Impaired Frontal Brain Activity in Patients With Heart Failure Assessed by Near‐Infrared Spectroscopy

Abstract

Background The prevalence of depression and/or anxiety disorders is reported to be higher in patients with heart failure ( HF ) than in the general population, and patients with HF also have coexisting cognitive problems. Recently, the development of near‐infrared spectroscopy ( NIRS ) has enabled noninvasive measurements of regional cerebral blood volume and brain activity, in terms of cerebral oxyhemoglobin in the cerebral cortex, with a high time resolution. The aim of the current study was to determine the associations between frontal brain activity and depressive symptoms, anxiety status, and cognitive function in patients with HF . Methods and Results We measured and compared frontal brain activity determined by NIRS during a verbal fluency task in patients with HF (n=35) and control subjects (n=28). The Center for Epidemiologic Studies Depression Scale for assessment of depressive symptoms, State‐Trait Anxiety Inventory for assessment of anxiety status, Mini‐Mental State Examination for assessment of cognitive function, and NIRS were simultaneously conducted. NIRS showed that frontal brain activity was significantly lower in the HF group than in the control subjects (28.5 versus 88.0 mM·mm; P <0.001). Next, we examined the associations between frontal brain activity and the findings of Center for Epidemiologic Studies Depression Scale, State‐Trait Anxiety Inventory, Mini‐Mental State Examination, and verbal fluency task. There were significant correlations between frontal brain activity and State‐Trait Anxiety Inventory ( R =−0.228, P =0.046), Mini‐Mental State Examination ( R =0.414, P =0.017), and verbal fluency task ( R =0.338, P =0.007), but not with Center for Epidemiologic Studies Depression Scale ( R =−0.160, P =0.233). Conclusions Frontal brain activity assessed by NIRS is reduced and is associated with high anxiety status and low cognitive function in patients with HF .

Cognitive impairment in myocardial infarction and heart failure

“…26 This study also showed that frontal brain activity assessed by NIRS reduced and was associated with high anxiety status and low cognitive function in patients with HF. 26 Further investigation to elucidate underlying pathological processes of associations between cardiac function to neurodegeneration during MI. Kresge et al performed a correlation analysis between LVEF t-tau and p-tau (biomarkers for Alzheimer's disease) in older adults (age ≥ 60 years).…”

“…28 Furthermore, several studies had a limitation in the number of patients, an increased number of participants may be the best representation in the general population. 5,26,28 All of these findings suggest that the exact molecular mechanisms underlying cognitive impairment in HF is still a gap of knowledge from both preclinical and clinical studies.…”

“…In addition, not only cognition was impaired after HF but the other psychological disorders also associate with HF. Ichijo et al found that a reduction of %EF showed a significant correlation with a lower cognitive function and depression 26 . There were significant correlations between frontal brain activity and State‐Trait Anxiety Inventory ( R = .228, P = .046), Mini‐Mental State Examination ( R = .414, P = .017), and verbal fluency task ( R = .338, P = .007), but not with Center for Epidemiologic Studies Depression Scale 26 .…”

“…Ichijo et al found that a reduction of %EF showed a significant correlation with a lower cognitive function and depression 26 . There were significant correlations between frontal brain activity and State‐Trait Anxiety Inventory ( R = .228, P = .046), Mini‐Mental State Examination ( R = .414, P = .017), and verbal fluency task ( R = .338, P = .007), but not with Center for Epidemiologic Studies Depression Scale 26 . This study also showed that frontal brain activity assessed by NIRS reduced and was associated with high anxiety status and low cognitive function in patients with HF 26 …”

“…Moreover, regarding hospitalized patients, the duration that patients stayed in hospital may affect to the evaluation of depression and anxiety scores 28 . Furthermore, several studies had a limitation in the number of patients, an increased number of participants may be the best representation in the general population 5,26,28 …”