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Dissertation
Assessment of cognition and neuromodulation using functional Near Infrared Spectroscopy (fNIRS) in mental health
Doctor of Philosophy (Ph.D.), Drexel University
Jun 2020
DOI:
https://doi.org/10.17918/00000041
Abstract
Prefrontal cortex activity can be effectively and routinely monitored using functional Near-Infrared Spectroscopy (fNIRS), a non-invasive neuroimaging method that measures cortical hemodynamic responses through relative changes in the absorption of near-infrared light. fNIRS offers a number of advantages over other neuroimaging methodologies, particularly in outpatient environments, and in recent years has become an emerging tool in clinical psychiatry. As ongoing technological improvements make neuroimaging systems more practical, more reliable, and more affordable, fNIRS is poised to tackle long-standing challenges in psychiatric practice. Despite these advances, research is often restricted to the observation of individual phenomena which are rarely successfully translated into use in clinical settings. The goal of this thesis is to propose the use and application of fNIRS-based neuroimaging to characterize cognitive function in mental health patients and monitor their response to pharmaceutical and non-pharmaceutical interventions. The platform introduced in this study offers potential new indices of patient status, treatment efficacy, and targets for novel treatment approaches. In this thesis, it is proposed that fNIRS can address two distinct, but related, needs in psychiatric practice: as a tool for comprehensive evaluation of patient cognition and to monitor neurophysiological response to non-invasive brain stimulation. In the first case, fNIRS is employed to evaluate patient cognition as a means of tracking patient status and procognitive treatment response. Using schizophrenia as a reference disorder, this work presents a novel multidomain cognitive battery as well as results from the performance of the battery. Participants' neurocognitive abilities were evaluated from the perspective of four domains: working memory, verbal fluency, speed of processing, and sustained attention. The primary goal of this assessment was to identify neural bases for these deficits and the secondary goal was to determine the degree to which they related to clinical status and response to antipsychotic treatment. While it was not expected that antipsychotic therapy would improve participant cognition, the identification of stable deficits and activity which relates to clinical state can help establish composite biomarkers of clinical status to inform future therapy through Brain-Integrated Psychiatry. These candidate biomarkers offer potential utility for diagnosis, classification, and monitoring of treatment response within schizophrenia. In the second case, fNIRS is assessed as a technique to monitor and evaluate noninvasive brain stimulation (NIBS) using repetitive transcranial magnetic stimulation (rTMS). rTMS is a growing non-pharmaceutical intervention that promises potential mitigation of psychosis, depression, and cognitive dysfunction. Neurostimulation using rTMS often requires targeting regions without any peripheral physiological measure to assess its immediate cortical or therapeutic effects. Here, the utility of fNIRS is presented as a technique to measure immediate cortical responses to TMS, the effects of stimulation on cognition, and the relationship of cortical response to clinical outcomes in major depressive disorder (MDD) and schizophrenia. This section includes for the first time, the monitoring of rTMS effects using an LED-based fNIRS sensor, the influence of rTMS on speed of processing, and the influence of different rTMS therapies on individuals with MDD and schizophrenia. Together, this project aims to promote non-invasive neuroimaging methodologies as a tool to shed light on patient state through objective measures of cognition and treatment response.
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Details
- Title
- Assessment of cognition and neuromodulation using functional Near Infrared Spectroscopy (fNIRS) in mental health
- Creators
- Adrian Bernhard Curtin
- Contributors
- Hasan Ayaz (Advisor)Shanbao Tong (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xxii, 248 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems (1997-2026); Drexel University
- Other Identifier
- 991014695136404721