Nah-Infrarot-Spektroskopie in der Psychiatrie

ZusammenfassungDie Nah-Infrarot-Spektroskopie (NIRS) ist eine nichtinvasive optische Methode zur Messung der regionalen Hirngewebeoxygenierung in vivo. Licht aus dem nah-infraroten Spektrum kann die Schädelkalotte durchdringen und wird im Hirngewebe hauptsächlich von Oxy- (O2Hb) und Deoxyhämoglobin (HHb) absorbiert. Aus der Relation von in das Gehirn abgegebenem zu reflektiertem Nah-Infrarot-Licht kann daher spektrophotometrisch die regionale Konzentrationsänderung von O2Hb und HHb berechnet werden. Es wurde bereits gezeigt, dass NIRS nicht nur massive Hirndurchblutungsstörungen bei schweren neurologischen Erkrankungen erfassen kann, sondern dass die Methode auch ausreichend sensitiv ist, um bei gesunden Probanden aufgabenspezifische Aktivierungsmuster während definierter kognitiver Prozesse zu messen. Erste Untersuchungen an psychiatrischen Patienten weisen auf veränderte regionale Hirngewebsoxygenierungen im Vergleich zu Kontrollgruppen während kognitiver Aktivierungsaufgaben hin. NIRS hat aufgrund seiner unkomplizierten, schnellen Durchführung, seiner Nebenwirkunsfreiheit und der hohen Akzeptanz bei psychiatrischen Patienten eindeutige Vorteile im Vergleich zu anderen Methoden der funktionellen Bildgebung, die die Methode auch als potenzielles Screeningverfahren in der Psychiatrie attraktiv erscheinen lassen. Voraussetzung dafür ist allerdings, dass sich in Zukunft stabile und reliable NIRS-Parameter mit diagnostischem und/oder prognostischem Wert für bestimmte psychiatrische Erkrankungen entwickeln lassen, was nur durch eine breitere Nutzung dieser Methode in der psychiatrischen Forschung in Verbindung mit bereits etablierten Methoden der Neurophysiologie und der funktionellen Bildgebung gelingen wird.SummaryNear-infrared spectroscopy (NIRS) is a noninvasive optical method for in vivo measurement of regional brain tissue oxygenation. Light from the near-infrared spectrum can penetrate the skull and is mainly absorbed by oxyhaemoglobin (O2Hb) and desoxyhaemoglobin (HHb). From the amount of reflected near-infrared light in relation to the amount absorbed by brain tissue, regional changes in O2Hb and HHb concentrations can be calculated spectrophotometrically. It has been shown that NIRS is not only able to measure massive disturbances in cerebral blood circulation due to serious neurological diseases, but that it also is sensitive enough to assess task-specific patterns of activation in healthy subjects during circumscribed cognitive processes. Preliminary investigations indicate altered regional brain tissue oxygenation in psychiatric patients during cognitive activation tasks. The NIRS outmatches other functional imaging methods in that it has no side effects and is well tolerated by psychiatric patients. Furthermore, it can be applied quickly and easily. Thus, NIRS is a potential screening method in psychiatric settings, provided that robust parameters of reliable diagnostic and/or prognostic value can be developed for individual psychiatric illnesses. However, this will depend on broader application of the method combined with established neurophysiological procedures and functional imaging techniques in psychiatric research.

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