Cerebral oxygenation changes in the prefrontal cortex: Effects of age and gender

Herrmann, Martin J.; Walter, Anna; Ehlis, Ann‐Christine; Fallgatter, Andreas J.

doi:10.1016/j.neurobiolaging.2005.04.013

Cited by 136 publications

(87 citation statements)

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“…Age and sex were used as covariates given the group differences (see Table 16), which, although non-significant, may influence fNIRS signal. 151,152 The effect of ECT and drug were analysed in patients alone using a repeated measures ANOVA with one between-group factor [drug (saline vs. ketamine)] and three within-group factors [ECT (baseline vs. mid-ECT), region and time]. The Huynh-Feldt correction was applied to correct for sphericity violation, and post hoc exploration of individual regions was carried out by repeated measures ANOVA or ANCOVA by region.…”

Section: Near-infrared Spectroscopy Analysismentioning

confidence: 99%

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 Analysismentioning

confidence: 99%

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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“…Beyond this shortcoming fNIRS combines a number of features extremely attractive for language research. Being compatible with a natural environment and silent, the method's advantage has been proven in a number of previous studies in language research even in earliest infanthood (Fallgatter et al, 1998;Herrmann et al, 2006;Homae et al, 2006;Horovitz and Gore, 2004;Noguchi et al, 2002;Pena et al, 2003;Taga et al, 2003;Wartenburger et al, 2007, Watanabe et al, 1998. Here we challenge the methodology's potential to explore its versatility and reliability to differentiate activation in the three target areas discussed above (SFG/IPG/IFG).…”

Section: Introductionmentioning

confidence: 97%

Differential activation of frontal and parietal regions during visual word recognition: An optical topography study

et al. 2008

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The present study examined cortical oxygenation changes during lexical decision on words and pseudowords using functional NearInfrared Spectroscopy (fNIRS). Focal hyperoxygenation as an indicator of functional activation was compared over three target areas over the left hemisphere. A 52-channel Hitachi ETG-4000 was used covering the superior frontal gyrus (SFG), the left inferior parietal gyrus (IPG) and the left inferior frontal gyrus (IFG). To allow for anatomical inference a recently developed probabilistic mapping method was used to determine the most likely anatomic locations of the changes in cortical activation [Tsuzuki, D., Jurcak, V., Singh, A.K., Okamoto, M., Watanabe, E., Dan, I., 2007. Virtual spatial registration of stand-alone fNIRS data to MNI space. NeuroImage 43 (4), 1506-1518.Subjects made lexical decisions on 50 low and 50 high frequency words and 100 pseudowords. With respect to the lexicality effect, words elicited a larger focal hyperoxygenation in comparison to pseudowords in two regions identified as the SFG and left IPG. The SFG activation difference was interpreted to reflect decision-related mechanisms according to the Multiple Read-Out Model [Grainger, J., Jacobs, A.M., 1996. Orthographic processing in visual word recognition: A multiple read-out model. Psychological Review 103, 518-565]. The greater oxygenation response to words in the left IPG suggests that this region connects orthographic, phonological and semantic representations. A decrease of deoxygenated hemoglobin was observed to low frequency in comparison to high frequency words in a region identified as IFG. This region's sensitivity to word frequency suggests its involvement in grapheme-phoneme conversion, or its role during the selection of preactivated semantic candidates.

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“…These differences in activation during word generation w.r.t. jaw movement and rest and forward audio w.r.t reverse audio and rest concur with past research on fMRI (Gitelman et al 2005;Papathanassiou et al 2000;Wilke et al 2009;Wonga et al 2011;Yetkin et al 1995) and NIRS towards language studies (Bortfeld et al 2009;Herrmann et al 2003;Herrmann et al 2006;Kubota et al 2005;Kuwabara et al 2006;Quaresima et al 2002;Sato et al 1999). In addition, the lateralization studies ( Figure 5.10 and Figure 5.15) demonstrate that there is not only differences in activation in the fronto-temporal regions in response to word generation and word reception stimulus, but also the fact that the AL region is dominant during word generation and PL region is dominant during Word reception.…”

Section: Discussionsupporting

confidence: 87%

“…In the area of understanding language in the brain, several researchers have applied NIRS to investigate either activation (Kuwabara et al 2006;Sato et al 1999;Quaresima et al 2002;Herrmann et al 2003;Kubota et al 2005;Kuwabara et al 2006;Herrmann et al 2006;Bortfeld et al 2009), functional connectivity (Schecklmann et al 2008) and/or lateralization (Watanabe et al 1998;Kennan et al 2002;Noguchi et al 2002;Watson et al 2004;Gallagher et al 2008) (in isolation). However, the effective connectivity analysis of language regions using NIRS has not been attempted to date.…”

Section: Introductionmentioning

confidence: 99%

Funtional Near Infrared Spectroscopy Study of Language, Joint Attention and Motor Skills

Chaudhary¹

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Cerebral oxygenation changes in the prefrontal cortex: Effects of age and gender

Cited by 136 publications

References 50 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)

Differential activation of frontal and parietal regions during visual word recognition: An optical topography study

Funtional Near Infrared Spectroscopy Study of Language, Joint Attention and Motor Skills

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