A group of researchers from Medical University of Lublin (Poland) published an article in Current Problems in Psychiatry where they used Photon Cap to validate the utility of the fNIRS method for monitoring potential changes in frontal cortical hemodynamic activity in response to electroconvulsive therapy (ECT).
Introduction
Treatment-Resistant Schizophrenia:
Schizophrenia is a mental illness with a global impact, affecting approximately 24 million people worldwide. Despite advancements in treatment, many patients do not achieve full remission, leading to a continued search for effective therapeutic interventions and predictive biomarkers. Electroconvulsive therapy (ECT) is recognized as a potent treatment for schizophrenia, especially in cases where clozapine, the gold standard for treatment-resistant schizophrenia (TRS), fails.
Hemodynamic monitoring with fNIRS
Recent advancements in neuroimaging techniques, particularly functional near-infrared spectroscopy (fNIRS), offer promising avenues for monitoring brain activity in psychiatric conditions. fNIRS is a non-invasive method that allows the assessment of neuronal activity by measuring changes in hemoglobin oxygenation within the brain’s cortical regions. Given its advantages -such as being relatively inexpensive, portable, and repeatable -fNIRS has gained attention as a potential tool for tracking the effects of therapeutic interventions like ECT. 
Objective
The primary objective of this study is to assess the feasibility of using fNIRS to monitor potential changes in the frontal cortex’s hemodynamic activity in response to ECT treatment in a patient with schizophrenia.
Method
A 30-year-old male patient with schizophrenia, resistant to pharmacotherapy including clozapine, underwent ECT. The study utilized fNIRS to measure the hemodynamic response of the frontal cortex during cognitive tasks, specifically verbal and non-verbal fluency tests. The Positive and Negative Syndrome Scale (PANSS) was employed to evaluate symptom severity before and after the ECT treatment.
Results
The study found that before ECT, the patient exhibited reduced frontal cortex activity, with atypical patterns of functional asymmetry during cognitive tasks. Following a series of 15 ECT sessions, there was a noticeable clinical improvement, reflected in a reduction of PANSS scores. The hemodynamic activity in the frontal cortex showed a shift towards a more normative pattern, particularly in the figural fluency task, suggesting that fNIRS could be a valuable tool for monitoring cortical activity changes in response to ECT.
Implications
These findings indicate that fNIRS could be an effective non-invasive technique for monitoring changes in brain activity during ECT treatment, offering potential as a diagnostic and prognostic tool in the management of schizophrenia. The study highlights the importance of continued research into neuroimaging technologies to enhance the understanding and treatment of psychiatric disorders.