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      Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study

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          Abstract

          Background

          Functional near-infrared spectroscopy (fNIRS) is an emerging neuroimaging modality that provides a direct and quantitative assessment of cortical haemodynamic response during a cognitive task. It may be used to identify neurophysiological differences between psychiatric disorders with overlapping symptoms, such as bipolar disorder (BD) and borderline personality disorder (BPD). Hence, this preliminary study aimed to compare the cerebral haemodynamic function of healthy controls (HC), patients with BD and patients with BPD.

          Methods

          Twenty-seven participants (9 HCs, 9 patients with BD and 9 patients with BPD) matched for age, gender, ethnicity and education were recruited. Relative oxy-haemoglobin and deoxy-haemoglobin changes in the frontotemporal cortex was monitored with a 52-channel fNIRS system during a verbal fluency task (VFT). VFT performance, clinical history and symptom severity were also noted.

          Results

          Compared to HCs, both patient groups had lower mean oxy-haemoglobin in the frontotemporal cortex during the VFT. Moreover, mean oxy-haemoglobin in the left inferior frontal region is markedly lower in patients with BPD compared to patients with BD. Task performance, clinical history and symptom severity were not associated with mean oxy-haemoglobin levels.

          Conclusions

          Prefrontal cortex activity is disrupted in patients with BD and BPD, but it is more extensive in BPD. These results provide further neurophysiological evidence for the separation of BPD from the bipolar spectrum. fNIRS could be a potential tool for assessing the frontal lobe function of patients who present with symptoms that are common to BD and BPD.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12888-021-03195-1.

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          Most cited references51

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          A RATING SCALE FOR DEPRESSION

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            A rating scale for mania: reliability, validity and sensitivity

            An eleven item clinician-administered Mania Rating Scale (MRS) is introduced, and its reliability, validity and sensitivity are examined. There was a high correlation between the scores of two independent clinicians on both the total score (0.93) and the individual item scores (0.66 to 0.92). The MRS score correlated highly with an independent global rating, and with scores of two other mania rating scales administered concurrently. The score also correlated with the number of days of subsequent stay in hospital. It was able to differentiate statistically patients before and after two weeks of treatment and to distinguish levels of severity based on the global rating.
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              A review on continuous wave functional near-infrared spectroscopy and imaging instrumentation and methodology.

              This year marks the 20th anniversary of functional near-infrared spectroscopy and imaging (fNIRS/fNIRI). As the vast majority of commercial instruments developed until now are based on continuous wave technology, the aim of this publication is to review the current state of instrumentation and methodology of continuous wave fNIRI. For this purpose we provide an overview of the commercially available instruments and address instrumental aspects such as light sources, detectors and sensor arrangements. Methodological aspects, algorithms to calculate the concentrations of oxy- and deoxyhemoglobin and approaches for data analysis are also reviewed. From the single-location measurements of the early years, instrumentation has progressed to imaging initially in two dimensions (topography) and then three (tomography). The methods of analysis have also changed tremendously, from the simple modified Beer-Lambert law to sophisticated image reconstruction and data analysis methods used today. Due to these advances, fNIRI has become a modality that is widely used in neuroscience research and several manufacturers provide commercial instrumentation. It seems likely that fNIRI will become a clinical tool in the foreseeable future, which will enable diagnosis in single subjects. Copyright © 2013 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                pcmrhcm@nus.edu.sg
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                20 April 2021
                20 April 2021
                2021
                : 21
                : 201
                Affiliations
                [1 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Institute for Health Innovation and Technology (iHealthtech), , National University of Singapore, ; Singapore, 117599 Singapore
                [2 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Department of Psychological Medicine, Yong Loo Lin School of Medicine, , National University of Singapore, ; Singapore, 119228 Singapore
                [3 ]GRID grid.444487.f, ISNI 0000 0004 0634 0540, Centre for Intelligent Signal and Imaging Research (CISIR), , University Teknologi PETRONAS, ; Darul Ridzuan, 32610 Seri Iskandar, Perak Malaysia
                [4 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, , National University of Singapore, ; Singapore, 117597 Singapore
                [5 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Johns Hopkins Bloomberg School of Public Health, , Johns Hopkins University, ; Baltimore, MD 21205 USA
                [6 ]GRID grid.56046.31, ISNI 0000 0004 0642 8489, Institute for Preventive Medicine and Public Health, , Hanoi Medical University, ; Hanoi, 116001 Vietnam
                [7 ]GRID grid.473736.2, ISNI 0000 0004 4659 3737, Center of Excellence in Behavioral Medicine, , Nguyen Tat Thanh University, ; Ho Chi Minh City, 70000 Vietnam
                Author information
                http://orcid.org/0000-0001-9629-4493
                Article
                3195
                10.1186/s12888-021-03195-1
                8056702
                33879125
                27a370cb-8566-4ab2-aca6-29f815dc385b
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 19 August 2020
                : 2 April 2021
                Funding
                Funded by: Department of Psychological Medicine, National University of Singapore
                Funded by: the Ministry of Education under HICOE scheme to CISIR at the University Teknologi PETRONAS
                Funded by: Health Innovation & Technology (iHealthTech, NUS)
                Funded by: Vingroup Innovation Foundation
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Clinical Psychology & Psychiatry
                functional near-infrared spectroscopy,verbal fluency task,prefrontal cortex,bipolar disorder,borderline personality disorder

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