Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Psychiatry, Shiga University of Medical Sciences, Otsu, Shiga, Japan.
Sci Rep. 2017 Aug 23;7(1):9258. doi: 10.1038/s41598-017-10024-7.
Delirium is a common and serious psychiatric syndrome caused by an underlying medical condition. It is associated with significant mortality and increased healthcare resource utilization. There are few biological markers of delirium, perhaps related to the etiologic heterogeneity of the syndrome. Functional near-infrared spectroscopy (fNIRS) is an optical topography system to measure changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the cerebral cortex. We examined whether altered cortical brain activity in delirious patients with end stage liver disease (ESLD) is detected by fNIRS. We found that the [oxy-Hb] change during the verbal fluency task (VFT) was reduced in patients with ESLD compared with healthy controls (HC) in the prefrontal and bi-temporal regions. The [oxy-Hb] change during the sustained attention task (SAT) was elevated in patients with ESLD compared to HC in the prefrontal and left temporal regions. Notably, [oxy-Hb] change in the left dorsolateral prefrontal cortex during SAT showed a positive correlation with the severity of delirium. Our results suggest that [oxy-Hb] change in the prefrontal cortex during the sustained attention task measured with fNIRS might serve as a biological marker associated with delirium in ESLD patients.
谵妄是一种由潜在医学状况引起的常见且严重的精神综合征。它与高死亡率和增加的医疗保健资源利用有关。谵妄的生物学标志物很少，这可能与该综合征的病因异质性有关。功能近红外光谱（fNIRS）是一种光学层析系统，用于测量大脑皮层中氧合血红蛋白（[oxy-Hb]）浓度的变化。我们研究了终末期肝病（ESLD）患者谵妄时是否通过 fNIRS 检测到皮质脑活动的改变。我们发现，与健康对照组（HC）相比，ESLD 患者在执行言语流畅性任务（VFT）期间前额叶和双侧颞叶区域的[oxy-Hb]变化减少。与 HC 相比，ESLD 患者在执行持续注意任务（SAT）期间前额叶和左侧颞叶区域的[oxy-Hb]变化增加。值得注意的是，SAT 期间左背外侧前额叶皮质中的[oxy-Hb]变化与谵妄的严重程度呈正相关。我们的结果表明，fNIRS 测量的持续注意任务期间前额叶皮质中的[oxy-Hb]变化可能作为与 ESLD 患者谵妄相关的生物学标志物。
