Impaired Oxygenation of the Prefrontal Cortex During Verbal Fluency Task in Young Adults With Major Depressive Disorder and Suicidality: A Functional Near-Infrared Spectroscopy Study

Hyewon Kim; JongKwan Choi; Bumseok Jeong; Maurizio Fava; David Mischoulon; Mi Jin Park; Hyun Soo Kim; Hong Jin Jeon

doi:10.3389/fpsyt.2022.915425

Impaired Oxygenation of the Prefrontal Cortex During Verbal Fluency Task in Young Adults With Major Depressive Disorder and Suicidality: A Functional Near-Infrared Spectroscopy Study

Front Psychiatry. 2022 Jun 23:13:915425. doi: 10.3389/fpsyt.2022.915425. eCollection 2022.

Authors

Hyewon Kim¹, JongKwan Choi², Bumseok Jeong³, Maurizio Fava⁴, David Mischoulon⁴, Mi Jin Park⁵, Hyun Soo Kim⁶, Hong Jin Jeon^{7

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Affiliations

¹ Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea.
² OBELAB Inc., Seoul, South Korea.
³ Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
⁴ Depression Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
⁵ Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
⁶ Department of Psychiatry, Dong-A University Hospital, Busan, South Korea.
⁷ Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁸ Department of Health Sciences and Technology, Department of Medical Device Management and Research, and Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
⁹ Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea.
¹⁰ Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea.

Abstract

Background: Few previous studies have focused on prefrontal activation in young adults diagnosed with major depressive disorder (MDD) and suicidality via functional near-infrared spectroscopy (fNIRS).

Materials and methods: A total of 59 healthy controls (HCs), 35 patients with MDD but without suicidality, and 25 patients with MDD and suicidality, between the ages of 18-34 years, were enrolled. Changes in oxygenated hemoglobin (oxy-Hb) levels of the prefrontal cortex at baseline, 4 weeks, and 8 weeks, were evaluated using a protocol consisting of three consecutively repeated trials of rest, speech, and verbal fluency test (VFT) via fNIRS. MDD was diagnosed and suicidality was evaluated based on Mini International Neuropsychiatric Interview (MINI).

Results: Oxy-Hb levels were impaired in patients with MDD compared with HCs (p = 0.018 for left prefrontal cortex; p = 0.021 for right ventromedial prefrontal cortex; p = 0.002 for left frontopolar cortex). Among the three groups including HCs, MDD without suicidality, and MDD with suicidality, prefrontal oxygenation was most decreased in MDD patients with suicidality. A significantly impaired prefrontal oxygenation in the right ventrolateral prefrontal cortex (VLPFC) was detected after adjusting for covariates in MDD patients with suicidality, compared to those without suicidality.

Conclusion: Impaired prefrontal oxygenation during cognitive execution may serve as a diagnostic biomarker for suicidality in young adult patients with MDD.

Keywords: fNIRS; major depressive disorder; oxygenated hemoglobin; prefrontal cortex; suicide.