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Punturieri C, Duncan WC, Greenstein D, Shandler G, Zarate CA, Evans JW. An exploration of actigraphy in the context of ketamine and treatment-resistant depression. Int J Methods Psychiatr Res 2023; 33:e1984. [PMID: 37668277 PMCID: PMC10804352 DOI: 10.1002/mpr.1984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/06/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVES This study explored the potential of non-parametric and complexity analysis metrics to detect changes in activity post-ketamine and their association with depressive symptomatology. METHODS Individuals with treatment-resistant depression (TRD: n = 27, 16F, 35.9 ± 10.8 years) and healthy volunteers (HVs: n = 9, 4F, 36.4 ± 9.59 years) had their activity monitored during an inpatient, double-blind, crossover study where they received an infusion of ketamine or saline placebo. All participants were 18-65 years old, medication-free, and had a MADRS score ≥20. Non-parametric metrics averaged over each study day, metrics derived from complexity analysis, and traditionally calculated non-parametric metrics averaged over two weeks were calculated from the actigraphy time series. A separate analysis was conducted for a subsample (n = 17) to assess the utility of these metrics in a hospital setting. RESULTS In HVs, lower intradaily variability was observed within daily rest/activity patterns post-ketamine versus post-placebo (F = 5.16(1,15), p = 0.04). No other significant effects of drug or drug-by-time or correlations between depressive symptomatology and activity were detected. CONCLUSIONS Weak associations between non-parametric variables and ketamine were found but were not consistent across actigraphy measures. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT00088699.
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Affiliation(s)
- Claire Punturieri
- Experimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthNational Institutes of HealthBethesdaMarylandUSA
| | - Wallace C. Duncan
- Experimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthNational Institutes of HealthBethesdaMarylandUSA
| | - Dede Greenstein
- Experimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthNational Institutes of HealthBethesdaMarylandUSA
| | - Gavi Shandler
- Experimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthNational Institutes of HealthBethesdaMarylandUSA
| | - Carlos A. Zarate
- Experimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthNational Institutes of HealthBethesdaMarylandUSA
| | - Jennifer W. Evans
- Experimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthNational Institutes of HealthBethesdaMarylandUSA
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Wüthrich F, Nabb CB, Mittal VA, Shankman SA, Walther S. Actigraphically measured psychomotor slowing in depression: systematic review and meta-analysis. Psychol Med 2022; 52:1208-1221. [PMID: 35550677 PMCID: PMC9875557 DOI: 10.1017/s0033291722000903] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Psychomotor slowing is a key feature of depressive disorders. Despite its great clinical importance, the pathophysiology and prevalence across different diagnoses and mood states are still poorly understood. Actigraphy allows unbiased, objective, and naturalistic assessment of physical activity as a marker of psychomotor slowing. Yet, the true effect-sizes remain unclear as recent, large systematic reviews are missing. We conducted a novel meta-analysis on actigraphically measured slowing in depression with strict inclusion and exclusion criteria for diagnosis ascertainment and sample duplications. Medline/PubMed and Web-of-Science were searched with terms combining mood-keywords and actigraphy-keywords until September 2021. Original research measuring actigraphy for ⩾24 h in at least two groups of depressed, remitted, or healthy participants and applying operationalized diagnosis was included. Studies in somatically ill patients, N < 10 participants/group, and studies using consumer-devices were excluded. Activity-levels between groups were compared using random-effects models with standardized-mean-differences and several moderators were examined. In total, 34 studies (n = 1804 patients) were included. Patients had lower activity than controls [standardized mean difference (s.m.d.) = -0.78, 95% confidence interval (CI) -0.99 to -0.57]. Compared to controls, patients with unipolar and bipolar disorder had lower activity than controls whether in depressed (unipolar: s.m.d. = -0.82, 95% CI -1.07 to -0.56; bipolar: s.m.d. = -0.94, 95% CI -1.41 to -0.46), or remitted/euthymic mood (unipolar: s.m.d. = -0.28, 95% CI -0.56 to 0.0; bipolar: s.m.d. = -0.92, 95% CI -1.36 to -0.47). None of the examined moderators had any significant effect. To date, this is the largest meta-analysis on actigraphically measured slowing in mood disorders. They are associated with lower activity, even in the remitted/euthymic mood-state. Studying objective motor behavior via actigraphy holds promise for informing screening and staging of affective disorders.
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Affiliation(s)
- Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carver B Nabb
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Vijay A Mittal
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston/Chicago, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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3
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Does Time of Day influence postural control and gait? A review of the literature. Gait Posture 2022; 92:153-166. [PMID: 34836768 DOI: 10.1016/j.gaitpost.2021.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/13/2021] [Accepted: 10/17/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Like many physiologic processes, Time of Day may influence postural control and gait. A better understanding of diurnal variations in postural control and gait may help to improve diagnoses, reduce falls, and optimize rehabilitation and training routines. This review summarizes the current literature that addresses these questions. RESEARCH QUESTION Does time of day affect postural control and gait? METHODS We searched PubMed, Google Scholar, and IEEE using a combination of keyword and MeSH terms. We included papers that studied human subjects and assessed gait or postural control as a function of time of day. We evaluated the quality of the identified papers based on nine assessment criteria and analyzed them considering the topic (postural control or gait), age, and characteristics of the conducted assessments. We then quantitatively synthesized the results across studies using a meta-analytical approach (i.e., Hedges' g model). RESULTS Twenty-two papers considered the relationship between time of day and postural control, and eleven considered the relationship between time of day and gait. Six studies found that postural control was best in the morning, four described postural control being best in the afternoon, four described optimal postural control in the evening, and eight reported no time of day effect. Two studies found gait best in the morning, five described gait best in the afternoon, two described optimal gait in the evening, and two reported no time of day effect. The results of the quantitative analysis suggest that both postural control and gait were best in the evening. SIGNIFICANCE While there is no clear consensus on whether there is a time of day effect for postural control and gait, the findings of this review provide initial evidence suggesting that a small but statistically significant effect exists in favor of the evening. Standardized testing, including repeated and continuous evaluations, may help provide more definitive information on time of day influences on postural control and gait.
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Damme KS, Park JS, Vargas T, Walther S, Shankman SA, Mittal VA. Motor abnormalities, depression risk, and clinical course in adolescence. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 2:61-69. [PMID: 35419552 PMCID: PMC9000199 DOI: 10.1016/j.bpsgos.2021.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 02/02/2023] Open
Abstract
Background Motor abnormalities, such as psychomotor agitation and retardation, are widely recognized as core features of depression. However, it is not currently known if motor abnormalities connote risk for depression. Methods Using data from the Adolescent Brain Cognitive Development (ABCD) Study, a nationally representative sample of youth (n=10,835, 9-11 years old), the present paper examines whether motor abnormalities are associated with (a) depression symptoms in early adolescence, (b) familial risk for depression (familial risk loading), and (c) future depression symptoms. Motor abnormalities measures included traditional (DSM) motor signs such as psychomotor agitation and retardation as well as other motor domains such as developmental motor delays and dyscoordination. Results Traditional motor abnormalities were less prevalent (agitation=3.2%, retardation=0.3%) than non-traditional domains (delays=13.79%, coordination=35.5%) among adolescents. Motor dysfunction was associated with depression symptoms (Cohen's ds=0.02 to 0.12). Familial risk for depression was related to motor abnormalities (Cohen's ds=0.08 to 0.27), with the exception of motor retardation. Family vulnerability varied in sensitivity to depression risk (e.g., retardation: .53%; dyscoordination: 32.05%). Baseline endorsement of motor abnormalities predicted future depression symptoms at one-year follow-up. Conclusions These findings suggest that motor signs reflect a novel, promising future direction for examining vulnerability to depression risk in early adolescence.
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Affiliation(s)
- Katherine S.F. Damme
- Department of Psychology, Northwestern University, Evanston, Illinois
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston and Chicago, Illinois
| | - Jadyn S. Park
- Department of Psychology, Northwestern University, Evanston, Illinois
- Department of Psychiatry, Northwestern University, Chicago, Illinois
| | - Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, Illinois
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston and Chicago, Illinois
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Stewart A. Shankman
- Department of Psychology, Northwestern University, Evanston, Illinois
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston and Chicago, Illinois
- Department of Psychiatry, Northwestern University, Chicago, Illinois
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Evanston, Illinois
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston and Chicago, Illinois
- Medical Social Sciences, Northwestern University, Chicago, Illinois
- Institute for Policy Research, Northwestern University, Chicago, Illinois
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Adolph D, Tschacher W, Niemeyer H, Michalak J. Gait Patterns and Mood in Everyday Life: A Comparison Between Depressed Patients and Non-depressed Controls. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10215-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Background
Previous laboratory findings suggest deviant gait characteristics in depressed individuals (i.e., reduced walking speed and vertical up-and-down movements, larger lateral swaying movements, slumped posture). However, since most studies to date assessed gait in the laboratory, it is largely an open question whether this association also holds in more naturalistic, everyday life settings. Thus, within the current study we (1) aimed at replicating these results in an everyday life and (2) investigated whether gait characteristics could predict change in current mood.
Methods
We recruited a sample of patients (n = 35) suffering from major depressive disorder and a sample of age and gender matched non-depressed controls (n = 36). During a 2-day assessment we continuously recorded gait patterns, general movement intensity and repetitively assessed the participant’s current mood.
Results
We replicated previous laboratory results and found that patients as compared to non-depressed controls showed reduced walking speed and reduced vertical up-and-down movements, as well as a slumped posture during everyday life episodes of walking. Moreover, independent of clinical diagnoses, higher walking speed, and more vertical up-and-down movements significantly predicted more subsequent positive mood, while changes in mood did not predict subsequent changes in gait patterns.
Conclusion
In sum, our results support expectations that embodiment (i.e., the relationship between bodily expression of emotion and emotion processing itself) in depression is also observable in naturalistic settings, and that depression is bodily manifested in the way people walk. The data further suggest that motor displays affect mood in everyday life.
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Minaeva O, Riese H, Lamers F, Antypa N, Wichers M, Booij SH. Screening for Depression in Daily Life: Development and External Validation of a Prediction Model Based on Actigraphy and Experience Sampling Method. J Med Internet Res 2020; 22:e22634. [PMID: 33258783 PMCID: PMC7894744 DOI: 10.2196/22634] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/13/2020] [Accepted: 10/26/2020] [Indexed: 12/28/2022] Open
Abstract
Background In many countries, depressed individuals often first visit primary care settings for consultation, but a considerable number of clinically depressed patients remain unidentified. Introducing additional screening tools may facilitate the diagnostic process. Objective This study aimed to examine whether experience sampling method (ESM)-based measures of depressive affect and behaviors can discriminate depressed from nondepressed individuals. In addition, the added value of actigraphy-based measures was examined. Methods We used data from 2 samples to develop and validate prediction models. The development data set included 14 days of ESM and continuous actigraphy of currently depressed (n=43) and nondepressed individuals (n=82). The validation data set included 30 days of ESM and continuous actigraphy of currently depressed (n=27) and nondepressed individuals (n=27). Backward stepwise logistic regression analysis was applied to build the prediction models. Performance of the models was assessed with goodness-of-fit indices, calibration curves, and discriminative ability (area under the receiver operating characteristic curve [AUC]). Results In the development data set, the discriminative ability was good for the actigraphy model (AUC=0.790) and excellent for both the ESM (AUC=0.991) and the combined-domains model (AUC=0.993). In the validation data set, the discriminative ability was reasonable for the actigraphy model (AUC=0.648) and excellent for both the ESM (AUC=0.891) and the combined-domains model (AUC=0.892). Conclusions ESM is a good diagnostic predictor and is easy to calculate, and it therefore holds promise for implementation in clinical practice. Actigraphy shows no added value to ESM as a diagnostic predictor but might still be useful when ESM use is restricted.
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Affiliation(s)
- Olga Minaeva
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Harriëtte Riese
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Niki Antypa
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Marieke Wichers
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sanne H Booij
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Developmental Psychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands.,Center for Integrative Psychiatry, Lentis, Groningen, Netherlands
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7
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Reichert M, Braun U, Gan G, Reinhard I, Giurgiu M, Ma R, Zang Z, Hennig O, Koch ED, Wieland L, Schweiger J, Inta D, Hoell A, Akdeniz C, Zipf A, Ebner-Priemer UW, Tost H, Meyer-Lindenberg A. A neural mechanism for affective well-being: Subgenual cingulate cortex mediates real-life effects of nonexercise activity on energy. SCIENCE ADVANCES 2020; 6:6/45/eaaz8934. [PMID: 33158875 PMCID: PMC7673710 DOI: 10.1126/sciadv.aaz8934] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 09/24/2020] [Indexed: 05/02/2023]
Abstract
Physical activity substantially improves well-being and mental health, but the underlying brain processes remain unclear. Most research concerns exercise, although the majority of everyday human behaviors, such as walking or stair climbing, are nonexercise activities. Combining neuroimaging with ecological assessment of activity and GPS-triggered smartphone diaries, we show a specific association of nonexercise activity with energy in two independent samples mediated by the subgenual part of the anterior cingulate cortex (sgACC), a key emotion regulatory site. Furthermore, energy predicted a range of mental health metrics. sgACC volume moderated humans' emotional gain from nonexercise activity in real life: Individuals with low sgACC volume, a risk factor for depression, felt less energized when inactive but benefited more from periods of high nonexercise activity. This suggests an everyday life mechanism affecting affective well-being in the general population and, if substantiated in patient samples, a risk and resilience process for mood disorders.
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Affiliation(s)
- Markus Reichert
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany.
- Mental mHealth Lab, Chair of Applied Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Baden-Wuerttemberg, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Gabriela Gan
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Iris Reinhard
- Division of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Marco Giurgiu
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
- Mental mHealth Lab, Chair of Applied Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Baden-Wuerttemberg, Germany
| | - Ren Ma
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Zhenxiang Zang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Oliver Hennig
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Elena D Koch
- Mental mHealth Lab, Chair of Applied Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Baden-Wuerttemberg, Germany
| | - Lena Wieland
- Mental mHealth Lab, Chair of Applied Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Baden-Wuerttemberg, Germany
| | - Janina Schweiger
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Dragos Inta
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Andreas Hoell
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Ceren Akdeniz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Alexander Zipf
- Institute of Geography, GIScience Research Group, Heidelberg University, Heidelberg, Baden-Wuerttemberg, Germany
| | - Ulrich W Ebner-Priemer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
- Mental mHealth Lab, Chair of Applied Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Baden-Wuerttemberg, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany
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Actigraphic recording of motor activity in depressed inpatients: a novel computational approach to prediction of clinical course and hospital discharge. Sci Rep 2020; 10:17286. [PMID: 33057207 PMCID: PMC7560898 DOI: 10.1038/s41598-020-74425-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 09/30/2020] [Indexed: 01/10/2023] Open
Abstract
Depressed patients present with motor activity abnormalities, which can be easily recorded using actigraphy. The extent to which actigraphically recorded motor activity may predict inpatient clinical course and hospital discharge remains unknown. Participants were recruited from the acute psychiatric inpatient ward at Hospital Rey Juan Carlos (Madrid, Spain). They wore miniature wrist wireless inertial sensors (actigraphs) throughout the admission. We modeled activity levels against the normalized length of admission-'Progress Towards Discharge' (PTD)-using a Hierarchical Generalized Linear Regression Model. The estimated date of hospital discharge based on early measures of motor activity and the actual hospital discharge date were compared by a Hierarchical Gaussian Process model. Twenty-three depressed patients (14 females, age: 50.17 ± 12.72 years) were recruited. Activity levels increased during the admission (mean slope of the linear function: 0.12 ± 0.13). For n = 18 inpatients (78.26%) hospitalised for at least 7 days, the mean error of Prediction of Hospital Discharge Date at day 7 was 0.231 ± 22.98 days (95% CI 14.222-14.684). These n = 18 patients were predicted to need, on average, 7 more days in hospital (for a total length of stay of 14 days) (PTD = 0.53). Motor activity increased during the admission in this sample of depressed patients and early patterns of actigraphically recorded activity allowed for accurate prediction of hospital discharge date.
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9
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Abstract
Major depressive disorder (MDD) is a serious public health problem that has, at best, modest treatment response—potentially due to its heterogeneous clinical presentation. One way to parse the heterogeneity is to investigate the role of particular features of MDD, an endeavor that can also help identify novel and focal targets for treatment and prevention efforts. Our R01 focuses on the feature of psychomotor disturbance (e.g., psychomotor agitation (PmA) and retardation (PmR)), a particularly pernicious feature of MDD, that has not been examined extensively in MDD. Aim 1 is comparing three groups of individuals—those with current MDD (n = 100), remitted MDD (n = 100), and controls (n = 50)—on multiple measures of PmR and PmA (assessed both in the lab and in the subjects’ natural environment). Aim 2 is examining the structural (diffusion MRI) and functional (resting state fMRI) connectivity of motor circuitry of the three groups as well as the relation between motor circuitry and the proposed indicators of PmR and PmA. Aim 3 is following up with subjects three times over 18 months to evaluate whether motor symptoms change in tandem with overall depressive symptoms and functioning over time and/or whether baseline PmR/PmA predicts course of depression and functioning. Aim 3 is particularly clinically significant. Finding that motor functioning and overall depression severity co-vary over time, or that motor variables predict subsequent change in overall depression severity, would support the potential clinical utility of these novel, reliable, and easily administered motor assessments.
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Canazei M, Turiaux J, Huber SE, Marksteiner J, Papousek I, Weiss EM. Actigraphy for Assessing Light Effects on Sleep and Circadian Activity Rhythm in Alzheimer's Dementia: A Narrative Review. Curr Alzheimer Res 2020; 16:1084-1107. [DOI: 10.2174/1567205016666191010124011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 08/10/2019] [Accepted: 09/08/2019] [Indexed: 12/18/2022]
Abstract
Background:
Alzheimer's Disease (AD) is often accompanied by severe sleep problems and
circadian rhythm disturbances which may to some extent be attributed to a dysfunction in the biological
clock. The 24-h light/dark cycle is the strongest Zeitgeber for the biological clock. People with AD,
however, often live in environments with inappropriate photic Zeitgebers. Timed bright light exposure
may help to consolidate sleep- and circadian rest/activity rhythm problems in AD, and may be a low-risk
alternative to pharmacological treatment.
Objective & Method:
In the present review, experts from several research disciplines summarized the
results of twenty-seven light intervention studies which used wrist actigraphy to measure sleep and circadian
activity in AD patients.
Results:
Taken together, the findings remain inconclusive with regard to beneficial light effects. However,
the considered studies varied substantially with respect to the utilized light intervention, study design,
and usage of actigraphy. The paper provides a comprehensive critical discussion of these issues.
Conclusion:
Fusing knowledge across complementary research disciplines has the potential to critically
advance our understanding of the biological input of light on health and may contribute to architectural
lighting designs in hospitals, as well as our homes and work environments.
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Affiliation(s)
- Markus Canazei
- Research Department, Bartenbach LichtLabor GmbH Ringgold Standard Institution, Bartenbach GmbH, Rinnerstrasse 14, Aldrans 6071, Austria
| | - Julian Turiaux
- Department of Psychology, University of Graz, Graz, Austria
| | - Stefan E. Huber
- Institute of Ion Physics and Applied Physics, University of Innsbruck, Innsbruck, Tirol, Austria
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy A, General Hospital, Milserstrasse 10 , Hall Tirol 6060, Austria
| | - Ilona Papousek
- Department of Psychology, University of Graz, Graz, Austria
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Foo JC, Sirignano L, Trautmann N, Kim J, Witt SH, Streit F, Frank J, Zillich L, Meyer-Lindenberg A, Ebner-Priemer U, Schilling C, Schredl M, Yamamoto Y, Gilles M, Deuschle M, Rietschel M. Association of Locomotor Activity During Sleep Deprivation Treatment With Response. Front Psychiatry 2020; 11:688. [PMID: 32792995 PMCID: PMC7385277 DOI: 10.3389/fpsyt.2020.00688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/30/2020] [Indexed: 11/13/2022] Open
Abstract
Disrupted circadian rhythms and sleep patterns are frequently observed features of psychiatric disorders, and especially mood disorders. Sleep deprivation treatment (SD) exerts rapid but transient antidepressant effects in depressed patients and has gained recognition as a model to study quick-acting antidepressant effects. It is of interest how locomotor activity patterns during SD might be associated with and potentially predict treatment response. The present study is an analysis of locomotor activity data, previously collected over a 24 h period, to examine the night of SD (Trautmann et al. 2018) as mood disorder patients suffering from a depressive episode (n = 78; after exclusions n = 59) underwent SD. In this exploratory analysis, the associations between response to SD, locomotor activity, and subjective mood during the 24 h period of SD were explored. Higher levels of activity overall were observed in non-responders (n = 18); in particular, non-responders moved more during the evening of SD until midnight and remained high thereafter. In contrast, activity in responders (n = 41) decreased during the evening and increased in the morning. Subjective mood was not found to be associated with locomotor activity. The window of data available in this analysis being limited, additional data from before and after the intervention are required to fully characterize the results observed. The present results hint at the possible utility of locomotor activity as a predictor and early indicator of treatment response, and suggest that the relationship between SD and locomotor activity patterns should be further investigated.
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Affiliation(s)
- Jerome Clifford Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Nina Trautmann
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jinhyuk Kim
- Department of Informatics, Graduate School of Integrated Science and Technology, Shizuoka University, Shizuoka, Japan
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ulrich Ebner-Priemer
- Department of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Claudia Schilling
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Schredl
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Yoshiharu Yamamoto
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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12
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Reichert M, Kapteinat I, Lauvai I, Hennig O, Reinhard I, Braun U, Limberger MF, Ebner-Priemer UW. Erste Schritte zu Smartphone-basierten Sportinterventionen im Alltag? ZEITSCHRIFT FUR SPORTPSYCHOLOGIE 2018. [DOI: 10.1026/1612-5010/a000243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Digitalisierung ermöglicht die vielversprechende Integration von Gesundheitsinterventionen in unseren Alltag, u.a. auf Smartphones, und bietet Chancen zur Implementierung von Bewegungsinterventionen, von denen auch insbesondere psychisch Erkrankte profitieren können. Allerdings ist die Kluft zwischen technisch bereits Umsetzbarem und Wissen um Wirkungen im Alltag groß. Beispielsweise wurde gezeigt, dass Sport generell Depressionssymptomen entgegenwirkt. Der spezifische Einfluss von Sportinterventionen auf die Alltags-Stimmung – einem der drei von Depressionen betroffenen Kernbereiche – ist jedoch unzureichend erforscht. Um diesen spezifischen Effekt zu untersuchen und den Weg zu evidenzbasierten Smartphoneinterventionen zu ebnen, statteten wir 15 depressive Personen jeweils drei Tage vor und nach einer zehnwöchigen Sportintervention mit Smartphone-Tagebüchern aus. Die Probanden beantworteten 83.6% aller Stimmungsabfragen. Signifikante Cross-Level-Interaktionen in Mehrebenen-Analysen bestätigten, dass Personen, die zu Interventionsbeginn weniger Sport trieben, größere Stimmungsverbesserungen nach der Intervention zeigten (Gute-Schlechte-Stimmung: b = 5.8; Ruhe-Unruhe: b = 5.3). Diese Pilotergebnisse sollen helfen, den vielversprechenden Weg zu evidenzbasierten sportpsychologischen Interventionen auf dem Smartphone zu ebnen.
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Affiliation(s)
- Markus Reichert
- Mental mHealth Lab, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
| | - Inga Kapteinat
- Mental mHealth Lab, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie
| | - Isaia Lauvai
- Mental mHealth Lab, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie
| | - Oliver Hennig
- Mental mHealth Lab, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie
| | - Iris Reinhard
- Abteilung für Biostatistik, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
| | - Urs Braun
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
| | - Matthias F. Limberger
- Mental mHealth Lab, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie
| | - Ulrich W. Ebner-Priemer
- Mental mHealth Lab, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie
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13
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Jiang J, Peng Y, Liang X, Li S, Chang X, Li L, Chang M. Centrally Administered Cortistation-14 Induces Antidepressant-Like Effects in Mice via Mediating Ghrelin and GABA A Receptor Signaling Pathway. Front Pharmacol 2018; 9:767. [PMID: 30072893 PMCID: PMC6060333 DOI: 10.3389/fphar.2018.00767] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/25/2018] [Indexed: 12/22/2022] Open
Abstract
Cortistatin-14 (CST-14), a recently discovered cyclic neuropeptide, can bind to all five cloned somatostatin receptors (SSTRs) and ghrelin receptor to exert its biological activities and co-exists with GABA within the cortex and hippocampus. However, the role of CST-14 in the control of depression processes is not still clarified. Here, we tested the behavioral effects of CST-14 in the in a variety of classical rodent models of depression [forced swimming test (FST), tail suspension test (TST) and novelty-suppressed feeding test]. In the models of depression, CST-14 produced antidepressant-like effects, and does not altered locomotor activity levels. And, we found that CST-14 mRNA and BDNF mRNA were significantly decreased in the hippocampus and cortex after mice exposed to stress. Further data show that i.c.v. administration of CST-14 produce rapid antidepressant effects, and does not altered locomotor activity levels. Then these antidepressant-like effects were significantly reversed by [D-Lys3]GHRP-6 (ghrelin receptor antagonist), but not c-SOM (SSTRs antagonist). Meanwhile, the effects of some neurotransmitter blockers indicates that only GABAA system, but not CRF1 receptor, α/β-adrenergic receptor, is involved in the antidepressant effect of CST-14. The effects of the mTOR inhibitor (rapamycin), the PI3K inhibitor (LY294002) and the p-ERK1/2 inhibitor (U0126) suggesting that the ERK/mTOR or PI3K/Akt/mTOR signaling pathway is not involved in the antidepressant effects of CST-14. Interestingly, intranasal administration of CST-14 led to reducing depressive-like behavior, and near-infrared fluorescent experiments showed the real-time in vivo bio-distribution in brain after intranasal infusion of Cy7.5-CST-14. Taken all together, the results of present study point to a role for CST-14 in the modulation of depression processes via the ghrelin and GABAA receptor, and suggest cortistation may represent a novel strategy for the treatment of depression disorders. Highlights:CST-14 and BDNF mRNA are decreased in hippocampus and cortex once mice exposed to stress. i.c.v. or intranasal administration of CST-14 produce rapid antidepressant effects. NIR fluorescence imaging detected the brain uptake and distribution after intranasal CST-14. Antidepressant effects of CST-14 were only related to ghrelin and GABAA system. Co-injection of CST-14 and NPS produce antidepressant effect, and do not impair memory.
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Affiliation(s)
- JinHong Jiang
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Life Sciences, Institute of Biochemistry and Molecular Biology, Lanzhou University, Lanzhou, China
| | - YaLi Peng
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Life Sciences, Institute of Biochemistry and Molecular Biology, Lanzhou University, Lanzhou, China
| | - XueYa Liang
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Life Sciences, Institute of Biochemistry and Molecular Biology, Lanzhou University, Lanzhou, China
| | - Shu Li
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Life Sciences, Institute of Biochemistry and Molecular Biology, Lanzhou University, Lanzhou, China
| | - Xin Chang
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Life Sciences, Institute of Biochemistry and Molecular Biology, Lanzhou University, Lanzhou, China
| | - LongFei Li
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Life Sciences, Institute of Biochemistry and Molecular Biology, Lanzhou University, Lanzhou, China
| | - Min Chang
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Life Sciences, Institute of Biochemistry and Molecular Biology, Lanzhou University, Lanzhou, China
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14
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Averill IR, Crowe M, Frampton CM, Beaglehole B, Lacey CJ, Jordan J, Wilson LD, Douglas KM, Porter RJ. Clinical response to treatment in inpatients with depression correlates with changes in activity levels and psychomotor speed. Aust N Z J Psychiatry 2018; 52:652-659. [PMID: 29417833 DOI: 10.1177/0004867417753549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Monitoring clinical response to treatment in depressed inpatients, particularly identifying early improvement, may be sub-optimal. This may impact adversely on patients through longer admissions and sub-optimal pharmacotherapy. Psychomotor speed is a prominent neuropsychological function which changes as recovery occurs. This study examines simple techniques used to quantify psychomotor change and their potential to contribute to monitoring recovery. METHODS Activity levels were continuously monitored in patients diagnosed with a major depressive episode from four acute psychiatric wards using two actigraphs (commercial and scientific) for 3 weeks and linear regression used to calculate a gradient to express rate of change. Psychomotor speed was assessed using the simple Coin Rotation Task. Mood and functioning were rated using the Quick Inventory of Depressive Symptoms, Clinical Global Impression Scale and Functioning Assessment Short Test. The assessments were completed at baseline and follow-up (3 weeks), and correlations were calculated for all change measures. RESULTS In all, 24 inpatients were recruited but not all completed baseline and follow-up measures. Change in activity count ( N = 16) and psychomotor speed ( N = 13) correlated significantly with improvement in clinical measures of depressive symptoms. Actigraphs were acceptable to hospital inpatients. LIMITATIONS The limited size of this pilot study precludes the analysis of predictive power or the influence of other variables such as depression subtypes, age, gender or variations related to medications. CONCLUSION Early change in simple activity and psychomotor speed warrant further investigation for utility in measuring treatment response in depressed inpatients.
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Affiliation(s)
- Ian Re Averill
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,2 Specialist Mental Health Services, Hillmorton Hospital, Christchurch, New Zealand
| | - Marie Crowe
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Chris M Frampton
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Ben Beaglehole
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,2 Specialist Mental Health Services, Hillmorton Hospital, Christchurch, New Zealand
| | - Cameron J Lacey
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,3 West Coast District Health Board, Greymouth, New Zealand
| | - Jennifer Jordan
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Lynere D Wilson
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,4 Pegasus Health, Christchurch, New Zealand
| | - Katie M Douglas
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard J Porter
- 1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,2 Specialist Mental Health Services, Hillmorton Hospital, Christchurch, New Zealand
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15
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Billiet L, Swinnen TW, Westhovens R, de Vlam K, Van Huffel S. Accelerometry-Based Activity Recognition and Assessment in Rheumatic and Musculoskeletal Diseases. SENSORS 2016; 16:s16122151. [PMID: 27999255 PMCID: PMC5191131 DOI: 10.3390/s16122151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/05/2016] [Accepted: 12/12/2016] [Indexed: 01/15/2023]
Abstract
One of the important aspects to be considered in rheumatic and musculoskeletal diseases is the patient's activity capacity (or performance), defined as the ability to perform a task. Currently, it is assessed by physicians or health professionals mainly by means of a patient-reported questionnaire, sometimes combined with the therapist's judgment on performance-based tasks. This work introduces an approach to assess the activity capacity at home in a more objective, yet interpretable way. It offers a pilot study on 28 patients suffering from axial spondyloarthritis (axSpA) to demonstrate its efficacy. Firstly, a protocol is introduced to recognize a limited set of six transition activities in the home environment using a single accelerometer. To this end, a hierarchical classifier with the rejection of non-informative activity segments has been developed drawing on both direct pattern recognition and statistical signal features. Secondly, the recognized activities should be assessed, similarly to the scoring performed by patients themselves. This is achieved through the interval coded scoring (ICS) system, a novel method to extract an interpretable scoring system from data. The activity recognition reaches an average accuracy of 93.5%; assessment is currently 64.3% accurate. These results indicate the potential of the approach; a next step should be its validation in a larger patient study.
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Affiliation(s)
- Lieven Billiet
- KU Leuven, Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Kasteelpark Arenberg 10 box 2446, 3001 Leuven, Belgium.
- iMinds, Medical IT, 3001 Leuven, Belgium.
| | - Thijs Willem Swinnen
- University Hospitals Leuven, Division of Rheumatology, Herestraat 49 box 7003, 3000 Leuven, Belgium.
- KU Leuven, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, Herestraat 49 box 7003, 3000 Leuven, Belgium.
- KU Leuven, Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Tervuursevest 101 box 1501, 3001 Leuven, Belgium.
| | - Rene Westhovens
- University Hospitals Leuven, Division of Rheumatology, Herestraat 49 box 7003, 3000 Leuven, Belgium.
- KU Leuven, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, Herestraat 49 box 7003, 3000 Leuven, Belgium.
| | - Kurt de Vlam
- University Hospitals Leuven, Division of Rheumatology, Herestraat 49 box 7003, 3000 Leuven, Belgium.
- KU Leuven, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, Herestraat 49 box 7003, 3000 Leuven, Belgium.
| | - Sabine Van Huffel
- KU Leuven, Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Kasteelpark Arenberg 10 box 2446, 3001 Leuven, Belgium.
- iMinds, Medical IT, 3001 Leuven, Belgium.
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16
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Reichert M, Tost H, Reinhard I, Zipf A, Salize HJ, Meyer-Lindenberg A, Ebner-Priemer UW. Within-Subject Associations between Mood Dimensions and Non-exercise Activity: An Ambulatory Assessment Approach Using Repeated Real-Time and Objective Data. Front Psychol 2016; 7:918. [PMID: 27445891 PMCID: PMC4919351 DOI: 10.3389/fpsyg.2016.00918] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/03/2016] [Indexed: 11/13/2022] Open
Abstract
A physically active lifestyle has been related to positive health outcomes and high life expectancy, but the underlying psychological mechanisms maintaining physical activity are rarely investigated. Tremendous technological progress yielding sophisticated methodological approaches, i.e., ambulatory assessment, have recently enabled the study of these mechanisms in everyday life. In practice, accelerometers allow to continuously and objectively monitor physical activity. The combination with e-diaries makes it feasible to repeatedly assess mood states in real-time and real life and to relate them to physical activity. This state-of-the-art methodology comes with several advantages, like bypassing systematic distortions of retrospective methods, avoiding distortions seen in laboratory settings, and revealing an objective physical activity assessment. Most importantly, ambulatory assessment studies enable to analyze how physical activity and mood wax and wane within persons over time in contrast to existing studies on physical activity and mood which mostly investigated between-person associations. However, there are very few studies on how mood dimensions (i.e., feeling well, energetic and calm) drive non-exercise activity (NEA; such as climbing stairs) within persons. Recent reviews argued that some of these studies have methodological limitations, e.g., scarcely representative samples, short study periods, physical activity assessment via self-reports, and low sampling frequencies. To overcome these limitations, we conducted an ambulatory assessment study in a community-based sample of 106 adults over 1 week. Participants were asked to report mood ratings on e-diaries and to wear an accelerometer in daily life. We conducted multilevel analyses to investigate whether mood predicted NEA, which was defined as the mean acceleration within the 10-min interval directly following an e-diary assessment. Additionally, we analyzed the effects of NEA on different time frames following the e-diary prompts in an exploratory manner. Our results revealed that valence significantly and positively predicted NEA within persons (p = 0.001). Feeling more energetic was associated with significantly increased NEA (p < 0.001), whereas feeling calmer was associated with significantly decreased NEA (p < 0.001) on the within-person level. The analyses on different time frames of NEA largely confirmed our findings. In conclusion, we showed that mood predicted NEA within adults but with distinct magnitudes and directions of effects for each mood dimension.
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Affiliation(s)
- Markus Reichert
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheim, Germany; Department of Sports and Sports Science, Karlsruhe Institute of TechnologyKarlsruhe, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Iris Reinhard
- Division of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Alexander Zipf
- GIScience Research Group, Institute of Geography, Heidelberg University Heidelberg, Germany
| | - Hans-Joachim Salize
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Ulrich W Ebner-Priemer
- Department of Sports and Sports Science, Karlsruhe Institute of TechnologyKarlsruhe, Germany; Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental HealthMannheim, Germany
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17
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Hird N, Ghosh S, Kitano H. Digital health revolution: perfect storm or perfect opportunity for pharmaceutical R&D? Drug Discov Today 2016; 21:900-11. [PMID: 26821131 DOI: 10.1016/j.drudis.2016.01.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/04/2016] [Accepted: 01/19/2016] [Indexed: 12/21/2022]
Abstract
The convergence of technology and medicine has pushed healthcare to the brink of a major disruption that pharma has, until recently, been slow to recognize. Tech players have pioneered the emerging field of digital wellness and health, and pharma is ideally placed to use its expertise in drug development and embrace these technologies to create digital applications that address major medical needs. This review describes digital innovation from a pharma R&D perspective, outlining principal drivers, digital components, opportunities and challenges as well as a sustainable new business model predicated on empowered patients and achieving therapeutic outcomes.
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Affiliation(s)
- Nick Hird
- Takeda Pharmaceutical Company Limited, Fujisawa 251-8555, Japan.
| | - Samik Ghosh
- The Systems Biology Institute, Tokyo 108-0071, Japan
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