Differentiating people with schizophrenia from healthy controls in a developing Country: An evaluation of portable functional near infrared spectroscopy (fNIRS) as an adjunct diagnostic tool

Abstract

IntroductionThis study aimed to evaluate portable functional near-infrared spectroscopy (fNIRS) device as an adjunct diagnostic tool in Vietnam to assess hemodynamics when people with schizophrenia and healthy controls performed cognitive tasks.MethodsOne hundred fifty-seven participants were divided into schizophrenia (n = 110) and healthy controls group (n = 47), which were recruited by match of age, and gender. Hemodynamic responses in the frontal cortex were monitored with a 48-channel portable device during the Stroop Color-Word Test (SCWT) and Verbal Fluency Test (VFT). General linear model compared the differences in oxyhemoglobin (HbO2) levels between the two groups. The Receiver Operating Characteristic (ROC) graph was generated for each neuroanatomical area.ResultsPeople with schizophrenia did not show significant activation in the frontal lobe during the SCWT and VFT as compared to pre-task. During the VFT, the area under the ROC curve of the bilateral dorsolateral prefrontal cortex, bilateral orbitofrontal cortex, bilateral frontopolar prefrontal cortex, and bilateral ventrolateral prefrontal cortex were greater than 0.7 (p < 0.001). The area under the ROC curve (AUC) for the right orbitofrontal cortex was maximal during the VFT (AUC = 0.802, 95%CI = 0.731–0.872). The Youden’s index reached a peak (0.57) at the optimal cut-point value (HbO2 cutoff <0.209 μmol/ml for schizophrenia) in which the sensitivity was 85%; specificity was 72%; positive predictive value (PPV) was 0.88; negative predictive value (NPV) was 0.68 and correct classification rate was 76%.DiscussionAssessing hemodynamics during VFT by portable fNIRS offers the potential as an adjunct diagnostic tool for schizophrenia in developing countries.

Changes in frontal cortex hemodynamic activity in a patient with schizophrenia undergoing electroconvulsive therapy – case analysis using functional near-infrared spectroscopy (fNIRS)

“…In recent years, one of the most interesting areas of research is the change in hemodynamic response of the prefrontal cortex as a predictor of response to electroconvulsive treatments [19,20,21].…”

Correlation between trait emotional intelligence and prefrontal activation during a verbal fluency task: A functional near-infrared spectroscopy study

“…Periáñez et al [9] recently compared the VFT and other tests, including the Stroop test, and suggested that the VFT only significantly correlated with the Stroop color-word (SCWT; Pearson coefficients of r = −0.21) and digit symbol substitution tests in the Wechsler adult intelligence scale (4 th edition; Pearson coefficients of R = 0.22). Moreover, Tran et al [10] recently compared the VFT with the SCWT for the detection of schizophrenia by the change in hemoglobin concentration obtained from fNIRS and showed that the area under the receiver operating characteristic curve of the VFT was higher than that of the SCWT in all regions of interest (ventrolateral PFC, dorsolateral PFC, frontopolar PFC, and orbitofrontal cortex), suggesting that the VFT has higher sensitivity and specificity than the SCWT.…”