The relationship between the prefrontal activation during a verbal fluency task and stress-coping style in major depressive disorder: A near-infrared spectroscopy study

Pu, Shenghong; Nakagome, Kazuyuki; Yamada, Takeshi; Yokoyama, Katsutoshi; Matsumura, Hiroshi; Mitani, Hiroaki; Adachi, Akiko; Nagata, Izumi; Kaneko, Koichi

doi:10.1016/j.jpsychires.2012.08.001

Cited by 86 publications

(44 citation statements)

References 51 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%

“…NIHR Journals Library www.journalslibrary.nihr.ac.uk reliably demonstrate decreased lateral prefrontal cortex-anterior temporal cortex haemodynamic responses compared with control subjects during a VF task, [94][95][96][97][98][99][100][101][102][103][104][105][106] including in bipolar depression. [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.…”

Section: Background and Objectivesmentioning

confidence: 91%

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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: 91%

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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“…Previous studies have reported reduced activation during cognitive tasks in each of the left and right frontotemporal regions in BD (Blumberg et al, 2003;Townsend et al, 2012) and MDD (Pu et al, 2012a(Pu et al, , 2012bNoda et al, 2012), compared to HCs. The present results are partially consistent with these studies in that they show bilateral VLPFC/aTC hypoactivation during cognitive tasks.…”

Section: Reduced Vlpfc/atc Activation In Patients With Bd and Mddmentioning

confidence: 86%

“…Previous studies examining patients with BD have reported divergent results: hypofrontality during the verbal fluency test (VFT) or working memory tasks Schecklmann et al, 2011), and hyperfrontality during the VFT (Kubota et al, 2009). On the other hand, studies using NIRS to examine brain activity in patients with MDD have consistently reported hypoactivity during the VFT (Noda et al, 2012;Pu et al, 2012aPu et al, , 2012bLiu et al, 2014) and working memory tasks (Pu et al, 2012a(Pu et al, , 2012b, compared to HCs. The divergence in results of studies of patients with BD might be caused by the mental state of the subject.…”

Section: Introductionmentioning

confidence: 99%

“…The reliability and validity of the Japanese version of the SASS have been confirmed (Goto et al, 2005). Reduced activation in the prefrontal and temporal regions during cognitive tasks has been associated with the lower SASS scores in patients with late onset major depression (Pu et al, 2012a(Pu et al, , 2012b. To our knowledge, no NIRS study has examined the association between this regional brain activation and social functioning assessed by SASS in patients with BD.…”

Section: Introductionmentioning

confidence: 99%

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Association between longitudinal changes in prefrontal hemodynamic responses and social adaptation in patients with bipolar disorder and major depressive disorder

Ohtani

Nishimura

Takahashi

et al. 2015

Journal of Affective Disorders

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Increased neural activity during overt and continuous semantic verbal fluency in major depression: mainly a failure to deactivate

Backes

Dietsche

Nagels

et al. 2014

Eur Arch Psychiatry Clin Neurosci

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Major depression is associated with impairments in semantic verbal fluency (VF). However, the neural correlates underlying dysfunctional cognitive processing in depressed subjects during the production of semantic category members still remain unclear. In the current study, an overt and continuous semantic VF paradigm was used to examine these mechanisms in a representative sample of 33 patients diagnosed with a current episode of unipolar depression and 33 statistically matched healthy controls. Subjects articulated words in response to semantic category cues while brain activity was measured with functional magnetic resonance imaging (fMRI). Compared to controls, patients showed poorer task performance. On the neural level, a group by condition interaction analysis, corrected for task performance, revealed a reduced task-related deactivation in patients in the right parahippocampal gyrus, the right fusiform gyrus, and the right supplementary motor area. An additional and an increased task-related activation in patients were observed in the right precentral gyrus and the left cerebellum, respectively. These results indicate that a failure to suppress potentially interfering activity from inferior temporal regions involved in default-mode network functions and visual imagery, accompanied by an enhanced recruitment of areas implicated in speech initiation and higher-order language processes, may underlie dysfunctional cognitive processing during semantic VF in depression. The finding that patients with depression demonstrated both decreased performance and aberrant brain activation during the current semantic VF task demonstrates that this paradigm is a sensitive tool for assessing brain dysfunctions in clinical populations.

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The relationship between the prefrontal activation during a verbal fluency task and stress-coping style in major depressive disorder: A near-infrared spectroscopy study

Cited by 86 publications

References 51 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)

Association between longitudinal changes in prefrontal hemodynamic responses and social adaptation in patients with bipolar disorder and major depressive disorder

Increased neural activity during overt and continuous semantic verbal fluency in major depression: mainly a failure to deactivate

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