近紅外光腦譜儀在精神醫學上的應用

The Application of Near-infrared Spectroscopy in Psychiatry

在精神醫學界，大家一直期待可以有如同其它主流醫學一般的工具，可以協助診斷、治 療追蹤、與預後變化預測的可測量儀器。人類在過去十數年間，不斷嘗試使用量測大腦結 構與功能的影像工具，如磁振造影、電腦斷層攝影、核子醫學的單光子放射斷層掃描與正子 放射斷層掃描等等，或是嘗試使用觀察大腦或神經的電生理訊號之儀器，如腦電波儀、磁腦 電波儀、或是心率變異測量儀等等，雖然在過去有一些學術上的進展，但距離臨床的實用化 還有一段距離。而光學儀器如近紅外光腦譜儀的興起，有其臨床應用可能性的優點：需要操 作時間短與受測者的空間需求與活動限制少，使得其在精神科學上的臨床應用性逐漸顯現出 來。本篇文章介紹這個新的臨床儀器與在精神科上面的應用。由於日本已經正式承認近紅外 光腦譜儀可以應在精神科疾病的診斷，尤其在鑑別診斷上的應用，成為精神醫學上臨床醫師 可以藉以量測精神症狀的一個實用工具，這也許是不久的將來很快可以實現的趨勢，可以實 踐客觀量測的精神醫學。

To measure behavioral indicators for human is always a struggle for scientists, especially psychiatrists. In the recent decades, there have been more progresses on the efforts to measure psychiatric symptoms by instruments, including different kinds of brain structural/functional tools (MRI, CT, and SPECT/PET scan), or different kinds of brain electrophysiological tools (EEG, MEG, HRV, etc.). But the practical use in psychiatry is limited so far. The photonic tool such as near-infrared spectroscopy (NIRS) application is an emerging tool to measure the brain function with least restriction in time and space requirement. In this overview, the author intends to introduce this new instrument and its application in psychiatric diagnoses, especially in differential diagnoses. Hopefully, a spotlight of hope in psychiatry is to be seen to help clinicians quantitatively measure psychiatric disorders in the near future.