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近红外光谱辅助诊断重度抑郁症、双相情感障碍和精神分裂症患者。

NIRS-aided differential diagnosis among patients with major depressive disorder, bipolar disorder, and schizophrenia.

机构信息

Department of Psychiatry, China Medical University Hsinchu Hospital, Hsinchu, Taiwan; Dr. Chou's Mental Health Clinic, Hsinchu, Taiwan.

An-Nan Hospital, China Medical University, Tainan, Taiwan.

出版信息

J Affect Disord. 2023 Nov 15;341:366-373. doi: 10.1016/j.jad.2023.08.101. Epub 2023 Aug 25.

Abstract

BACKGROUND

To establish a clinically applicable neuroimaging-guided diagnostic support system that uses near-infrared spectroscopy (NIRS) for differential diagnosis at the individual level among major depressive disorder (MDD), bipolar disorder (BPD), and schizophrenia (SZ).

METHODS

A total of 192 participants were recruited, including 40 patients with MDD, 38 patients with BPD, 65 patients with SZ, and 49 healthy individuals. We analyzed the spatiotemporal characteristics of hemodynamic responses in the frontotemporal cortex during a verbal fluency test (VFT) measured by NIRS to assess the accuracy of single-subject classification for differential diagnosis among the three psychiatric disorders. The optimal threshold of the frontal centroid value (54 seconds) was utilized on the basis of the findings of the Japanese study.

RESULTS

The application of the optimal threshold of the frontal centroid value (54 seconds) allowed for the accurate differentiation of patients with unipolar MDD (72.5%) from BPD (78.9%) or SZ (84.6%).

CONCLUSION

These results suggest that the NIRS-aided differential diagnosis of major psychiatric disorders can be a promising biomarker in Taiwan. Future multi-site studies are needed to validate our findings.

摘要

背景

建立一个临床可用的神经影像学引导的诊断支持系统,该系统使用近红外光谱(NIRS)对重度抑郁症(MDD)、双相情感障碍(BPD)和精神分裂症(SZ)进行个体水平的鉴别诊断。

方法

共招募了 192 名参与者,包括 40 名 MDD 患者、38 名 BPD 患者、65 名 SZ 患者和 49 名健康个体。我们分析了 NIRS 测量的言语流畅性测试(VFT)中前额叶皮质血流动力学反应的时空特征,以评估单个受试者分类对三种精神障碍鉴别诊断的准确性。基于日本研究的结果,使用额心值(54 秒)的最佳阈值。

结果

额心值(54 秒)的最佳阈值的应用能够准确地区分单相 MDD(72.5%)与 BPD(78.9%)或 SZ(84.6%)患者。

结论

这些结果表明,NIRS 辅助的主要精神障碍鉴别诊断可能是台湾有前途的生物标志物。需要进行多中心研究来验证我们的发现。

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