A multi-channel near-infrared spectroscopy study of prefrontal cortex activation during working memory task in major depressive disorder

Pu, Shenghong; Yamada, Tōru; Yokoyama, Katsutoshi; Matsumura, Hiroshi; Kobayashi, Hokuto; Sasaki, Natsuko; Mitani, Hiroaki; Adachi, Akiko; Kaneko, Koichi; Nakagome, Kazuyuki

doi:10.1016/j.neures.2011.01.001

Cited by 91 publications

(46 citation statements)

References 52 publications

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“…There is less extensive literature on using WM tasks with fNIRS, but, again, bilateral activation has been found. 92,113 Consistent with extensive literature, [94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][112][113][114] we found significantly decreased, and possibly delayed, prefrontal haemodynamic responses in depressed patients in the VF task and, less certainly, in the n-back task. For the VF task we found a significant negative correlation between MADRS score and the haemodynamic response in the LVF cortex in patients.…”

Section: Near-infrared Spectroscopy Studysupporting

confidence: 91%

“…[107][108][109] There is some uncertainty over whether this is a state or trait abnormality, as some studies have found restored activation to a VF task following treatment 110 and increased activation has been seen in hypomanic patients, 108 whereas blunted responses have been found in remitted depressed patients 111 and euthymic bipolar patients 109 or failure to normalise after antidepressant treatment in depressed patients. 99 WM has been less investigated using fNIRS, but studies have also shown a decrease in lateral frontal haemodynamic responses in depression, [112][113][114] which were associated with decreased performance in one study. 112 We hypothesised that severely ill depressed patients will have decreased lateral frontal activation to a VF task, which will correlate with clinical measures, and that ketamine will alleviate the further suppression of frontal activation by ECT, in line with its benefits in preserving cognitive function.…”

Section: Background and Objectivesmentioning

confidence: 99%

“…99 WM has been less investigated using fNIRS, but studies have also shown a decrease in lateral frontal haemodynamic responses in depression, [112][113][114] which were associated with decreased performance in one study. 112 We hypothesised that severely ill depressed patients will have decreased lateral frontal activation to a VF task, which will correlate with clinical measures, and that ketamine will alleviate the further suppression of frontal activation by ECT, in line with its benefits in preserving cognitive function.…”

Section: Background and Objectivesmentioning

confidence: 99%

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Randomised controlled trial of ketamine augmentation of electroconvulsive therapy to improve neuropsychological and clinical outcomes in depression (Ketamine-ECT study)

et al. 2017

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BackgroundElectroconvulsive therapy (ECT) is the most effective acute treatment for severe depression, but there are concerns about its adverse cognitive effects. ECT may impair cognition through stimulation of glutamate receptors, and preliminary evidence has suggested that ketamine, a glutamate antagonist, may alleviate these effects. Ketamine has been shown to have a rapid, but temporary, antidepressant effect after a single infusion.ObjectiveTo determine the efficacy and safety of adjunctive low-dose ketamine to reduce cognitive impairments caused by ECT and, secondarily, to improve symptomatic outcome.DesignMulticentre, two-arm, parallel-group, patient-randomised, placebo-controlled superiority trial.SettingEleven ECT suites based in seven NHS trusts in the north of England.ParticipantsSeverely depressed hospitalised patients or outpatients who received ECT as part of their usual clinical care.InterventionsPatients were randomised to ketamine (0.5 mg/kg) or saline as an adjunct to their anaesthetic for their ECT course in a 1 : 1 ratio.Main outcome measuresThe primary outcome was delayed verbal recall on the Hopkins Verbal Learning Task – Revised (HVLT-R) after four ECT treatments (mid-ECT), analysed using a Gaussian repeated measures model. Secondary outcomes included autobiographical, working and visual memory and verbal fluency, symptoms and quality of life; assessments occurred at mid-ECT, end of treatment and 1 and 4 months after the last ECT. Neuropsychological function was compared with that of healthy control subjects and a functional near-infrared spectroscopy (fNIRS) substudy investigated prefrontal cortex function. A patient survey of study participation was carried out.ResultsSeventy-nine severely depressed patients were randomised to ketamine (0.5 mg/kg) or saline as an adjunct to their anaesthetic for their ECT course; the modified intention-to-treat sample included 70 patients. Compared with saline, adjunctive ketamine had no significant effect on HVLT-R delayed recall [treatment effect difference –0.43, 95% confidence interval (CI) –1.73 to 0.87], other neuropsychological outcomes, improvement in depression [difference in Montgomery–Åsberg Depression Rating Scale (MADRS) score of 0.44, 95% CI –1.03 to 1.91], the number of ECT treatments to remission (MADRS score of ≤ 10: 0.83, 95% CI –3.2 to 4.9), anxiety symptoms or quality of life. By the end of ECT treatment, 37% (saline 35%, ketamine 39%) of patients had remitted. Tolerability was similar in the two treatment arms; two patients had isolated transient psychological effects attributable to ketamine. Preliminary fNIRS analysis found that patients had blunted prefrontal cortical haemodynamic responses compared with control subjects during a verbal fluency task at baseline; this was further diminished at mid-ECT without modulation by ketamine. Greater haemodynamic responsivity to ECT appeared to be associated with a better clinical response. The majority of patients surveyed reported a positive experience of study participation.ConclusionsThe results of the study do not support the use of adjunctive ketamine in routine ECT treatment in the NHS. Although no evidence of benefit was found for ketamine, moderate benefits or harms cannot be excluded, as recruitment was < 50% of that planned, limiting the power of the clinical trial. Low numbers also meant that in the fNIRS substudy the effect of ketamine could not be assessed and the other findings must be viewed as preliminary. Included patients were younger than those not included and had only limited cognitive impairment with ECT, limiting generalisation to more cognitively compromised patients. fNIRS appeared to be a potentially feasible portable brain imaging technology in severely ill patients and further research is warranted to investigate its clinical utility.Trial registrationCurrent Controlled Trials ISRCTN14689382.FundingThis project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research partnership.

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Section: Near-infrared Spectroscopy Studysupporting

confidence: 91%

Section: Background and Objectivesmentioning

confidence: 99%

Section: Background and Objectivesmentioning

confidence: 99%

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Randomised controlled trial of ketamine augmentation of electroconvulsive therapy to improve neuropsychological and clinical outcomes in depression (Ketamine-ECT study)

et al. 2017

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“…Last, the fNIRS technique has been employed for the investigation of WM abnormalities in a number of psychiatric cohorts, ranging from patients with major depressive disorder, 32 to those with schizophrenia 33 and children showing attention deficit/hyperactivity disorder. 34 The present study mainly introduces two items of novelty with respect to the literature mentioned above: (1) the employment of NIRS devices in the investigation of the modulatory effect arisen in the frontal hemodynamic pattern by means of stimulation with differential cognitive load and (2) the use of time-domain fNIRS (based on high-repetition-rate light sources and picosecond detection of photon time-of-flight) to improve depth sensitivity to cortical hemodynamic changes.…”

Section: Introductionmentioning

confidence: 99%

Load-dependent brain activation assessed by time-domain functional near-infrared spectroscopy during a working memory task with graded levels of difficulty

et al. 2012

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Abstract. We evaluated frontal brain activation during a mixed attentional/working memory task with graded levels of difficulty in a group of 19 healthy subjects, by means of time-domain functional near-infrared spectroscopy (fNIRS). Brain activation was assessed, and load-related oxy-and deoxy-hemoglobin changes were studied. Generalized linear model (GLM) was applied to the data to explore the metabolic processes occurring during the mental effort and, possibly, their involvement in short-term memorization. GLM was applied to the data twice: for modeling the task as a whole and for specifically investigating brain activation at each cognitive load. This twofold employment of GLM allowed (1) the extraction and isolation of different information from the same signals, obtained through the modeling of different cognitive categories (sustained attention and working memory), and (2) the evaluation of model fitness, by inspection and comparison of residuals (i.e., unmodeled part of the signal) obtained in the two different cases. Results attest to the presence of a persistent attentional-related metabolic activity, superimposed to a task-related mnemonic contribution. Some hemispherical differences have also been highlighted frontally: deoxy-hemoglobin changes manifested a strong right lateralization, whereas modifications in oxy-and total hemoglobin showed a medial localization. The present work successfully explored the capability of fNIRS to detect the two neurophysiological categories under investigation and distinguish their activation patterns.

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“…The study of Pu et al (2011) showed that patients showed a smaller increase in lateral prefrontal and superior temporal cortex activation during the working memory task and associated poorer task performance than healthy controls. The results contradicted with some previous fMRI studies.…”

Section: Functional Neuroimaging Of Working Memory In Patients With Dmentioning

confidence: 99%

Working Memory and Functional Neuroimaging in Patients with Depression

Chen¹,

Chen²,

Dai³

2015

PSYCH

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Numerous studies have demonstrated that patients suffering from depression present impairment in working memory. This paper firstly introduced the concept of working memory, and then elucidated the deficits of working memory of patients with depression. It also reviewed the neuroimaging studies of working memory in patients with depression. In the final part, we further summarized the future research orientations. In short, exploration of working memory on the regulative mechanisms of depression and figuring out that working memory impairment is the cause or the result of depressive symptoms will be the core problem that the future research needs to address.

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A multi-channel near-infrared spectroscopy study of prefrontal cortex activation during working memory task in major depressive disorder

Cited by 91 publications

References 52 publications

Randomised controlled trial of ketamine augmentation of electroconvulsive therapy to improve neuropsychological and clinical outcomes in depression (Ketamine-ECT study)

Randomised controlled trial of ketamine augmentation of electroconvulsive therapy to improve neuropsychological and clinical outcomes in depression (Ketamine-ECT study)

Load-dependent brain activation assessed by time-domain functional near-infrared spectroscopy during a working memory task with graded levels of difficulty

Working Memory and Functional Neuroimaging in Patients with Depression

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