Near-Infrared Spectroscopy In atypical Depression: A Diagnostic Possibility
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 19, Issue 3
Abstract
Optical topography is a non-invasive device with high resolution for imaging hemodynamic changes to assess brain function, using near-infrared spectroscopy (NIRS). In Japan, the cost of this technique can be covered by healthcare insurance for differentiating depressive symptoms. Although atypical depression is often seen in psychosomatic clinics and known to have a relationship with other physiological disorders, such as metabolic syndrome and other physical conditions, NIRS findings are limited to understanding the neurophysiological aspects of atypical depression. In this brief paper, we address the possible role of NIRS diagnostic accuracy for depression and show cases of NIRS diagnosis in atypical depression that relate to the body and mind, in contrast to melancholic types of depression and bipolar disorders. This article could help psychosomatic medicine practitioners when debating the similarities and differences between depressions in psychosomatic illness.Near-infrared spectroscopy (NIRS) is a non-invasive technique using relatively small and portable equipment, with high temporal resolution for imaging hemodynamic changes to assess brain function [1-4]. This device was first introduced by Jöbsis in 1977, which allowed measurement of tissue components [5]. NIRS can detect brain function by evaluating changes in the concentration of oxygenated hemoglobin, deoxygenated hemoglobin, totalhemoglobin or cytochrome-c-oxidase [6] using near-infrared light. In addition, it has been used to resolve changes in the combination of hemoglobin and cytochrome-c-oxidase, which has led to many clinical applications for measurements in the human brain [6]. NIRS has a high resolution, it can be used to detect a similar cortical activation pattern to functional magnetic resonance imaging (fMRI) [7], positron emission tomography (PET) [8], and single photon emission computed tomography (SPECT) [9]. NIRS was largely unknown to clinicians in mental health in Japan; however, since 2009 it has been approved by the Ministry of Health, Labor and Welfare as an advanced medical technology to differentiate psychiatric diagnosis [10]. The cost of this technique has been covered by healthcare insurance to differentiate major depressive disorder and bipolar disorder since 2014. Therefore, many Japanese psychiatric hospitals and university affiliated hospitals have introduced NIRS for diagnostic accuracy in depression both for clinical and research purposes. Major depressive disorder was ranked as the third leading contributor to the global burden of disease in 2004 and is expected to move to first place by 2030 [11]. Depression is associated with physiological disorders, such as metabolic syndrome and other physical conditions. Of the various specifiers created for major depressive disorder to help clinicians for its treatment, atypical depression is thought to have the strongest relationship to lifestyle diseases [12,13]. More specifically, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM- 5), atypical depression is defined as a condition presenting with mood reactivity plus at least two of the following four symptoms: hyperphagia, hypersomnia, laden paralysis, and interpersonal rejection sensitivity [14].
Authors and Affiliations
Takeaki Takeuchi, Kazuaki Hashimoto, Masahiro Hashizume
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