Browsing by Author "Chou, Po-Han"

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Antidepressant efficacy and immune effects of bilateral theta burst stimulation monotherapy in major depression: A randomized, double-blind, sham-controlled study
(2020-08-01)
Chou, Po-Han
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Lu, Ming-Kuei
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Tsai, Chon-Haw
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Hsieh, Wan-Ting
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Lai, Hui-Chen
Antidepressants and risk of cataract development: A population-based, nested case-control study
(2017-06-01)
Chou, Po-Han
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Chu, Che-Sheng
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Chen, Yi-Huei
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Hsu, Min-Yen
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Huang, Min-Wei
Background: Previous studies demonstrated increased risk of cataract development among users of selective serotonin reuptake inhibitors (SSRIs). However, it remains unknown whether this risk also prevails with the use of other types of antidepressants. The aim of this study was to investigate whether use of antidepressants is associated with an increased risk of cataract development. Moreover, the relationship between binding affinities of serotonin transporter (SERT) of antidepressant and the risk of cataracts is examined. Methods: We conducted a nested case-control study using National Health Insurance Research Database in Taiwan. A total of 14,288 patients were included; 7651 in the cataract group and 6637 in the control group. Antidepressant exposure was categorized by type, duration of use, and binding affinities of SERT. The association between antidepressant exposure and cataract development was assessed using conditional logistic regression analysis. Results: The adjusted odds ratios (AORs) for developing cataracts among continuous users of SSRIs, serotonin norepinephrine reuptake inhibitors (SNRIs), and other antidepressants were 1.26 (95% confidence interval (CI): 1.12-1.41, p < 0.001), 1.21 (95% CI: 1.02-1.43, p=0.027), and 1.18 (95% CI: 1.04-1.34, p=0.009) respectively. Specifically, continuous uses of fluoxetine (AOR: 1.21; 95% CI: 1.01-1.46, p=0.042), fluvoxamine (AOR: 1.47; 95% CI: 1.01-2.12, p=0.043), venlafaxine (AOR: 1.44; 95% CI: 1.19-1.74, p < 0.001) significantly increased the risk of cataract development. Moreover, continuous users of antidepressants with intermediate SERT binding affinities (AOR: 1.68; 95% CI: 1.10-2.56, p=0.017) were significantly associated with increased risks of cataract development. Limitations: Several confounding factors such as obesity, multiple drug users, family history of cataracts, substance use, and environmental factors (such as sunlight or radiation exposure) were acquired. Conclusions: We found increased risk of cataract development in patients continuously using antidepressants. Regular ocular evaluations in these patients are warranted.
Association between antipsychotic drug use and cataracts in patients with bipolar disorder: A population-based, nested case-control study
(2017-02)
Chu, Che-Sheng
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Chou, Po-Han
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Chen, Yi-Huei
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Huang, Min-Wei
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Hsu, Min-Yen
Background: No previous study has focused on the association between use of antipsychotic drugs and the development of cataracts in patients with bipolar disorder (BD); hence, we aimed to examine this association in the present study. Methods: We conducted a retrospective nested case-control study using data from the National Health Insurance Database of Taiwan between 2000 and 2011. A. total of 3292 BD patients, 1684 with cataracts and 1608 controls matched for age, sex, and index date, were included. Antipsychotic drug exposure was categorized by type of drug and duration of use. A conditional logistic regression analysis was used to analyze the association. Results: Among BD patients, we found significantly reduced odds ratio (OR) of cataract development among past (adjusted OR (AOR), 0.74; 95% confidence interval (CI), 0.62-0.89; p=0.001) and continuous users (AOR, 0.71; 95% CI, 0.59-0.85; p < 0.001) of atypical antipsychotics. No association was found between the odds of cataract development and typical antipsychotics. Besides, concomitant use of antidepressants (AOR, 1.23; 95% CI, 1.06-1.43; p=0.007) and mood stabilizers (AOR, 1.23; 95% CI, 1.06-1.42; p=0.007) were associated with increased odds of cataract development. Limitations: Some important contributors to cataract development such as family history of cataract, smoking and alcohol exposure could not be measured from the claims data and this may confound the results. Conclusions: Reduced odds of cataract were found in patients with BD taking atypical antipsychotics. However, given that BD patients often have risk factors for developing cataract, regular ocular evaluations are recommended for those treated with antipsychotics drugs.
Associations between use of mood stabilizers and risk of cataract: A population-based nested case-control study
(2018-02-01)
Chu, Che-Sheng
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Lin, Ching-Heng
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Lan, Tsuo-Hung
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Chou, Po-Han
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光電工程學系
Background: The aim of this study was to investigate whether use of mood stabilizers (MS) is associated with an increased risk of cataract development. Methods: We conducted a nested case-control study using National Health Insurance Research Database in Taiwan. A total of 14,288 patients with bipolar disorder (BD) and schizophrenia were included; 7651 in the cataract group and 6637 in the control group. Based on overall cumulative period of MS (lithium, carbamazepine, valproate, and lamotrigine) treatment, we categorized into following groups: no use, and duration < 1 year, 1 to 2 years, and > 2 years. Conditional logistic regression analysis was used to explore the association between use of MS and risk of cataract development. Results: The risks for cataract development were significantly higher in patients using lithium alone and lithium combined with other MS for more than 2 years (adjusted odd ratio [AOR] = 1.39; 95% CI= 1.01-1.92, p = 0.043 and AOR = 1.44; 95% CI = 1.13-1.85, p = 0.003, respectively) than in non-users. Furthermore, the risks of cataract development increased in those treated with valproic acid combined with other MS (AOR = 1.26; 95% CI= 1.02-1.57, p = 0.035). Finally, no increased risks of cataract development were found in carbamazepine and lamotrigine users. Conclusions: We found increased risks of cataract development in long-term users of lithium, lithium combined with other MS and valproic acid combined with other MS for more than two years among patients with BD and schizophrenia.
Current-Aware Flash Scheduling for Current Capping in Solid State Disks
(2020-02-01)
Chang, Li-Pin
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Cheng, Chia-Hsiang
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Chang, Shu-Ting
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Chou, Po-Han
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資訊工程學系
Solid state disks (SSDs) employ internal parallelism to boost their input/output (I/O) performance, but a high degree of flash parallelism inevitably consumes a high level of current. To budget power or support multiple power sources, system software may force an SSD into a new power mode that has a specific current supply limit. This paper introduces a firmware approach to optimize SSD internal parallelism subject to a current supply limit. The proposed method involves two steps. First, we constructed current models of flash operations on the basis of real-world measurement results. Second, we designed a firmware scheduler to determine the actual starting time of each flash operation. The proposed scheduler accounted for flash aging, process variation, and internal resource contention, and it avoided any current cap violation by checking a few time points instead of every unit of time. Our experimental results indicated that the proposed approach outperformed existing methods with respect to I/O response time and throughput under realistic workloads.
Estimating the survival of elderly patients diagnosed with dementia in Taiwan: A longitudinal study
(2018-07-25)
Lee, Kwo-Chen
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Hsu, Wen-Hsuan
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Chou, Po-Han
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Yiin, Jia-Jean
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Muo, Chih-Hsin
Background Dementia is characterized by prolonged progressive disability. Therefore, predicting mortality is difficult. An accurate prediction tool may be useful to ensure that end-of-life patients with dementia receive timely palliative care. Purpose This study aims to establish a survival prediction model for elderly patients with dementia in Taiwan. Methods Data from the 2001 to 2010 National Health Insurance Research Database in Taiwan were used to identify 37,289 patients with dementia aged >= 65 years for inclusion in this retrospective longitudinal study. Moreover, this study examined the mortality indicators for dementia among demographic characteristics, chronic physical comorbidities, and medical procedures. A Cox proportional hazards model with time-dependent covariates was used to estimate mortality risk, and risk score functions were formulated using a point system to establish a survival prediction model. The prediction model was then tested using the area under the receiver operating characteristic curve. Results Thirteen mortality risk factors were identified: age, sex, stroke, chronic renal failure, liver cirrhosis, cancer, pressure injury, and retrospectively retrieved factors occurring in the 6 months before death, including nasogastric tube placement, supplemental oxygen supply, >= 2 hospitalization, receiving >= 1 emergency services, >= 2 occurrences of cardiopulmonary resuscitation, and receiving >= 2 endotracheal intubations. The area under the receiver operating characteristic curves for this prediction model for mortality at 6 and 12 months were 0.726 and 0.733, respectively. Conclusions The survival prediction model demonstrated moderate accuracy for predicting mortality at 6 and 12 months before death in elderly patients with dementia. This tool may be valuable for helping health care providers and family caregivers to make end-of-life care decisions.
Functional Connectivity During Phonemic and Semantic Verbal Fluency Test: A Multichannel Near Infrared Spectroscopy Study
(2016-05-06)
Huang, Chun-Jung
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Chou, Po-Han
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Wei, Hao-Lin
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Sun, Chia-Wei
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光電工程學系
Verbal fluency tests (VFTs) are widely used frontal lobe neuropsychological tests. They have been frequently used in various functional brain mapping studies. There are two versions of VFTs based on the type of cue: the letter fluency task (LFT) and the category fluency task (CFT). However, the fundamental aspects of brain connectivity across the frontotemporal regions during the VFTs have not been elucidated. In this study, we hypothesized that differences in cortical functional connectivity over the left and right frontotemporal regions may be observed by means of multi-channel functional near-infrared spectroscopy (fNIRS) during the performance of LFT and CFT. Our results from fNIRS (ETG-4000) showed different patterns of brain functional connectivity during the two types of VFTs, which was consistent with the different cognitive requirements of each task. We demonstrate increased brain functional connectivity over the frontal and temporal regions during the LFT than during the CFT; these results are in line with previous brain activity studies using fNIRS to demonstrate higher frontal and temporal region activation during LFT and CFT, with more pronounced frontal activation by the LFT.
"Functional Connectivity During Phonemic and Semantic Verbal Fluency Test: A Multichannel Near Infrared Spectroscopy Study" (vol 22, pg 43, 2016)
(2019-11-01)
Huang, Chun-Jung
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Chou, Po-Han
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Lin, Wei-Hao
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Sun, Chia-Wei
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交大名義發表
Increased prevalence and risk of anxiety disorders in adults with tinnitus: A population-based study in Taiwan
(2018-01-01)
Lin, Ching-En
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Chen, Li-Fen
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Chou, Po-Han
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Chung, Chi-Hsiang
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生物科技學系
Objective: Tinnitus is a common disorder that may cause psychological distress and anxiety. The aim of this study was to investigate the association between anxiety disorders (ADs) and tinnitus in a large population. Method: We conducted a cross-sectional study using the National Health Insurance Research Database in Taiwan. Study subjects included 14,772 patients with tinnitus and 709,963 people in the general population who sought treatment in 2005. Distributions in ADs, age, sex, and medical comorbidities were compared between groups using chi-squared tests. Multivariate logistic regression models adjusted for age, sex, and medical comorbidities were used to analyze the association between tinnitus and ADs. Results: Prevalence of ADs in tinnitus and general population groups was 3.9% and 1.5%, respectively, and this difference was significant (P < 0.001). Diabetes mellitus, hypertension, hyperlipidemia, concussion or head injury, Meniere's disease, sensorineural hearing impairment, renal disease, coronary artery disease, and cerebrovascular disease were significantly more prevalent in the tinnitus group (all P-values < 0.001). Multivariate logistic regression model demonstrated that patients with tinnitus were significantly associated with increased risk of ADs (adjusted OR = 1.99; 95% CI = 1.81-2.19; P < 0.001). Conclusion: Because the risk of ADs was significantly higher in patients with tinnitus than in the general population, physicians should be aware of the importance of psychological factors in tinnitus management.
Perceived Occupational Stress is associated with Decreased Cortical Activity of the Prefrontal Cortex: A Multichannel Near-infrared Spectroscopy Study
(2016-12-13)
Chou, Po-Han
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Lin, Wei-Hao
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Hung, Chao-An
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Chang, Chiung-Chih
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Li, Wan-Rung
Despite an increasing number of reports on the associations between chronic occupational stress and structural and functional changes of the brain, the underlying neural correlates of perceived occupational stress is still not clear. Perceived stress reflects the extents to which situations are appraised as stressful at a given point in one's life. Using near-infrared spectroscopy, we investigated the associations between perceived occupational stress and cortical activity over the bilateral frontotemporal regions during a verbal fluency test. Sixty-eight participants (17 men, 51 women), 20-62 years of age were recruited. Perceived occupational stress was measured using the Chinese version of Job Content Questionnaire, and the Chinese version of the Copenhagen Burnout Inventory. We found statistically significant negative associations between occupational burnout and brain cortical activity over the fronto-polar and dorsolateral prefrontal cortex during the VFT (r = -0.343 to -0.464). In conclusion, our research demonstrated a possible neural basis of perceived occupational stress that are distributed across the prefrontal cortex.
Reduced frontal activity during a verbal fluency test in fibromyalgia: A near-infrared spectroscopy study
(2018-04-01)
Chou, Po-Han
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Tang, Kuo-Tung
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Chen, Yi-Hsing
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Sun, Chia-Wei
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Huang, Chih-Mao
Fibromyalgia (FM) is a complex disorder characterized by widespread chronic pain and associated sleep problems and cognitive dysfunction. However, only few studies focusing on cognitive dysfunction in FM are available so far. In the present study, we aimed to use near infrared spectroscopy (NIRS) to evaluate the brain function in FM patients subjected to a verbal fluency test (VFT). A total of 11 primary FM patients and 13 healthy individuals (HC) underwent NIRS while performing a VFT. The Fibromyalgia Impact Questionnaire (FIQ) was used to evaluate the symptom severity of FM and Beck Depression Inventory II (BDI) was used to evaluate the severities depression symptoms in study participants. Five regions of interests (ROIs) were defined: the frontal-, bilateral inferior frontal gyrus (IFG), and temporal regions. Brain activities of ROIs between the two groups were compared. In addition, we investigated the relationship between clinical symptoms and brain cortical activity in FM patients. Our results showed that there were no significant differences between HC and FM patients in age, sex, and BDI scores. We found significantly reduced brain activity over the frontal regions during a VFT in FM patients (p =.026). In addition, we found decreased frontal activity was associated with BDI scores (rho = -0.755, p =.007). Furthermore, there were no significant correlations between frontal activity and FIQ subscales. In conclusion, our study demonstrated a reduced frontal cortical activity during VET in FM patients, and that NIRS could be a potential tool for evaluating brain function in FM patients in clinical settings. (C) 2018 Elsevier Ltd. All rights reserved.
Reduced language lateralization in first episode schizophrenia: A near infrared spectroscopy study
(2017-08-01)
Chou, Po-Han
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Lin, Wei-Hao
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Li, Wang-Rung
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Huang, Chih-Mao
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Sun, Chia-Wei
Background: Diminished functional lateralization in language-related areas is found in chronic schizophrenia (SZ). However, whether this reduced lateralization exists at the early stage of SZ remains unclear. The present study aimed to investigate language lateralization in first episode schizophrenia (FES) using near infrared spectroscopy (NIBS) during a letter version of verbal fluency test (VFT). Methods: A total of 28 FES patients and 33 healthy controls (HCs) underwent NIBS while performing a VFT. Six regions of interests (ROIs) were defined: the bilateral frontal-, inferior frontal gyrus (IFG), and temporal regions. Laterality index (LI) was calculated and compared between the two groups in ROIs. In addition, we investigated whether language lateralization was correlated with severity of clinical symptoms. Results: Across all ROIs, LI was significantly reduced in FES patients (p = 0.037) compared to controls in the IFG region. In addition, LI was not found to be correlated with VFT performance, the PANSS positive, negative or general psychopathology subscales. Conclusions: Our study demonstrated a diminution of leftward functional lateralization in the IFG during a VFT in FES patients. This is the first NIBS study to report reduced functional lateralization in patients at the early stage of schizophrenia.
Risk of incident hypertension, diabetes, and dyslipidemia after first posttraumatic stress disorder diagnosis: A nationwide cohort study in Taiwan
(2019-05-01)
Lin, Ching-En
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Chung, Chi-Hsiang
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Chen, Li-Fen
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You, Ching-Hui
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Chien, Wu-Chien
The Impact of Antidepressants on the Risk of Developing Obstructive Sleep Apnea in Posttraumatic Stress Disorder: A Nationwide Cohort Study in Taiwan
(2019-09-15)
Lin, Ching-En
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Chung, Chi-Hsiang
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Chen, Li-Fen
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Chien, Wu-Chien
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Chou, Po-Han
Study Objectives: The association between posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) has been reported inconsistently, and the association between antidepressant use and the risk of developing OSA in patients with PTSD has not been previously studied. Therefore, we used the Longitudinal National Health Insurance Database (LHID) to investigate the impact of PTSD and antidepressant use on the risk of OSA development. Methods: Identified from the LHID, 2,316 individuals aged >= 18 years with PTSD, but with no history of OSA, and 23,160 control individuals matched forage, sex, obesity and index date were enrolled between 2000 and 2015 and followed up until the end of 2015 to identify the development of OSA. A two-tailed Bonferroni-corrected P < .00038 (.05/13) was considered statistically significant as we examined 13 antidepressants. Results: Individuals with PTSD had increased risk of developing OSA (adjusted hazard ratio 4.672, 95% confidence interval 2.246-9.787, P < .001) after adjusting for demographic data, medical comorbidities, and medication. Treatment with antidepressants was not significantly associated with an increased risk of developing OSA compared to no antidepressant treatment. Conclusions: Asian patients with PTSD had increased risk of developing OSA, and treatment with antidepressants did not play a key role in increasing the risk of OSA development. Further studies are required to investigate the underlying mechanisms of PTSD and the roles of antidepressants on the risk of developing OSA.
The Potential Role of Functional Near-Infrared Spectroscopy as Clinical Biomarkers in Schizophrenia
(2020-01-01)
Chou, Po-Han
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Huang, Chun-Jun
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Sun, Chia-Wei
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交大名義發表
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生物科技學系
Functional near-infrared spectroscopy (fNIRS) is a recently developed technique that can measure hemoglobin changes in the cerebral cortex, and fNIRS-based research in psychiatry has been progressing rapidly. fNIRS is advantageous in its noninvasiveness, ease of administration, tolerance of small movements, inexpensiveness, strong signal correlations with fMRI signals, and in providing imaging with excellent time resolution and moderate spatial resolution. However, fNIRS has several disadvantages, such as low spatial resolution and shallower measurements in brain regions compared with other functional neuroimaging techniques (e.g. functional magnetic resonance imaging and positron emission tomography). Therefore, fNIRS may be a candidate instrument for clinical use in psychiatry, as it can measure brain activity in a clinical setting. Moreover, previous studies have demonstrated that altered brain activity in the prefrontal cortex is associated with clinical symptoms and functional outcomes in patients with schizophrenia, suggesting that fNIRS could be used as a potential biomarker. Future studies aimed at exploring fNIRS differences in different clinical stages, longitudinal changes, medication effects, variations during different cognitive task paradigms, cross-cultural comparisons, and applying more delicate statistical analytic methodologies are warranted to develop more accurate biomarkers that can be applied in clinical practice for differential diagnosis, monitoring symptoms, predicting functional outcomes, and the personalized decision regarding treatment options in patients with schizophrenia.
Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study
(2016-09-09)
Chu, Che-Sheng
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Chou, Po-Han
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Lin, Ching-Heng
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Cheng, Chin
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Tsai, Chia-Jui
Background Previous research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI). Methods A retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009. A total of 527 OCD patients with 412 subjects in the SSRI use group and 115 in the non SSRI use group were included. Multivariable Cox proportional-hazards models were used to explore the associations between SSRI use and the occurrence of stroke, controlling for age, gender, concomitant medications, and comorbid medical illnesses. Results A total of nineteen OCD patients were diagnosed with new onset of stroke during the follow-up period including six cases in the SSRI group and thirteen in the non SSRI use group. SSRI use was demonstrated to be associated with a decreased risk of stroke (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.10-0.86, P = 0.02). The increase in age-related risk of strokes was 2.55 per decade (HR = 2.55; 95% CI = 1.74-3.75, P<0.001). Alternatively, sex, concomitant use of aspirin and non-steroidal anti-inflammatorydrugs, and comorbidities with angina pectoris, diabetes mellitus, hypertension, and hyperlipidemia were not found to be associated with an increased risk for stroke in OCD patients. Conclusions Our study showed that SSRI use was associated with decreased risk of stroke in OCD patients. Further investigation into the possible biological mechanisms underlying the relationship between stroke and SSRI use in OCD patients is warranted.