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  1. 5-Minutes Mindfulness for palliative care: Integrating evidence and good design
    Zhang MWB, Ho RCM, Ng CG
    Technol Health Care, 2017 Dec 04;25(6):1173-1176.
    PMID: 28946598 DOI: 10.3233/THC-170868
    In psychiatry, mindfulness based intervention has been increasingly popular as a means of psychosocial intervention over the last decade. With the alvanche of technological advances, there has been a myriad of mindfulness based applications. Recent reviews have highlighted how these applications are lacking in functionalities and without demonstrated efficacy. Other reviews have emphasized that there is a need to take into consideration the design of an application, due to placebo effects. It is the aim of this technical note to illustrate how the 5-Minutes Mindfulness application, which is an application designed to provide mindfulness exercises to relieve distress and suffering amongst palliative patients, have been conceptualized. The conceptualized application builds on previous evidence of the efficacy of 5-Minutes Mindfulness demonstrated by pilot and randomized trials. In terms of design, the currently conceptualized application has been designed such that placebo effects could be controlled for.
  2. An fNIRS investigation of cortical responses to expressed emotion in bipolar disorder
    Wang C, Zhang Y, Zhang W, Zhang X, McIntyre RS, Li Z, et al.
    Asian J Psychiatr, 2026 Oct 28;126:105197.
    PMID: 42976437 DOI: 10.1016/j.ajp.2026.105197
    OBJECTIVES: High expressed emotion (EE) environments-characterized by critical, hostile, or emotionally overinvolved family interactions-are associated with increased relapse rates and poorer long-term outcomes in individuals with bipolar disorder (BD). This study aimed to investigate cortical responses to EE environments in individuals with BD.

    METHODS: The study included healthy controls (HCs; n=40) and individuals with BD (n=33). Participants listened to audio stimuli representing low- and high-EE environments while cortical hemodynamic activity was recorded using functional near-infrared spectroscopy (fNIRS). Hemodynamic activation and functional connectivity were examined in the left ventrolateral prefrontal cortex (vlPFC), left superior temporal gyrus (STG), and medial prefrontal cortex (mPFC)-regions implicated in emotion processing and regulation.

    RESULTS: Both groups showed significantly greater hemodynamic activation in the left vlPFC and left STG, together with greater nodal efficiency within the left vlPFC-STG network, under the high-EE condition than under the low-EE condition (p<0.05), with no significant between-group differences in these EE-related changes. In contrast, individuals with BD showed significantly reduced mPFC modulation relative to baseline and lower mPFC nodal efficiency than HCs (p<0.05). Within the BD group, mPFC nodal efficiency was significantly lower under the high-EE condition than under the low-EE condition (p<0.05).

    CONCLUSION: The findings indicate region- and context-specific differences in cortical hemodynamic responses and functional coupling in individuals with BD during EE processing. These fNIRS-derived measures may serve as candidate features for further investigation in larger and independent studies, including computational models aimed at characterizing cortical responses associated with BD.

  3. Fulltext An fNIRS investigation of novel expressed emotion stimulations in schizophrenia
    Wang C, Zhang Y, Lim LG, Cao W, Zhang W, Wan X, et al.
    Sci Rep, 2023 Jul 10;13(1):11141.
    PMID: 37429942 DOI: 10.1038/s41598-023-38057-1
    Living in high expressed emotion (EE) environments tends to increase the relapse rate in schizophrenia (SZ). At present, the neural substrates responsible for high EE in SZ remain poorly understood. Functional near-infrared spectroscopy (fNIRS) may be of great use to quantitatively assess cortical hemodynamics and elucidate the pathophysiology of psychiatric disorders. In this study, we designed novel low- (positivity and warmth) and high-EE (criticism, negative emotion, and hostility) stimulations, in the form of audio, to investigate cortical hemodynamics. We used fNIRS to measure hemodynamic signals while participants listened to the recorded audio. Healthy controls (HCs, [Formula: see text]) showed increased hemodynamic activation in the major language centers across EE stimulations, with stronger activation in Wernicke's area during the processing of negative emotional language. Compared to HCs, people with SZ ([Formula: see text]) exhibited smaller hemodynamic activation in the major language centers across EE stimulations. In addition, people with SZ showed weaker or insignificant hemodynamic deactivation in the medial prefrontal cortex. Notably, hemodynamic activation in SZ was found to be negatively correlated with the negative syndrome scale score at high EE. Our findings suggest that the neural mechanisms in SZ are altered and disrupted, especially during negative emotional language processing. This supports the feasibility of using the designed EE stimulations to assess people who are vulnerable to high-EE environments, such as SZ. Furthermore, our findings provide preliminary evidence for future research on functional neuroimaging biomarkers for people with psychiatric disorders.
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