Changes in Cerebral Hemodynamic Among Patients With Schizophrenia or Bipolar Disorder Receiving Electroconvulsive Therapy: A Task-Related Functional Near-Infrared Spectroscopy Study.

Abstract

Abstract: There remains a scarcity of studies to evaluate the treatment effect of electroconvulsive therapy (ECT). Functional near-infrared spectroscopy (fNIRS) offers a cost-effective method to measure cerebral hemodynamics. This study used fNIRS to evaluate the effect of ECT in patients suffering from schizophrenia or bipolar disorder (manic phase). Thirty patients with mania and 31 with schizophrenia were recruited. Each participant received 6 sessions of ECT. This study utilized the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and fNIRS-verbal fluency test paradigm at baseline and after each session of ECT. The prefrontal cortex hemodynamic response during the performance of verbal fluency test was recorded via a commercial wireless high-density continuous-wave fNIRS system device. The effect of categorical and continuous variables was determined using Pearson's chi-square test and Student's t test or 1-way analysis of variance with Bonferroni-corrected post hoc pairwise comparison, respectively. Comparing the Positive and Negative Syndrome Scale and Young Mania Rating Scale scores between baseline, sessions 3 and 6, the scores were significantly decreased (P < 0.001), with both patient groups achieving more than 50% reduction in scores from baseline to session 6. The fNIRS also showed significant increases in oxy-hemoglobin levels (session 6 vs baseline) in the right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex for both patient groups (P < 0.05). There were significant correlations in the reduction of symptom severity and increase in HbO2 levels in people with bipolar disorder (manic phase) and schizophrenia (P < 0.05). Monitoring the activation in the right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex is an objective ECT monitoring indicator for patients suffering from bipolar disorder (manic phase) or schizophrenia.