Effects of sedative and nonsedative antihistamines on prefrontal activity during verbal fluency task in young children: a near-infrared spectroscopy (NIRS) study

Abnormal regional brain activity in patients with first-episode medication-naïve depressive disorder: A longitudinal fNIRS study

The potential relationship between abnormal brain activity and clinical symptoms in patients with major depressive disorder (MDD) is important for auxiliary diagnosis and prediction of the curative effect of treatments for MDD. Before antidepressant treatment (T1), 4 weeks after treatment (T2), and 8 weeks after treatment (T3), 33 patients with first-episode medication-naïve MDD and 30 healthy controls (HCs) were examined using functional near-infrared spectroscopy (fNIRS) to evaluate the cerebral hemodynamic response in the frontal and temporal cortex during the Verbal Fluency Task (VFT). Compared with HCs, VFT scores and activation levels of the frontal pole, inferior frontal gyrus, and dorsolateral prefrontal cortex were significantly decreased in the first-episode medication-naïve depressive disorder patients (FMD). Compared with T2, the activation levels of the superior temporal gyrus and inferior central gyrus were increased at T3 in the FMD. The low activation pattern of the frontal pole, inferior frontal gyrus, and dorsolateral prefrontal cortex in the FMD during VFT is helpful for clinical diagnosis of MDD. The superior temporal gyrus and inferior central gyrus may be sensitive brain regions that reflect the clinical effect of MDD in patients.

Individual Differences in Hemodynamic Responses Measured on the Head Due to a Long-Term Stimulation Involving Colored Light Exposure and a Cognitive Task: A SPA-fNIRS Study

When brain activity is measured by neuroimaging, the canonical hemodynamic response (increase in oxygenated hemoglobin ([O2Hb]) and decrease in deoxygenated hemoglobin ([HHb]) is not always seen in every subject. The reason for this intersubject-variability of the responses is still not completely understood. This study is performed with 32 healthy subjects, using the systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS) approach. We investigate the intersubject variability of hemodynamic and systemic physiological responses, due to a verbal fluency task (VFT) under colored light exposure (CLE; blue and red). Five and seven different hemodynamic response patterns were detected in the subgroup analysis of the blue and red light exposure, respectively. We also found that arterial oxygen saturation and mean arterial pressure were positively correlated with [O2Hb] at the prefrontal cortex during the CLE-VFT independent of the color of light and classification of the subjects. Our study finds that there is substantial intersubject-variability of cerebral hemodynamic responses, which is partially explained by subject-specific systemic physiological changes induced by the CLE-VFT. This means that both subgroup analyses and the additional assessment of systemic physiology are of crucial importance to achieve a comprehensive understanding of the effects of a CLE-VFT on human subjects.

An optical window into brain function in children and adolescents: A systematic review of functional near-infrared spectroscopy studies

Despite decades of research, our understanding of functional brain development throughout childhood and adolescence remains limited due to the challenges posed by certain neuroimaging modalities. Recently, there has been a growing interest in using functional near-infrared spectroscopy (fNIRS) to elucidate the neural basis of cognitive and socioemotional development and identify the factors shaping these types of development. This article, focusing on the fNIRS methods, presents an up-to-date systematic review of fNIRS studies addressing the effects of age and other factors on brain functions in children and adolescents. Literature searches were conducted using PubMed and PsycINFO. A total of 79 fNIRS studies involving healthy individuals aged 3-17 years that were published in peer-reviewed journals in English before July 2020 were included. Six methodological aspects of these studies were evaluated, including the research design, experimental paradigm, fNIRS measurement, data preprocessing, statistical analysis, and result presentation. The risk of bias, such as selective outcome reporting, was assessed throughout the review. A qualitative synthesis of study findings in terms of the factor effects on changes in oxyhemoglobin concentration was also performed. This unregistered review highlights the strengths and limitations of the existing literature and suggests directions for future research to facilitate the improved use of fNIRS in developmental cognitive neuroscience research.

Prefrontal Asymmetry during Cognitive Tasks and its Relationship with Suicide Ideation in Major Depressive Disorder: An fNIRS Study

Reduced oxygenation changes in the prefrontal cortex during cognitive tasks have been reported in major depressive disorder (MDD). However, prefrontal asymmetry during cognitive tasks and its relation to suicide ideations have been less frequently examined in patients with MDD. This study investigated prefrontal asymmetry and its moderating effect on the relationship between depression severity and suicidal ideation in MDD patients during cognitive tasks. Forty-two patients with MDD and 64 healthy controls (HCs) were assessed for changes in oxygenated and deoxygenated hemoglobin (Hb) in the prefrontal cortex using functional near-infrared spectroscopy (fNIRS) during the verbal fluency task (VFT), Stroop task, and two-back task. Depression, anxiety, and suicide ideation were measured through self-report questionnaires. Relatively smaller left oxy-Hb changes during VFT, but not during the Stroop or two-back tasks, were found in MDD patients compared with HCs. Furthermore, prefrontal asymmetry during VFT moderated the effect of depression severity on suicide ideation, and was significantly and positively correlated with suicide ideation in patients with MDD. Specifically, relatively greater left oxy-Hb changes were associated with greater suicide ideation. These findings suggest fNIRS-measured prefrontal asymmetry as a potential biomarker for MDD and for the assessment of suicidal risk in patients with MDD.

Brain functional alterations observed 4-weekly in major depressive disorder following antidepressant treatment

BACKGROUND

Major depressive disorder (MDD) is a heterogeneous condition. Identifying the brain responses to antidepressant treatment is of particular interest as these may represent potential neural networks related to treatment response, forming one aspect of the biological markers of MDD. Near-infrared spectroscopy (NIRS) is suitable for repeated measurements with short intervals because of its noninvasiveness, and can provide detailed time courses of functional alterations in prefrontal regions.

METHODS

We conducted a 12-week longitudinal study to explore prefrontal hemodynamic changes at 4-week intervals following sertraline treatment in 11 medication-naïve participants with MDD using 52-channel NIRS.

RESULTS

While all participants achieved remission after treatment, intra-class correlation coefficient of oxygenated hemoglobin [oxy-Hb] values throughout the 12-week observation was moderate at the spatially and temporally contiguous cluster located in the left inferior frontal and temporal gyri. There was a significant negative correlation between mean [oxy-Hb] values in the significant cluster at 4 weeks and changes in Hamilton Rating Scale for Depression total score from 4 to 8 weeks (r = -0.73, P = 0.011) and from 4 to 12 weeks (r = -0.63, P = 0.039).

LIMITATIONS

Without healthy controls for comparison, we were unable to fully evaluate whether improvement of [oxy-Hb] activations after treatment in MDD reached normal levels or not.

CONCLUSION

Our NIRS findings of detailed prefrontal hemodynamic alterations over short interval observations such as 4 weeks may have revealed potential trait marker for MDD and biological maker for predicting clinical response to sertraline treatment in MDD.

The effects of antihistamines on the semiology of febrile seizures

OBJECTIVE

The aim of this study was to clarify the effects of antihistamines on the semiology of febrile seizures.

METHODS

The manifestations of febrile seizures were recorded using a structured questionnaire immediately after patients arrived at the hospital. We focused on events at seizure commencement, including changes in behavior and facial expression, and ocular and oral symptoms. The presence or absence of focal and limbic features was determined for each patient. Drugs taken within 6 h prior to seizure were noted. Seizure manifestations were compared between children who did not take antihistamines and those who took antihistamines.

RESULTS

Seizures lasting ≥5 min were relatively more frequent in children who did not take antihistamines, although the difference was not statistically significant. One or more focal features were present in 60 of 78 children with no antihistamines and 17 of 23 children with antihistamines. One or more limbic features were present in 32 of 78 children with no antihistamines and 9 of 23 children with antihistamines. No significant difference in the numbers of focal or limbic features was apparent between children who did not take antihistamines and those who took antihistamines.

CONCLUSION

Antihistamines did not significantly affect the semiology of febrile seizures.

Effects of levocetirizine and diphenhydramine on regional glucose metabolic changes and hemodynamic responses in the human prefrontal cortex during cognitive tasks

OBJECTIVE

Antihistamines often have sedative side effects. This was the first study to measure regional cerebral glucose (energy) consumption and hemodynamic responses in young adults during cognitive tests after antihistamine administration.

METHODS

In this double-blind, placebo-controlled, three-way crossover study, 18 healthy young Japanese men received single doses of levocetirizine 5 mg and diphenhydramine 50 mg at intervals of at least six days. Subjective feeling, task performances, and brain activity were evaluated during three cognitive tests (word fluency, two-back, and Stroop). Regional cerebral glucose consumption changes were measured using positron emission tomography with [¹⁸ F]fluorodeoxyglucose. Regional hemodynamic responses were measured using near-infrared spectroscopy.

RESULTS

Energy consumption in prefrontal regions was significantly increased after antihistamine administration, especially diphenhydramine, whereas prefrontal hemodynamic responses, evaluated with oxygenated hemoglobin levels, were significantly lower with diphenhydramine treatment. Stroop test accuracy was significantly impaired by diphenhydramine, but not by levocetirizine. There was no significant difference in subjective sleepiness.

CONCLUSIONS

Physiological "coupling" between metabolism and perfusion in the healthy human brain may not be maintained under pharmacological influence due to antihistamines. This uncoupling may be caused by a combination of increased energy demands in the prefrontal regions and suppression of vascular permeability in brain capillaries after antihistamine treatment. Further research is needed to validate this hypothesis.

High-dose antidepressants affect near-infrared spectroscopy signals: A retrospective study

BACKGROUND

Recent studies have highlighted the clinical usefulness of near-infrared spectroscopy (NIRS) in psychiatry. However, the potential effects of psychotropics on NIRS signals remain unknown.

METHODS

We conducted a systematic chart review of 40 depressed patients who underwent NIRS scans during a verbal fluency task to clarify the relationships between psychotropic dosage and NIRS signals. The dosage of psychotropic medications was calculated using defined daily dose (DDD). We investigated the associations between the DDD of psychotropic medications and oxygenated hemoglobin (oxy-Hb) in single channel levels.

LIMITATIONS

Retrospective study design and small sample size are the main limitations.

RESULTS

Multiple regression analysis revealed that one channel in the right temporoparietal region had a significant association with antidepressant DDD controlling for age, sex, depression severity, and the DDD of antipsychotics and benzodiazepines. Moreover, high doses of antidepressants had significant effects on NIRS signals compared with low doses, in group comparisons.

CONCLUSIONS

The dose-dependent impact of antidepressants on NIRS signals should be taken into account when interpreting NIRS data.

Brain imaging and human nutrition: which measures to use in intervention studies?

The present review describes brain imaging technologies that can be used to assess the effects of nutritional interventions in human subjects. Specifically, we summarise the biological relevance of their outcome measures, practical use and feasibility, and recommended use in short- and long-term nutritional studies. The brain imaging technologies described consist of MRI, including diffusion tensor imaging, magnetic resonance spectroscopy and functional MRI, as well as electroencephalography/magnetoencephalography, near-IR spectroscopy, positron emission tomography and single-photon emission computerised tomography. In nutritional interventions and across the lifespan, brain imaging can detect macro- and microstructural, functional, electrophysiological and metabolic changes linked to broader functional outcomes, such as cognition. Imaging markers can be considered as specific for one or several brain processes and as surrogate instrumental endpoints that may provide sensitive measures of short- and long-term effects. For the majority of imaging measures, little information is available regarding their correlation with functional endpoints in healthy subjects; therefore, imaging markers generally cannot replace clinical endpoints that reflect the overall capacity of the brain to behaviourally respond to specific situations and stimuli. The principal added value of brain imaging measures for human nutritional intervention studies is their ability to provide unique in vivo information on the working mechanism of an intervention in hypothesis-driven research. Selection of brain imaging techniques and target markers within a given technique should mainly depend on the hypothesis regarding the mechanism of action of the intervention, level (structural, metabolic or functional) and anticipated timescale of the intervention's effects, target population, availability and costs of the techniques.

The application of near infrared spectroscopy in nutritional intervention studies

Functional near infrared spectroscopy (NIRS) is a non-invasive optical imaging technique used to monitor cerebral blood flow (CBF) and by proxy neuronal activation. The use of NIRS in nutritional intervention studies is a relatively novel application of this technique, with only a small, but growing, number of trials published to date. These trials—in which the effects on CBF following administration of dietary components such as caffeine, polyphenols and omega-3 polyunsaturated fatty acids are assessed—have successfully demonstrated NIRS as a sensitive measure of change in hemodynamic response during cognitive tasks in both acute and chronic treatment intervention paradigms. The existent research in this area has been limited by the constraints of the technique itself however advancements in the measurement technology, paired with studies endeavoring increased sophistication in number and locations of channels over the head should render the use of NIRS in nutritional interventions particularly valuable in advancing our understanding of the effects of nutrients and dietary components on the brain.

Effects of sedative antidepressants on prefrontal cortex activity during verbal fluency task in healthy subjects: a near-infrared spectroscopy study

RATIONALE

Japanese researchers have recently conducted studies using near-infrared spectroscopy (NIRS) to help diagnose psychiatric disorders based on changes in brain activity. However, the influence of psychotropic drugs on NIRS measurements has not been clarified.

OBJECTIVE

To assess the effects of sedative antidepressants on prefrontal cortex activity in healthy subjects using NIRS in a double-blinded, placebo-controlled, crossover trial.

METHODS

Nineteen healthy males received nocturnal doses of mirtazapine 15 mg, trazodone 25 mg, or placebo for eight consecutive days in rotation, with a washout period of more than 1 week between each rotation. Subjects performed a verbal fluency task during NIRS on a total of seven occasions during the study period: more than a week prior to receiving the first dose of the first medication; and on days 2 and 9 of each rotation. The number of words correctly generated during the task (behavioral performance) was also recorded. Stanford Sleepiness Scale (SSS) scores were determined each day.

RESULTS

Mirtazapine 15 mg significantly increased oxyhemoglobin (oxy-Hb) concentration change in NIRS on day 9, compared to trazodone 25 mg and placebo. Mirtazapine 15 mg significantly increased SSS on day 2, compared to the other conditions. No significant differences in behavioral performance were observed.

CONCLUSIONS

Administration of mirtazapine for eight consecutive days affected oxy-Hb changes on NIRS. This result indicates that researchers should consider how certain types of antidepressant could influence brain function when the brain activity of patients with psychiatric disorders is assessed.

Carryover effect on next-day sleepiness and psychomotor performance of nighttime administered antihistaminic drugs: a randomized controlled trial

BACKGROUND

Antihistamines with strong sedative-hypnotic properties are frequently prescribed for insomnia secondary to allergy, but the potential risks of such administration have not been fully elucidated.

SUBJECTS AND METHODS

This randomized, double-blind, placebo-controlled crossover study was conducted to evaluate next-day sleepiness and psychomotor performance following the administration of antihistamines. Twenty-two healthy male participants participated in four drug administration sessions with more than a 1-week interval between the sessions. Either zolpidem 10 mg, or diphenhydramine 50 mg, or ketotifen 1 mg, or a placebo was administered before sleep, and polysomnography was conducted to evaluate sleep. In the morning and afternoon of the day after administration, the participants were evaluated for subjective sleepiness, objective sleepiness, and psychomotor performance.

RESULTS

The antihistamines with high blood-brain barrier-crossing efficiency were significantly associated with sleepiness and psychomotor performance decline the next day. Ketotifen showed the strongest carryover effect, followed by diphenhydramine. Compared with the placebo, no significant carryover effect was observed with zolpidem.

CONCLUSION

The results suggest that the risk-benefit balance should be considered in the ready use of antihistamines that easily cross the blood-brain barrier for alleviating secondary insomnia associated with allergies.

Functional near-infrared spectroscopy for the assessment of speech related tasks

Over the past years functional near-infrared spectroscopy (fNIRS) has substantially contributed to the understanding of language and its neural correlates. In contrast to other imaging techniques, fNIRS is well suited to study language function in healthy and psychiatric populations due to its cheap and easy application in a quiet and natural measurement setting. Its relative insensitivity for motion artifacts allows the use of overt speech tasks and the investigation of verbal conversation. The present review focuses on the numerous contributions of fNIRS to the field of language, its development, and related psychiatric disorders but also on its limitations and chances for the future.

Clinically-oriented monitoring of acute effects of methylphenidate on cerebral hemodynamics in ADHD children using fNIRS

OBJECTIVE

Attention Deficit Hyperactivity Disorder (ADHD), a common developmental syndrome with inattention, hyperactivity, and impulsivity, is typically treated with the psychostimulant drug, methylphenidate (MPH). We explored the feasibility of using functional near-infrared spectroscopy (fNIRS) to search for a clinically implementable biological marker for the acute MPH effect on ADHD children.

METHODS

Following an MPH washout period, twelve ADHD children performed a go/no-go task before and 1.5 h after MPH intake. fNIRS was used to monitor the lateral prefrontal cortical hemodynamics of ADHD children performing a go/no-go task.

RESULTS

There was no significant activation in the lateral prefrontal cortices examined before MPH intake. However, after MPH intake, significant MPH-elicited activation (oxygenated hemoglobin signal increase) was detected in the right lateral prefrontal cortex (LPFC) implicated with response inhibition functions. There was a large significant correlation between increases in task performance and activation in the right LPFC.

CONCLUSIONS

The improved cognitive performance was associated with activation in the right LPFC, which might serve as a biological marker to monitor the effect of MPH in ADHD children.

SIGNIFICANCE

MPH-effect assessment in ADHD children using fNIRS can be performed within a 3 h stay at a hospital during a single visit, and thus may be integrated into clinical practice.

Characterization of the acute effects of alcohol on asymmetry of inferior frontal cortex activity during a Go/No-Go task using functional near-infrared spectroscopy

RATIONALE

Successful response inhibition is associated with right-lateralized inferior frontal cortex (IFC) activity, and alcohol impairs this inhibitory control, thereby enhancing false-alarm responses in the Go/No-Go task. However, the neural correlates of effect of alcohol on response inhibition remain unclear.

OBJECTIVE

This study characterized the acute effects of alcohol on IFC activity during Go/No-Go tasks using near-infrared spectroscopy (NIRS).

METHODS

Thirty-two subjects visited our laboratory twice: once for alcohol intake and once for placebo intake. On each visit, subjects performed Go/No-Go tasks immediately before and 10 min after intake of the alcohol or placebo. NIRS was used to evaluate IFC activity measured during Go/No-Go tasks.

RESULTS

Alcohol significantly enhanced false-alarm responses in No-Go trials. NIRS analysis showed that IFC activity was greater in the right hemisphere than in the left hemisphere prior to alcohol or placebo intake. This right hemispheric superiority was eliminated in response to alcohol but not in response to placebo. Correlation analysis showed that subjects with right-lateralized IFC activity made fewer false-alarm responses in No-Go trials and that alcohol-induced inhibition of hemispheric IFC asymmetry resulted in higher false-alarm rates.

CONCLUSION

These findings suggest that the right IFC may mediate the acute effects of alcohol on inhibitory control. When the alcohol impairs the right IFC activity, subjects cannot inhibit the pre-potent responses for No-Go trials, resulting in enhanced false-alarm responses. Thus, this study successfully demonstrated the neural correlates of the alcohol effect in the right IFC activity during inhibitory control processes.

Evaluating the roles of the inferior frontal gyrus and superior parietal lobule in deductive reasoning: an rTMS study

This study used off-line repetitive transcranial magnetic stimulation (rTMS) to examine the roles of the superior parietal lobule (SPL) and inferior frontal gyrus (IFG) in a deductive reasoning task. Subjects performed a categorical syllogistic reasoning task involving congruent, incongruent, and abstract trials. Twenty four subjects received magnetic stimulation to the SPL region prior to the task. In the other 24 subjects, TMS was administered to the IFG region before the task. Stimulation lasted for 10min, with an inter-pulse frequency of 1Hz. We found that bilateral SPL (Brodmann area (BA) 7) stimulation disrupted performance on abstract and incongruent reasoning. Left IFG (BA 45) stimulation impaired congruent reasoning performance while paradoxically facilitating incongruent reasoning performance. This resulted in the elimination of the belief-bias. In contrast, right IFG stimulation only impaired incongruent reasoning performance, thus enhancing the belief-bias effect. These findings are largely consistent with the dual-process theory of reasoning, which proposes the existence of two different human reasoning systems: a belief-based heuristic system; and a logic-based analytic system. The present findings suggest that the left language-related IFG (BA 45) may correspond to the heuristic system, while bilateral SPL may underlie the analytic system. The right IFG may play a role in blocking the belief-based heuristic system for solving incongruent reasoning trials. This study could offer an insight about functional roles of distributed brain systems in human deductive reasoning by utilizing the rTMS approach.

Neural correlates of belief-bias reasoning under time pressure: a near-infrared spectroscopy study

The dual-process theory of reasoning explained the belief-bias effect, the tendency for human reasoning to be erroneously biased when logical conclusions are incongruent with belief about the world, by proposing a belief-based fast heuristic system and a logic-based slow analytic system. Although the claims were supported by behavioral findings that the belief-bias effect was enhanced when subjects were not given sufficient time for reasoning, the neural correlates were still unknown. The present study therefore examined the relationship between the time-pressure effect and activity in the inferior frontal cortex (IFC) during belief-bias reasoning using near-infrared spectroscopy (NIRS). Forty-eight subjects performed congruent and incongruent reasoning tasks, involving long-span (20 s) and short-span trials (10 s). Behavioral analysis found that only incongruent reasoning performance was impaired by the time-pressure of short-span trials. NIRS analysis found that the time-pressure decreased right IFC activity during incongruent trials. Correlation analysis showed that subjects with enhanced right IFC activity could perform better in incongruent trials, while subjects for whom the right IFC activity was impaired by the time-pressure could not maintain better reasoning performance. These findings suggest that the right IFC may be responsible for the time-pressure effect in conflicting reasoning processes. When the right IFC activity was impaired in the short-span trials in which subjects were not given sufficient time for reasoning, the subjects may rely on the fast heuristic system, which result in belief-bias responses. We therefore offer the first demonstration of neural correlates of time-pressure effect on the IFC activity in belief-bias reasoning.