Identification of functional near-infrared spectroscopy for older adults with mild cognitive impairment: a systematic review

TL;DR

This review explores how functional near-infrared spectroscopy (fNIRS) can help diagnose mild cognitive impairment in older adults by analyzing brain activity patterns.

Contribution

The study systematically reviews fNIRS features in older adults with MCI to identify potential objective diagnostic markers.

Findings

Working memory tasks and prefrontal cortex activation are commonly studied in MCI using fNIRS.

Activation levels in MCI patients vary inconsistently compared to controls, depending on study design.

Theoretical frameworks suggest factors like task design and MCI subtypes may explain inconsistent results.

Abstract

Mild cognitive impairment (MCI), a common state of cognitive impairment without significant impairment in daily functioning among older adults, is mainly identified using various neuropsychological tests, clinical interviews, and collateral history with some subjective interferences. This systematic review aimed to investigate the functional near-infrared spectroscopy (fNIRS) features of older adults with MCI compared with those with normal cognitive function to assist in the diagnosis of MCI.

A literature search was conducted in electronic databases, including PubMed, Web of Science, Embase, and Cochrane Library, up to June 15, 2024. The data on article information (first author and year of publication), participant characteristics, task paradigms, regions of interest (ROIs), fNIRS device attributes, and results related to cerebral oxygenation and hemodynamics were extracted.

Finally, 34 relevant studies were identified, involving 1033 patients with MCI and 1107 age-, sex-, and education-matched controls with normal cognitive function. We found that the studies frequently used working memory–related task paradigms and resting-state measurements. Also, the prefrontal cortex was a primary ROI, and the changes in oxygenated hemoglobin concentration were the most basic research attributes used to derive measures such as functional connectivity (FC), FC variability, slope, and other parameters. However, ROI activation levels differed inconsistently between patients with MCI and individuals with normal cognition across studies. In general, the activation levels in the ROI of MCI patients may be higher than, lower than, or comparable to those in the normal control group.

Research on fNIRS in elderly patients with MCI aims to provide an objective marker for MCI diagnosis. The current findings are mixed. However, these differences can be partly explained with the theoretical support from the interaction of cognitive load theory and scaffolding theory of aging and cognition, taking into account factors such as unspecified MCI subtypes, task difficulty, task design, monitoring duration, and population characteristics. Therefore, future studies should consider definite MCI subtypes, strict and well-designed paradigms, long-term monitoring, and large sample sizes to obtain the most consistent results, thereby providing objective references for the clinical diagnosis of MCI in elderly patients.

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