Night-time Motor Activity Research Articles

Classification of Depressive and Schizophrenic Episodes Using Night-Time Motor Activity Signal.

Major depressive disorder (MDD) is the most recurrent mental illness globally, affecting approximately 5% of adults. Furthermore, according to the National Institute of Mental Health (NIMH) of the U.S., calculating an actual schizophrenia prevalence rate is challenging because of this illness’s underdiagnosis. Still, most current global metrics hover between 0.33% and 0.75%. Machine-learning scientists use data from diverse sources to analyze, classify, or predict to improve the psychiatric attention, diagnosis, and treatment of MDD, schizophrenia, and other psychiatric conditions. Motor activity data are gaining popularity in mental illness diagnosis assistance because they are a cost-effective and noninvasive method. In the knowledge discovery in databases (KDD) framework, a model to classify depressive and schizophrenic patients from healthy controls is constructed using accelerometer data. Taking advantage of the multiple sleep disorders caused by mental disorders, the main objective is to increase the model’s accuracy by employing only data from night-time activity. To compare the classification between the stages of the day and improve the accuracy of the classification, the total activity signal was cut into hourly time lapses and then grouped into subdatasets depending on the phases of the day: morning (06:00–11:59), afternoon (12:00–17:59), evening (18:00–23:59), and night (00:00–05:59). Random forest classifier (RFC) is the algorithm proposed for multiclass classification, and it uses accuracy, recall, precision, the Matthews correlation coefficient, and F1 score to measure its efficiency. The best model was night-featured data and RFC, with 98% accuracy for the classification of three classes. The effectiveness of this experiment leads to less monitoring time for patients, reducing stress and anxiety, producing more efficient models, using wearables, and increasing the amount of data.

A systematic review of the novel applications of cannabinoids in dementia care: food refusal and neuropsychiatric symptoms

<h3>Introduction</h3> In recent years, there has been increased research interest investigating the novel use of cannabinoids in the treatment of patients living with dementia. Early clinical research suggests that cannabinoids may be beneficial in a variety of areas, including pain, sleep, weight loss, and behavioral aggression. In particular, cannabinoids may be especially valuable in dementia care in areas where there are currently limited therapies, including food refusal and neuropsychiatric symptoms (NPS) such as agitation and sleep disruption. Pharmacologic interventions for disordered eating in dementia are limited. And although atypical antipsychotics are commonly used to treat NPS, they are associated with an increased risk of serious adverse events and all-cause mortality in older patients. Thus, this study aims to review the current literature on the potential applications of cannabinoids in the treatment of food refusal and neuropsychiatric symptoms in dementia populations. <h3>Methods</h3> A systematic literature review was performed utilizing six major electronic databases (PubMed, MEDLINE, EMBASE, PsycINFO, Google Scholar, Cochrane CENTRAL) for articles published from database inception to November 2020. Search strings including keywords and Medical Subject Headings (MeSH terms) related to cannabinoids, dementia, food refusal, weight loss, agitation, and neuropsychiatric symptoms were used to identify relevant articles. <h3>Results</h3> A total of 23 relevant articles were identified that examined the use of cannabinoids including tetrahydrocannabinol, dronabinol, and nabilone in dementia patients. Regarding treatment of NPS in dementia, numerous studies found that use of cannabinoids was associated with potential benefits including reduced nighttime motor activity, improved sleep duration, reduced agitation, and lower Neuropsychiatric Inventory scores. With regards to food refusal, multiple articles documented use of cannabinoids being associated with increased percentage of meals consumed, with one crossover placebo-controlled trial finding increased overall body weight in dementia patients on dronabinol. Documented potential side effects include possible worsening of psychosis and anxiety, although overall, the literature appears to show cannabinoids to be generally well-tolerated. <h3>Conclusions</h3> Use of cannabinoids as potential treatments for food refusal and neuropsychiatric symptoms in dementia populations is an ongoing area of research. Completed clinical studies done on the subject to date have been small in scale, but have shown cannabinoids to be relatively well-tolerated and have yielded positive results. Thus, cannabinoids may have potential as a therapeutic intervention in dementia care, and these findings warrant further investigation. <h3>Funding</h3> Not applicable

Actigraphic, but not subjective, sleep measures are associated with cognitive impairment in memory clinic patients.

Sleep disturbances are prevalent in various dementia subtypes but rarely investigated in early clinical stages. Although memory clinics have become an established institution for the early diagnosis of dementia, sleep assessment is not part of their routine diagnostics. This study aimed to examine whether subjective and objective sleep variables are related to cognitive impairment in patients referred to a memory clinic. On two consecutive days, patients underwent routine diagnostic procedures, including a neuropsychological examination (consortium to establish a registry for alzheimer's disease), and had their sleep quality evaluated by the Pittsburgh Sleep Quality Index and overnight hand-wrist actigraphy. Data of 31 patients (age, M ± SEM: 74.1 ± 1.5; 18 women, 13 men; Clinical Dementia Rating: 0-1) were analysed. One had been diagnosed with subjective cognitive impairment, 13 with mild cognitive impairment with or without depression, and 17 with dementia syndrome due to Alzheimer's and/or cerebrovascular disease. Compared to patients with subjective or mild cognitive impairment, dementia patients showed a significantly increased nocturnal acceleration magnitude; other differences in subjective and objective sleep measures were not significant. Comparing patients with subjectively poor (Pittsburgh Sleep Quality Index > 5: n = 9) and good sleep (Pittsburgh Sleep Quality Index ≤ 5: n = 22) yielded no differences in any neuropsychological and clinical variables. In contrast, patients with low actigraphically recorded sleep efficiency (<85%: n = 11) exhibited a significantly more impaired cognitive performance than those in the high sleep efficiency group (≥85%: n = 20). Correlation analyses demonstrated that actigraphically assessed disturbed sleep continuity accompanied by increased night-time motor activity was substantially associated with cognitive impairment. This study highlights that objectively assessed, but not self-reported, parameters of disturbed sleep are closely related to cognitive dysfunction in the early stages of dementia of different aetiologies. Possible diagnostic and treatment implications are discussed.

Effect of a robotic seal on the motor activity and sleep patterns of older people with dementia, as measured by wearable technology: A cluster-randomised controlled trial

ObjectivesThe robotic seal, PARO, has been used as an alternative to animal-assisted therapies with residents with dementia in long-term care, yet understanding of its efficacy is limited by a paucity of research. We explored the effects of PARO on motor activity and sleep patterns, as measured by a wearable triaxial accelerometer. Study designCluster-randomised controlled trial, involving 28 facilities in Queensland, Australia. Nine facilities were randomised to the PARO group (individual, non-facilitated, 15-min sessions three afternoons per week for 10 weeks), 10 to a plush toy (PARO with robotic features disabled) and nine to usual care. Main outcome measuresChanges in day- and nighttime motor activity and sleep after the 10-week intervention, as measured by SenseWear® armbands, worn by participants continuously for 24 h at baseline, during two single intervention days in weeks 5 and 10 respectively, and post-intervention (week 15). Analyses followed intention-to-treat, using repeated-measures mixed-effects models. ResultsAfter 10 weeks, the PARO group showed a greater reduction in daytime step count than usual care (p = 0.023), and in nighttime step count (p = 0.028) and daytime physical activity (p = 0.026) compared with the plush toy group. At post-intervention, the PARO group showed a greater reduction in daytime step count than the plush toy group (p = 0.028), and at nighttime compared with both the plush toy group (p = 0.019) and the usual-care group (p = 0.046). The PARO group also had a greater reduction in nighttime physical activity than the usual-care group (p = 0.015). ConclusionsPARO may have some effect on motor activity of older people with dementia in long-term care, but not on sleep patterns.Australian New Zealand Clinical Trials Registry (ACTRN12614000508673).

Analgesic efficacy of tramadol in cats with naturally occurring osteoarthritis.

ObjectivesThis study aimed to (1) compare outcome assessments in normal and osteoarthritic cats and (2) evaluate the analgesic efficacy of tramadol in feline osteoarthritis (OA), in a prospective, randomised, blinded, placebo-controlled, crossover design.MethodsTwenty cats were included after clinical examination, blood work and full body radiographs were performed. In Phase 1, outcome assessments aimed to differentiate normal (n = 5; i.e. exempt of any radiographic and clinical sign of OA) from OA (n = 15) cats. In Phase 2, OA cats were treated twice daily with a placebo (PG: cornstarch 15 mg) or tramadol (TG: 3 mg/kg) orally for 19 days, with a 3-month washout period between treatments. Evaluations were performed in normal and OA cats at baseline and consisted of: 1) peak vertical force (PVF) after staircase exercise; 2) telemetered night-time motor activity (NMA); and 3) response to mechanical temporal summation (RMTS). After treatment, PVF, NMA and RMTS evaluations were repeated in OA cats. Data were analysed with mixed model methods with an alpha-threshold of 5%.ResultsPhase 1: 1) PVF (% of body weight; mean ± SD) was higher in normal (59 ± 10.5) than in OA cats (50.6 ± 5.7) (p = 0.005); 2) NMA (no unit) was not different between groups; 3) RMTS (number of stimuli; median (range)) was higher in normal [29.5 (23.5–30)] than in OA cats [14 (8.5–28)] (p < 0.0001). Phase 2: PVF, NMA and RMTS presented a treatment effect (p = 0.024, p = 0.008 and p = 0.018, respectively). No clinically important adverse-effects were observed.ConclusionOutcome assessments such as kinetics (PVF) and evaluation of central sensitisation (RMTS) are discriminant of OA status. Mobility measured by NMA was not discriminant of OA status, however it increased in OA cats with tramadol treatment. Nociceptive hypersensitivity quantified by RMTS was evident in OA cats and was responsive to tramadol treatment.

ACTIGRAPHIC EVIDENCE FOR NIGHT-TIME HYPERKINESIA IN PARKINSON’S DISEASE

Parkinson's disease is a common motor disorder that not only leads to motor symptoms but also autonomic dysregulation, mental changes, sensory disturbances, and sleep disorders such as increased daytime sleepiness and sleep fragmentation. The aim of this study was to find out how the daytime and night-time motor activity levels in individuals without motor disorders differ from patients with Parkinson's disease. Daytime and night-time motor activity levels in 17 PD patients and 69 controls were measured for three consecutive days and nights via actigraphy, a method of continuous long-term assessment of activity levels. A ratio between night-time and daytime motor activity was calculated. PD patients had a 1.5–2-fold lower daytime motor activity but also showed 1.5–2-fold higher motor activity at night time. Older controls showed a lower daytime but similar night-time motor activity when compared to younger controls. A ratio of night-time to daytime motor activity could clearly distinguish controls and patients. The possibility to distinguish patients and controls by the ratio of night-time to daytime motor activity is worth further investigation.

Phenotypic segregation of aphakia and Pitx3-null mutants reveals that Pitx3 deficiency increases consolidation of specific movement components

Deficiency of the meso-diencephalic dopamine (mdDA) neuron specific transcription factor Pitx3 in aphakia ( ak) mice results in the loss of the substantia nigra compacta (SNc). Concomitantly, reduced spontaneous locomotor behavior, symptoms reminiscent to those in Parkinson's disease, has been reported. However, the ak mouse line originates from the 1960s and has been compared to C57BL/6J inbred controls. Therefore, to define Pitx3 gene function in baseline and novelty-induced locomotor behavior and mdDA neuronal activity, we analyzed Pitx3-deficiency in a controlled genetic and epigenetic background. The analysis implicated that, in contrast to the controversial and previously reported hypo-activity in ak mice, Pitx3−/− mice showed normal dark phase motor activity levels. Our data also revealed that ak and Pitx3−/− mice both display a similar neuro-anatomical and physiological phenotype, and, interestingly, showed increased spontaneous home cage activity levels during their habitual sleep phase. Further behavioral analysis revealed that both ak and Pitx3−/− mice have reduced transitions but increased consolidation of specific locomotor behaviors, such as rearing and horizontal movement. Thus, Pitx3 is not involved in the expression of nighttime motor activity levels, but is critical for selective mdDA neuronal activity and associated with increased consolidation of movement.

Effects of zolpidem 10 mg, zopiclone 7.5 mg and flunitrazepam 1 mg on night-time motor activity

The effects of a single dose of zolpidem (10 mg), zopiclone (7.5 mg) and flunitrazepam (1 mg) on motor activity the following 3 nights were compared to those of a placebo in a double-blind, crossover study. Thirty-three healthy subjects received medication between 10.30 and 11.30 p.m. and were asked to rise between 7.30 and 8.30 a.m. During the night under treatment, flunitrazepam, zopiclone and zolpidem significantly reduced motor activity. Changes in motor activity are quantitatively compatible with the hypothesis of reduced light sleep and wakefulness after sleep onset. During the first or second post-drug night, for zolpidem and zopiclone the opposite effect was observed, i.e. increased activity compared with placebo. These modifications cannot be explained by modified sleep structure. This last result underlines our inadequate understanding of the underlying mechanisms of motor activity during sleep. However, being sensitive and easy to use, actigraphy is an ideal technique to assess the effect of hypnotics on large populations and for long duration studies.

Actigraphic monitoring (actigraphy) of circadian locomotor activity in schizophrenic patients with acute neuroleptic-induced akathisia

Background: Actigraphy is a quantitative method for measurement of motor activity. In the present study we used actigraphy to examine diurnal variations in locomotor activity of schizophrenic patients with neuroleptic-induced akathisia (NIA). Method: Thirty-two schizophrenic patients, 16 with NIA and 16 without (DSM-IV criteria) underwent 24-h actigraphic monitoring. Clinical assessments of NIA were conducted with Barnes Akathisia Scale (BAS) at 08:00, 12:00, 16:00 and 20:00. Sleep parameters (duration, latency, continuity and efficacy) were assessed by actigraphy. Sleep quality was evaluated by a self-rated sleep questionnaire. Results: NIA patients demonstrated persistent higher daytime motor activity from 11:30 to 14:15 and from 18:00 to 21:00 than controls. There were no differences between the groups in nighttime motor activity, confirming clinical observations that NIA tends to disappear during sleep. Subject’s sleep assessments were similar in the two groups. Conclusions: Actigraphy seems to be a reliable, non-invasive, method of measuring motor activity in patients with NIA. Its sensitivity and specificity as an objective quantitative diagnostic instrument in patients with NIA merits further investigation.

Plasma arginine vasopressin and motor activity in major depression

Previously, we found that mean plasma concentrations of arginine vasopressin (AVP), but not of oxytocin (OT), were higher in depressed patients than in healthy controls. Plasma AVP concentrations were positively correlated to clinically rated psychomotor retardation. To further explore this previously reported relation we studied psychomotor retardation by means of an activity monitor, which is a more fine-focused and more objective instrument to analyze motor retardation than a clinical rating scale. Plasma AVP and OT concentrations, and day- and nighttime wrist activity were measured in 48 in- and outpatients with major depression and 30 healthy controls during a period of 5 consecutive days and nights. Principal components analysis revealed three components of motor activity: motor activity during wakefulness, motor activity during sleep, and the awake/sleep time ratio. In patients and controls an inverse relationship between plasma AVP concentrations and motor activity during wakefulness was found. Patients with elevated AVP plasma levels showed increased motor activity during sleep. These results suggest that high plasma AVP levels are related to the clinical picture of daytime psychomotor retardation and nighttime motor activity in major depression. Mean plasma OT concentrations were not related to measures of motor activity.

Circadian rest-activity rhythms in demented and nondemented older community residents and their caregivers.

Disruptive nocturnal behaviors (DNBs) of older people often threaten the caregiving arrangements on which their community tenure depends. Dementing disorders are especially prone to result in disrupted sleep and agitated behaviors ("sundowning"). The objective here was to develop an objective correlate of DNBs, by which their severity and effects on caregivers can be measured. Quantitative comparison of subjective sleep and motor activity patterns in older people and their caregivers. It was hypothesized that older people with reported DNBs would be more motorically active at night than their caregivers. Subjects' homes. Twenty-five demented and 18 nondemented older day-care participants and their paired caregivers. Older subjects and caregivers simultaneously kept daily sleep logs and recorded wrist motor activity every .5 minute for 9 days. A novel method was devised to identify and exclude from analysis periods when the activity monitor was not being worn. Such periods were common. Activity data were analyzed by computing hourly means and by fitting cosine models by least squares. Demented older people were not significantly more active at night than their caregivers, though group differences varied by time of night. They were significantly less active in the daytime than were their caregivers. Nondemented older people were significantly more active at night than their caregivers and were as active by day as their caregivers. The caregivers of demented and nondemented older people had similar rest-activity patterns. The mean amplitudes of cosine models were smaller in the older adults. Acrophases (peaks) fell between 2 and 3 pm and did not differ significantly among the groups. As a result of increased nighttime motor activity and decreased daytime activity, rest-activity rhythms were flatter in older adults than in caregivers. This was not explained fully by age and does not necessarily imply that the output of a circadian pacemaker was low. Decreased daytime activity may have resulted from deficient physical stimulation or frailty. Frailty may also explain why nighttime activity was not more elevated in the demented older people. Increased nighttime activity is probably explained by depression, sleep-schedule disturbances, restless legs, or other sleep disorders. Judging by their shared variations of activity, caregivers interacted mainly with the demented older people at bedtime and at rising time in the morning.

Psychomotor activity as a correlate of Depression and sleep in acutely disturbed psychiatric inpatients

Combining a lightweight telemetric mobility sensing system with nightly EEG-sleep recordings, the authors obtained continuous monitoring of rest-activity cycles among psychiatric patients hospitalized for primary depression or acute schizophreniform thought disorder. The patients with primary depression had a significantly higher percentage of their total 24-hour motor activity distributed during the night. Furthermore, this increased nocturnal motor activity did not correlate significantly with concurrent EEG-sleep measures of wakefulness. Indeed, the best predictors of wakefulness were measures of daytime activity. This desynchronization of sleep and nighttime motor activity in primary depression may explain the need for combined pharmacotherapy in some severely depressed patients. The authors suggest that expressing activity as a percentage distribution function, rather than in terms of absolute amplitude, provides an objective diagnostic index of depression.

Behavior and brain contents of catecholamines in mice during chronic administration of methyldopa

The behavioral effects of methyldopa were examined after the addition of this drug to the diet of mice. During the first 24 hr of the methyldopa diet, continuous night-time motor activity was reduced, but neither exploratory activity nor amphetamine-stimulated activity was altered. Norepinephrine was almost totally depleted from the brain whereas the brain content of dopamine was only slightly reduced; substantial amounts of α-methylnorepinephrine but relatively little α-methyldopamine accumulated in the brain. Tolerance developed to the depression of continuous activity after 2–4 days of methyldopa diet. Aggressive behavior and enhanced amphetamine stimulation accompanied the tolerance development, but neither exploratory activity nor pipradrol-stimulated activity was increased. Tolerance to the depression of continuous activity and the onset of aggression and enhanced amphetamine stimulation were not accompanied by changes in brain levels of catecholamines; the contents of norepinephrine, dopamine, α-methylnorepinephrine and α-methyldopamine on day 1 and on day 4 of the diet were the same.