Cognitive improvement and prefrontal network interactions in individuals with remitted bipolar disorder after transcranial infrared laser stimulation.

IF 3.2 3区医学 Q2 PSYCHIATRY Frontiers in Psychiatry Pub Date : 2025-01-30 eCollection Date: 2025-01-01 DOI:10.3389/fpsyt.2025.1547230

Douglas W Barrett, Roger E Davis, Jennifer E Siegel-Ramsay, Amy Bichlmeier, Jorge R C Almeida, F Gonzalez-Lima

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Abstract

Background: Converging evidence suggests that bipolar disorder (BD) involves mitochondrial dysfunction and prefrontal cortex (PFC) hypometabolism associated with cognitive impairment, which persists in remitted BD individuals. Transcranial infrared laser stimulation (TILS) provides safe, non-invasive brain stimulation that enhances PFC metabolism via photobiomodulation of mitochondrial respiration and tissue oxygenation. We tested the hypothesis that the neurocognitive deficits found in BD may be ameliorated by TILS treatments.

Methods: This is the first study to explore neurocognitive effects of repeated TILS administration in BD. Using an open-label design, 29 individuals with remitted BD received six weekly TILS treatments. Working memory and attention were assessed with trail-making and 2-back tasks sensitive to TILS cognitive effects in individuals with BD. Changes in PFC network interactions were measured with functional near-infrared spectroscopy (fNIRS) because this method can measure TILS effects on oxygen metabolism in the PFC of individuals with BD.

Results: Participants reported no adverse effects from treatment, confirming the safety of this intervention in individuals with BD. Cognitive test results showed that in people with remitted BD, TILS was effective at improving cognition, i.e., enhanced speed and accuracy in tasks reflecting cognitive flexibility, working memory, and attentional control. Antipsychotic medication improved TILS cognitive effects. The fNIRS results showed a significant reduction in PFC network correlations of oxygenated hemoglobin changes driven by cognitive task performance. The right-hemisphere frontopolar cortex showed greater TILS effects than its left-hemisphere counterpart.

Conclusions: Repeated TILS is a safe intervention to improve cognition in people with remitted BD. Continued antipsychotic medication may have contributed to the cognitive improvement. To confirm TILS efficacy, a sham-controlled, double-blinded randomized trial is needed.

Clinical trial registration: https://clinicaltrials.gov/, identifier NCT05354895.

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经颅红外激光刺激缓解双相情感障碍患者的认知改善和前额叶网络相互作用。

背景：越来越多的证据表明，双相情感障碍（BD）涉及与认知障碍相关的线粒体功能障碍和前额叶皮质（PFC）低代谢，这在缓解的双相情感障碍患者中持续存在。经颅红外激光刺激（TILS）提供安全、无创的脑刺激，通过光生物调节线粒体呼吸和组织氧合来增强PFC代谢。我们检验了在双相障碍中发现的神经认知缺陷可能通过TILS治疗得到改善的假设。方法：这是第一个探索重复使用TILS对双相障碍患者神经认知影响的研究。采用开放标签设计，29名缓解的双相障碍患者每周接受6次TILS治疗。采用对TILS认知效应敏感的trail-making任务和2-back任务评估双相障碍患者的工作记忆和注意力。使用功能近红外光谱（fNIRS）测量PFC网络相互作用的变化，因为该方法可以测量TILS对双相障碍患者PFC氧代谢的影响。参与者没有报告治疗的不良反应，证实了这种干预对双相障碍患者的安全性。认知测试结果显示，在双相障碍缓解患者中，TILS有效改善了认知，即提高了反映认知灵活性、工作记忆和注意力控制的任务的速度和准确性。抗精神病药物改善了TILS的认知效果。fNIRS结果显示，认知任务表现驱动的PFC网络中含氧血红蛋白变化的相关性显著降低。右半球额极皮层比左半球表现出更大的TILS效应。结论：重复TILS是一种安全的干预措施，可以改善双相障碍缓解患者的认知。持续的抗精神病药物治疗可能有助于认知改善。为了证实TILS的有效性，需要进行一项假对照、双盲随机试验。临床试验注册：https://clinicaltrials.gov/，标识符NCT05354895。

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来源期刊

Frontiers in Psychiatry Medicine-Psychiatry and Mental Health

CiteScore

6.20

自引率

8.50%

发文量

2813

审稿时长

14 weeks

期刊介绍： Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.