Differentiating early and late‐onset depression with multichannel near‐infrared spectroscopy

Abstract

Background: Individuals with late-life depression can be divided into two categories, those with early and late-onset depression (EOD and LOD, respectively). It has been reported that LOD has more accentuated subcortical vascular lesions and frontal lobe dysfunction (hypofrontality). The aim of the present study was to examine whether LOD exhibits more prominent hypofrontality than EOD during performance of the word fluency task (WFT) under multichannel near-infrared spectroscopy (NIRS), a newly developed non-invasive functional neuroimaging technique. Methods: Eleven patients with EOD, 12 patients with LOD, and 13 healthy controls participated in the study. Clinical symptoms of depression were equivalent in the EOD and LOD groups. Brain magnetic resonance imaging demonstrated more robust subcortical vascular changes in LOD than EOD. The NIRS images were obtained using an ETG-4000, 52-channel NIRS system (Hitachi Medical, Tokyo, Japan). Mean changes in oxy-hemoglobin (oxy-Hb) were evaluated while the participants performed the phonemic WFT. Results: Healthy controls exhibited clear increases in oxy-Hb bilaterally throughout the medial to the lateral frontal cortices and the superior temporal areas during the WFT. In contrast, increases in oxy-Hb were mildly attenuated in EOD and severely attenuated in LOD in most channels. Subsequent analyses revealed that increases in oxy-Hb in LOD during the WFT was significantly poorer than in EOD in the left lateral portion of the cortex, including the dorsolateral prefrontal and the superior temporal areas. In addition, significant negative correlations were obtained between the age of onset and oxy-Hb, as well as between subcortical vascular changes and oxy-Hb in the lateral channels. These findings suggest that the higher the age of onset of depression, and the more prominent the vascular lesions, the greater the attenuation in lateral frontal and temporal activation, as indicated by NIRS. Conclusions: Multichannel NIRS is useful for demonstrating attenuated functional activation in the left lateral prefrontal and temporal areas in LOD and, thus, for differentiating between LOD and EOD. The NIRS findings observed may have useful clinical implications for treatment-resistant LOD.

Near‐infrared spectroscopy for examination of prefrontal activation during cognitive tasks in patients with major depressive disorder: A meta‐analysis of observational studies

“…The NIRS instruments that were used varied markedly across studies. One study used single‐channel NIRS (HEO‐200, Omron, Tokyo, Japan), one study used two‐channel NIRS (NIRO‐300, Hamamatsu Photonics K.K., Hamamatsu City, Japan), two studies used 24‐channel NIRS (Hitachi ETG‐100, Hitachi Medical Corporation, Tokyo, Japan), one study used 28‐channel CW5 NIRS (TechEn, Milford, MA, USA), and nine studies used 52‐channel NIRS (Hitachi ETG‐4000) …”

“…Studies included in quantitative synthesis of deoxyHb (n = 5) 22 one study used two-channel NIRS (NIRO-300, Hamamatsu Photonics K.K., Hamamatsu City, Japan), 23 two studies used 24-channel NIRS (Hitachi ETG-100, Hitachi Medical Corporation, Tokyo, Japan), 24,25 one study used 28-channel CW5 NIRS (TechEn, Milford, MA, USA), 25 and nine studies used 52-channel NIRS (Hitachi ETG-4000). [27][28][29][30][31][32][33][34][35] According to our review of the authors' conclusions, all of the studies reached the unanimous conclusion that patients with MDD had significantly lower activation of the prefrontal cortex during cognitive tasks than controls. However, for quantitative meta-analysis, the original data needed were incomplete or missing in most of the included studies.…”

“…A total of 2260 citations were identified within our database search. After reviewing the titles and abstracts and removing duplicate publications, 19 full-text articles [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were reviewed. Of these 19 articles, 14 studies 22-35 met the inclusion criteria ( Fig.…”

Serum amyloid β protein in young and elderly depression: a pilot study

“…The elderly depression is heterogeneous, requiring various interventions, [18][19][20] and different pathogenic processes are speculated with younger elderly and older elderly depression. 21,22 No study, however, has been reported the Ab levels in younger subjects with depression. The present study therefore examined serum Ab40 and Ab42 levels and the Ab40/42 ratio in patients with major depressive disorder (MDD) and healthy controls, and compared young and elderly groups.…”

Preliminary application of processed electroencephalogram monitoring to differentiate senile dementia from depression

“…Brain imaging techniques are very powerful in differentiating between Alzheimer's disease (AD) and other diseases; however, they are inconvenient as an initial step. For the diagnosis of depression, physiological examinations and brain imaging, namely near‐infrared spectroscopy, have been used 3,4 and convenient methods are always required for use in routine clinical practice. For example, the usefulness of the electroencephalogram (EEG) has been reported recently.…”