break, and 15 min without VR. The average values of oxyhemoglobin and deoxyhemoglobin concentrations in the prefrontal cortex on fNIRS were calculated at four stages: temporal delay time with only RAGT, RAGT without VR, temporal delay time with RAGT and VR, and RAGT with VR. The pain scores and CBF were evaluated in sessions 1, 5, and 10 of the RAGT. The mean VAS pain scores were significantly lower (p < 0.05) in the experimental condition than in the control condition. Oxyhemoglobin in the prefrontal lobe significantly increased when RAGT was performed with VR. In conclusion, VR may be a strong nonpharmacological pain reduction technique for burn patients during physical therapy.
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Affiliation(s)
- Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon 14158, Korea;
| | - Jeong Yeon Cha
- Department of Rehabilitation Medicine, College of Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul 07247, Korea;
| | - Ji Won Yoo
- Department of Internal Medicine, School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV 89154, USA;
| | - Matheu Nazareno
- School of Life Sciences, University of Nevada, Las Vegas, Las Vegas, NV 89154, USA;
| | - Yoon Soo Cho
- Department of Rehabilitation Medicine, College of Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul 07247, Korea;
- Correspondence: (Y.S.C.); (S.Y.J.); (C.H.S.); Tel.: +82-2-2639-5738 (C.H.S.)
| | - So Young Joo
- Department of Rehabilitation Medicine, College of Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul 07247, Korea;
- Correspondence: (Y.S.C.); (S.Y.J.); (C.H.S.); Tel.: +82-2-2639-5738 (C.H.S.)
| | - Cheong Hoon Seo
- Department of Rehabilitation Medicine, College of Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul 07247, Korea;
- Correspondence: (Y.S.C.); (S.Y.J.); (C.H.S.); Tel.: +82-2-2639-5738 (C.H.S.)
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7
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Wang LM, Huang YH, Chou PH, Wang YM, Chen CM, Sun CW. Characteristics of brain connectivity during verbal fluency test: Convolutional neural network for functional near-infrared spectroscopy analysis. JOURNAL OF BIOPHOTONICS 2022; 15:e202100180. [PMID: 34553833 DOI: 10.1002/jbio.202100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/29/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
Human connectome describes the complicated connection matrix of nervous system among human brain. It also possesses high potential of assisting doctors to monitor the brain injuries and recoveries in patients. In order to unravel the enigma of neuron connections and functions, previous research has strived to dig out the relations between neurons and brain regions. Verbal fluency test (VFT) is a general neuropsychological test, which has been used in functional connectivity investigations. In this study, we employed convolutional neural network (CNN) on a brain hemoglobin concentration changes (ΔHB) map obtained during VFT to investigate the connections of activated brain areas and different mental status. Our results show that feature of functional connectivity can be identified accurately with the employment of CNN on ΔHB mapping, which is beneficial to improve the understanding of brain functional connections.
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Affiliation(s)
- Le-Mei Wang
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Hua Huang
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Yi-Min Wang
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chung-Ming Chen
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Chia-Wei Sun
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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8
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Ibraheem W, Mckenzie S, Wilcox-Omubo V, Abdelaty M, Saji SE, Siby R, Alalyani W, Mostafa JA. Pathophysiology and Clinical Implications of Cognitive Dysfunction in Fibromyalgia. Cureus 2021; 13:e19123. [PMID: 34858761 PMCID: PMC8614169 DOI: 10.7759/cureus.19123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/29/2021] [Indexed: 11/24/2022] Open
Abstract
Cognitive dysfunction is a complaint of many patients diagnosed with fibromyalgia. Although the main symptoms of the disease are fatigue, widespread musculoskeletal pain, poor sleep quality, and tenderness points, the cognitive symptoms can be more distressing than the pain itself, and negatively affect their lives; however, many healthcare professionals underestimate these cognitive complaints and it is still one of the least researched topics. Proper management of these symptoms at an early stage may have a great impact to improve the mental health, physical function, and overall health of these patients. Hence, this traditional review aimed to look at the previous body of literature in PubMed in the past five years to address the pathophysiology of the cognitive dysfunction in fibromyalgia patients, to find the risk factors of cognitive dysfunction in these patients, to discover the recent modalities for treatment, and to figure out the clinical implications and recent recommendations by researchers on screening, diagnosis, and management of fibromyalgia and its cognitive dysfunction symptoms. This review has shown the various mechanisms of cognitive dysfunction. Some mechanisms are related to disease symptomologies, such as excessive pain perception, and others are related to hormonal and metabolite changes in the brain. Tobacco smoking and high body mass index showed an inverse impact on cognitive dysfunction and quality of life in fibromyalgia. Other risk factors and clinical implications were discussed in detail.
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Affiliation(s)
- Weaam Ibraheem
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Simon Mckenzie
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Victory Wilcox-Omubo
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohamed Abdelaty
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sandra E Saji
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Rosemary Siby
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Wafaa Alalyani
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Hu XS, Nascimento TD, DaSilva AF. Shedding light on pain for the clinic: a comprehensive review of using functional near-infrared spectroscopy to monitor its process in the brain. Pain 2021; 162:2805-2820. [PMID: 33990114 PMCID: PMC8490487 DOI: 10.1097/j.pain.0000000000002293] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
ABSTRACT Pain is a complex experience that involves sensation, emotion, and cognition. The subjectivity of the traditional pain measurement tools has expedited the interest in developing neuroimaging techniques to monitor pain objectively. Among noninvasive neuroimaging techniques, functional near-infrared spectroscopy (fNIRS) has balanced spatial and temporal resolution; yet, it is portable, quiet, and cost-effective. These features enable fNIRS to image the cortical mechanisms of pain in a clinical environment. In this article, we evaluated pain neuroimaging studies that used the fNIRS technique in the past decade. Starting from the experimental design, we reviewed the regions of interest, probe localization, data processing, and primary findings of these existing fNIRS studies. We also discussed the fNIRS imaging's potential as a brain surveillance technique for pain, in combination with artificial intelligence and extended reality techniques. We concluded that fNIRS is a brain imaging technique with great potential for objective pain assessment in the clinical environment.
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Affiliation(s)
- Xiao-Su Hu
- University of Michigan, School of Dentistry, Biologic & Materials Sciences Department, Hedache & Orofacial Pain Effort Lab
| | - Thiago D. Nascimento
- University of Michigan, School of Dentistry, Biologic & Materials Sciences Department, Hedache & Orofacial Pain Effort Lab
| | - Alexandre F. DaSilva
- University of Michigan, School of Dentistry, Biologic & Materials Sciences Department, Hedache & Orofacial Pain Effort Lab
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10
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The mapping of cortical activation by near-infrared spectroscopy might be a biomarker related to the severity of fibromyalgia symptoms. Sci Rep 2021; 11:15754. [PMID: 34344913 PMCID: PMC8333354 DOI: 10.1038/s41598-021-94456-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 07/05/2021] [Indexed: 01/01/2023] Open
Abstract
The delta value of oxyhemoglobin (Δ-HbO) determined by functional near-infrared spectroscopy at prefrontal cortex (PFC) and motor cortex (MC) based on primary (25 °C) and secondary (5 °C) thermal stimuli presented a larger peak latency at left MC in fibromyalgia than in controls. The difference between HbO concentration 15 s after the thermal stimuli ending and HbO concentration before the thermal stimuli onset (Δ-HbO*) at left PFC increased 47.82% in fibromyalgia and 76.66% in controls. This value had satisfactory discriminatory properties to differentiate cortical activation in fibromyalgia versus controls. A receiver operator characteristics (ROC) analysis showed the Δ-HbO* cutoffs of − 0.175 at left PFC and − 0.205 at right PFC offer sensitivity and specificity of at least 80% in screening fibromyalgia from controls. In fibromyalgia, a ROC analysis showed that these cutoffs could discriminate those with higher disability due to pain and more severe central sensitization symptoms (CSS). The ROC with the best discriminatory profile was the CSS score with the Δ-HbO* at left PFC (area under the curve = 0.82, 95% confidence interval = 0.61–100). These results indicate that cortical activation based on Δ-HbO* at left PFC might be a sensitive marker to identify fibromyalgia subjects with more severe clinical symptoms.
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Richard-Devantoy S, Bertrand JA, Béziat S, Jaussent I, Cazals A, Ducasse D, Greenway KT, Guillaume S, Courtet P, Olié E. Psychological pain and depression: it's hard to speak when it hurts. Int J Psychiatry Clin Pract 2021; 25:180-186. [PMID: 33275047 DOI: 10.1080/13651501.2020.1836225] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the neuropsychological features of depressed patients reporting high level of psychological pain. METHODS Sixty-two inpatients were included and divided into two groups according to the level of psychological pain assessed by a Likert scale. Cognitive abilities were assessed using the Trail Making Test, the Stroop test, and Verbal Fluency Test (semantic and phonemic verbal fluency). Univariate and multivariate analyses were performed to determine neuropsychological factors associated with a high level of psychological pain. RESULTS The median level of psychological pain was 8/10. High level of psychological pain was associated with poor phonemic verbal fluency performance in men (p = 0.009), but not in women, even after controlling for confounding factors (age, level of depression, anxiety). Groups did not differ on the Trail Making Test, the Stroop test, or the semantic verbal fluency measure. CONCLUSION Psychological pain is a specific clinical entity that should be considered to be more significant than just a symptom of depression. High level of psychological pain appears to be associated with a deficit of phonemic verbal fluency in depressed men. This finding could help to target psychotherapeutic treatments and improve screening.Key pointsPatients with high psychological pain do not differ on the Trail Making Test, the Stroop Test or the Sematic Verbal Fluency Measure to patients with low psychological painHigh psychological pain is associated with a deficit in phonemic verbal fluency in depressed menFuture research should aim to clarify gender differences in psychological pain in participants with and without major depressive disorder, as well as explore the complex relationship between cognition and the different forms of pain (psychological, physical and psychosomatic).
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Affiliation(s)
- Stéphane Richard-Devantoy
- McGill Group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, Canada.,CISSS des Laurentides, Saint-Jérôme, Canada
| | - Josie-Anne Bertrand
- CISSS des Laurentides, Saint-Jérôme, Canada.,Douglas Mental Health University Institute, Montréal, Canada
| | - Séverine Béziat
- Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France
| | - Isabelle Jaussent
- Université Montpellier, Montpellier, France.,Inserm U1061, Montpellier, France
| | - Aurélie Cazals
- Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.,Université Montpellier, Montpellier, France
| | - Déborah Ducasse
- Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.,Université Montpellier, Montpellier, France
| | - Kyle T Greenway
- McGill Group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, Canada
| | - Sébastien Guillaume
- Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.,Université Montpellier, Montpellier, France.,Inserm U1061, Montpellier, France
| | - Philippe Courtet
- Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.,Université Montpellier, Montpellier, France.,Inserm U1061, Montpellier, France
| | - Emilie Olié
- Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.,Université Montpellier, Montpellier, France.,Inserm U1061, Montpellier, France
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Chou PH, Lin YF, Lu MK, Chang HA, Chu CS, Chang WH, Kishimoto T, Sack AT, Su KP. Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder According to the Existing Psychiatric Comorbidity. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:190-205. [PMID: 33888649 PMCID: PMC8077054 DOI: 10.9758/cpn.2021.19.2.190] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 12/19/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are evidenced-based treatments for patients with major depressive disorder (MDD) who fail to respond to standard first-line therapies. However, although various TMS protocols have been proven to be clinically effective, the response rate varies across clinical applications due to the heterogeneity of real-world psychiatric comorbidities, such as generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or substance use disorder, which are often observed in patients with MDD. Therefore, individualized treatment approaches are important to increase treatment response by assigning a given patient to the most optimal TMS treatment protocol based on his or her individual profile. This literature review summarizes different rTMS or TBS protocols that have been applied in researches investigating MDD patients with certain psychiatric comorbidities and discusses biomarkers that may be used to predict rTMS treatment response. Furthermore, we highlight the need for the validation of neuroimaging and electrophysiological biomarkers associated with rTMS treatment responses. Finally, we discuss on which directions future efforts should focus for developing the personalization of the treatment of depression with rTMS or iTBS.
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Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.,Taiwan Allied Clinics for Integrative TMS, Taipei, Taiwan
| | - Yen-Feng Lin
- Taiwan Allied Clinics for Integrative TMS, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan.,Department of Public Health & Medical Humanities, Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.,Balance Psychiatric Clinic, Hsinchu, Taiwan
| | - Ming-Kuei Lu
- Ph.D. Program for Translational Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain+Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
| | - Kuan-Pin Su
- Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
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13
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Lang X, Wen D, Li Q, Yin Q, Wang M, Xu Y. fNIRS Evaluation of Frontal and Temporal Cortex Activation by Verbal Fluency Task and High-Level Cognition Task for Detecting Anxiety and Depression. Front Psychiatry 2021; 12:690121. [PMID: 34267690 PMCID: PMC8277106 DOI: 10.3389/fpsyt.2021.690121] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022] Open
Abstract
Anxiety and depression are widespread psychosis which are believed to affect cerebral metabolism, especially in frontal and temporal cortex. The comorbidity patients of anxiety and depression (A&D) have more serious clinical symptoms. Functional near-infrared spectroscopy (fNIRS) is a noninvasive modality used to monitor human brain oxygenation, and it could be considered as a potential tool to detect psychosis which may lead to abnormal cerebral oxygen status when the brain is activated. However, how sensitive the cerebral oxygenation response to the cortex activation and whether these responses are consistent at different stages of A&D or different regions still remains unclear. In this study, a conventional physiological paradigm for cortex activation, i.e., verbal fluency task (VFT), and a relatively new paradigm, i.e., high-level cognition task (HCT), were compared to detect A&D through a longitudinal measurement of cerebral oxygen status by fNIRS. The A&D patients at the acute, consolidation and maintenance stages as well as the healthy subjects participated in the VFT and HCT paradigms, respectively. For the VTF paradigm, the subject was instructed to answer questions of phrase constructions within 60 s. For the HCT paradigm, the subject was instructed to categorize items, logical reasoning, and comprehensive judgment and write down the answers within 60 s. For most of the subjects, the oxy-Hb is found to increase remarkably, accompanied with a relatively small reduction in deoxy-Hb when subject to both paradigms. The statistical analyses show a relatively large variability within any group, leading to the significant difference that was only found between A&D at the acute stage and healthy subjects in the temporal lobe region (p < 0.001). Nevertheless, HCT would activate more oxygen increment when compared with the VFT, with a large integral value in oxy-Hb. On average, the oxy-Hb integral value of the A&D patients differs substantially at different stages when subject to HCT paradigm. Moreover, the prefrontal lobe and temporal lobe responses were more consistent to the HCT paradigm rather than the VFT paradigm. Under the VFT paradigm, however, no remarkable difference in integral value was found among the three stages, either at the prefrontal lobe or at the temporal lobe. This study indicated that HCT, which is intensively involved in brain function, would activate more oxygenation changes in the cerebral cortex. Additionally, with good performance at distinguishing different stages according to the oxy-Hb criterion, the HCT has the potential to evaluate the therapeutic effects for A&D patients.
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Affiliation(s)
- Xuenan Lang
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Dan Wen
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Qiqi Li
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Qin Yin
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Mingyu Wang
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yong Xu
- First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Department of Mental Health, Shanxi Medical University, Taiyuan, China
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14
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Joo SY, Cho YS, Lee KJ, Lee SY, Seo CH. Frontal lobe oxyhemoglobin levels in patients with lower extremity burns assessed using a functional near-Infrared spectroscopy device during usual walking: a pilot study. Comput Methods Biomech Biomed Engin 2020; 24:115-121. [PMID: 32915075 DOI: 10.1080/10255842.2020.1812583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Understanding the mechanisms associated with locomotor networks may be of benefit for rehabilitation of burn victims with neurological locomotor deficits. A wearable functional near-infrared spectroscopy (fNIRS) device has been developed for studying cortical hemodynamics. OBJECTIVES To investigate cortical brain activity during usual walking, we examined patterns of cortical activation using fNIRS device (NIRSIT®; OBELAB Inc., Seoul, Korea), in patients with neurological injury caused by lower extremity burns. METHODS This cross-sectional study assessed 15 patients with lower extremity burns, 10 patients with upper extremity burns, and 11 healthy controls. We measured walking-related cortical activity using an fNIRS device at baseline and during usual walking. RESULTS There was no significant difference between the burns groups in terms of age (43.50 ± 14.08 and 44.67 ± 6.92 years, P = 1.00), pain score of NRS (Numeric rating scale) (5.83 ± 1.19 and 6.67 ± 1.21, P = 0.18) or the mean time since injury (228.50 ± 83.43 and 199.33 ± 68.84 days, P = 0.78). Measures showed increased cortical activation in the prefrontal cortex in patients with lower extremity burns than in patients with healthy controls(P = 0.015). The measured HbO2 datas of the regions during usual walking in patients with lower extremity burn were insignificantly higher compared with the datas in patient with upper extremity burn (P = 0.302). CONCLUSIONS The patients with neurological injury due to lower extremity burns significantly rely more on cognitive resources even when performing a usual walking task.
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Affiliation(s)
- So Young Joo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Yoon Soo Cho
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Kuem Ju Lee
- Department of Rehabilitation & Assistive Technology, Korea National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Korea
| | - Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - Cheong Hoon Seo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
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15
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Lysne P, Cohen R, Hoyos L, Fillingim RB, Riley JL, Cruz-Almeida Y. Age and pain differences in non-verbal fluency performance: Associations with cortical thickness and subcortical volumes. Exp Gerontol 2019; 126:110708. [PMID: 31445107 DOI: 10.1016/j.exger.2019.110708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 11/20/2022]
Abstract
Musculoskeletal pain is a cause of disability in older individuals and is commonly associated with executive function deficits. In particular, verbal fluency deficits have been previously reported in older individuals with and without musculoskeletal pain, however, no studies have examined non-verbal fluency. The present study investigated non-verbal fluency performance in younger and older individuals and associations with clinical and experimental pain. The NEPAL study included older (n = 63) and younger (n = 28) individuals who completed demographic, and clinical pain assessments followed by a multi-modal QST battery. A subset of participants (older n = 39/63, younger n = 11/28) underwent a structural 3T MRI to extract cortical thickness and subcortical gray matter volumes. The Ruff Figural Fluency Test was administered to assess fluid/divergent thinking, ability to shift cognitive set, and planning strategies. Total Unique Designs drawn and Error Ratio assessed participants' ability to minimize repetition while maximizing unique productions. Adjusting for race and education, older participants with chronic pain had significantly lower Total Unique Designs (67.1 ± 20.3) compared to older adults without chronic pain (78.8 ± 15.9) and younger controls (93.8 ± 20.3, p < 0.001). Within the older sample, those with chronic pain had a significantly greater Error Ratio (0.22 ± 0.3) compared to those without chronic pain (0.09 ± 0.06) and younger controls (0.05 ± 0.05, p = 0.002). In older participants, greater Total Unique Design scores were significantly associated only with lower pressure pain sensitivity (r = 0.300, p = 0.031) while greater Error Ratio scores were significantly associated with greater thermal pain sensitivity (r = 0.304, p = 0.027). However, after accounting for sleep quality, clinical and experimental pain associations were eliminated. Across all participants, non-verbal fluency performance was associated with cortical thickness in frontal, parietal and temporal regions as well as several subcortical gray matter structures even after adjusting for multiple comparisons (p's < 0.001). Our findings suggest a pain-related deficit in non-verbal fluency beyond the established age-related decrements that may be dependent on sleep quality and was associated with specific patterns of gray matter structure.
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Affiliation(s)
- Paige Lysne
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States of America; Institute on Aging, University of Florida, Gainesville, FL, United States of America
| | - Ronald Cohen
- Center for Cognitive Aging & Memory, McKnight Brain Foundation, University of Florida, Gainesville, FL, United States of America; Department of Clinical & Health Psychology, College of Health Professions, University of Florida, Gainesville, FL, United States of America
| | - Lorraine Hoyos
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States of America; Institute on Aging, University of Florida, Gainesville, FL, United States of America
| | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States of America; Institute on Aging, University of Florida, Gainesville, FL, United States of America; Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States of America
| | - Joseph L Riley
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States of America; Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States of America
| | - Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States of America; Institute on Aging, University of Florida, Gainesville, FL, United States of America; Center for Cognitive Aging & Memory, McKnight Brain Foundation, University of Florida, Gainesville, FL, United States of America; Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States of America; Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States of America.
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