Differentiating people with schizophrenia from healthy controls in a developing Country: An evaluation of portable functional near infrared spectroscopy (fNIRS) as an adjunct diagnostic tool

Bach Xuan Tran; Tham Thi Nguyen; Laurent Boyer; Guillaume Fond; Pascal Auquier; Hao Si Anh Nguyen; Ha Thi Nhi Tran; Hung Manh Nguyen; Jongkwan Choi; Huong Thi Le; Carl A Latkin; Kalpana Isabel Nathan; Syeda F Husain; Roger S McIntyre; Cyrus S H Ho; Melvyn W B Zhang; Roger C M Ho

doi:10.3389/fpsyt.2023.1061284

Differentiating people with schizophrenia from healthy controls in a developing Country: An evaluation of portable functional near infrared spectroscopy (fNIRS) as an adjunct diagnostic tool

Front Psychiatry. 2023 Jan 26:14:1061284. doi: 10.3389/fpsyt.2023.1061284. eCollection 2023.

Authors

Bach Xuan Tran¹, Tham Thi Nguyen¹, Laurent Boyer², Guillaume Fond², Pascal Auquier², Hao Si Anh Nguyen³, Ha Thi Nhi Tran⁴, Hung Manh Nguyen⁵, Jongkwan Choi⁶, Huong Thi Le¹, Carl A Latkin⁷, Kalpana Isabel Nathan⁸, Syeda F Husain⁹, Roger S McIntyre^{10

11

12

13}, Cyrus S H Ho¹⁴, Melvyn W B Zhang¹⁵, Roger C M Ho^{14

16}

Affiliations

¹ Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
² EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France.
³ Institute of Health Economics and Technology, Hanoi, Vietnam.
⁴ Hanoi Department of Health, Hanoi, Vietnam.
⁵ Mai Huong Daycare Psychiatric Hospital, Hanoi, Vietnam.
⁶ OBELAB, Inc., Seoul, Republic of Korea.
⁷ Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
⁸ Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.
⁹ Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹⁰ Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada.
¹¹ Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
¹² Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
¹³ Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
¹⁴ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹⁵ Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.
¹⁶ Institute for Health Innovation and Technology, National University of Singapore, Singapore, Singapore.

Abstract

Introduction: This study aimed to evaluate portable functional near-infrared spectroscopy (fNIRS) device as an adjunct diagnostic tool in Vietnam to assess hemodynamics when people with schizophrenia and healthy controls performed cognitive tasks.

Methods: One hundred fifty-seven participants were divided into schizophrenia (n = 110) and healthy controls group (n = 47), which were recruited by match of age, and gender. Hemodynamic responses in the frontal cortex were monitored with a 48-channel portable device during the Stroop Color-Word Test (SCWT) and Verbal Fluency Test (VFT). General linear model compared the differences in oxyhemoglobin (HbO₂) levels between the two groups. The Receiver Operating Characteristic (ROC) graph was generated for each neuroanatomical area.

Results: People with schizophrenia did not show significant activation in the frontal lobe during the SCWT and VFT as compared to pre-task. During the VFT, the area under the ROC curve of the bilateral dorsolateral prefrontal cortex, bilateral orbitofrontal cortex, bilateral frontopolar prefrontal cortex, and bilateral ventrolateral prefrontal cortex were greater than 0.7 (p < 0.001). The area under the ROC curve (AUC) for the right orbitofrontal cortex was maximal during the VFT (AUC = 0.802, 95%CI = 0.731-0.872). The Youden's index reached a peak (0.57) at the optimal cut-point value (HbO₂ cutoff <0.209 μmol/ml for schizophrenia) in which the sensitivity was 85%; specificity was 72%; positive predictive value (PPV) was 0.88; negative predictive value (NPV) was 0.68 and correct classification rate was 76%.

Discussion: Assessing hemodynamics during VFT by portable fNIRS offers the potential as an adjunct diagnostic tool for schizophrenia in developing countries.

Keywords: NIR spectroscopy; Vietnam; cortical hemodynamic response; near-infrared; schizophrenia; spectrometry.

Grants and funding

This study received funding from the Gia Lam Urban Development and Investment Company Limited, Vingroup, Vingroup Innovation Foundation (VINIF) (Grant No. VINIF.2019.DA14), NUS Department of Psychological Medicine (R-177-000-100-001/R-177-000-003-001), and NUS iHeathtech Other Operating Expenses (R-722-000-004-731). The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.