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Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series

BACKGROUND: Actigraphy could be an objective alternative to clinical ratings of motor activity in bipolar disorder (BD), which is of importance now that increased activity and energy are added as cardinal symptoms of (hypo)mania in the DSM-5 and commonly used rating scales give inadequate informatio...

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Autores principales: Krane-Gartiser, Karoline, Asheim, Andreas, Fasmer, Ole Bernt, Morken, Gunnar, Vaaler, Arne E., Scott, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161984/
https://www.ncbi.nlm.nih.gov/pubmed/29511876
http://dx.doi.org/10.1186/s40345-017-0115-3
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author Krane-Gartiser, Karoline
Asheim, Andreas
Fasmer, Ole Bernt
Morken, Gunnar
Vaaler, Arne E.
Scott, Jan
author_facet Krane-Gartiser, Karoline
Asheim, Andreas
Fasmer, Ole Bernt
Morken, Gunnar
Vaaler, Arne E.
Scott, Jan
author_sort Krane-Gartiser, Karoline
collection PubMed
description BACKGROUND: Actigraphy could be an objective alternative to clinical ratings of motor activity in bipolar disorder (BD), which is of importance now that increased activity and energy are added as cardinal symptoms of (hypo)mania in the DSM-5 and commonly used rating scales give inadequate information about motor symptoms. To date, most actigraphy studies have been conducted in groups and/or used mean activity levels as the variable of interest. The novelty of this case series is therefore to indicate the potential of actigraphy and non-parametric analysis as an objective and personalized marker of intra-individual activity patterns in different phases of BD. To our knowledge, this is the first case series that provides an objective assessment of non-linear dynamics in within-person activity patterns during acute BD episodes. RESULTS: We report on three cases of bipolar I disorder with 24-h actigraphy recordings undertaken during the first few days of two or more separate admissions for an acute illness episode, including admissions for individuals in different phases of BD, or with different levels of severity in the same phase of illness. For each recording, we calculated mean activity levels over 24 h, but especially focused on key measures of variability and complexity in activity. Intra-individual activity patterns were found to be different according to phase of illness, but showed consistency within the same phase. With increasing psychotic symptoms, there was evidence of a lower overall level and greater irregularity in activity. As such, sample entropy (a measure of irregularity) may have particular utility in characterizing mania and psychotic symptoms, while assessment of the distribution of rest versus activity over 24 h may distinguish between phases of BD within an individual. CONCLUSIONS: This case series indicates that objective, intra-individual, real-time recordings of patterns of activity may have clinical impact as a valuable adjunct to clinical observation and symptom ratings. We suggest that actigraphy combined with detailed mathematical analysis provides a biological variable that could become an important tool for developing a personalized approach to diagnostics and treatment monitoring in BD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40345-017-0115-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-61619842018-10-12 Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series Krane-Gartiser, Karoline Asheim, Andreas Fasmer, Ole Bernt Morken, Gunnar Vaaler, Arne E. Scott, Jan Int J Bipolar Disord Case Report BACKGROUND: Actigraphy could be an objective alternative to clinical ratings of motor activity in bipolar disorder (BD), which is of importance now that increased activity and energy are added as cardinal symptoms of (hypo)mania in the DSM-5 and commonly used rating scales give inadequate information about motor symptoms. To date, most actigraphy studies have been conducted in groups and/or used mean activity levels as the variable of interest. The novelty of this case series is therefore to indicate the potential of actigraphy and non-parametric analysis as an objective and personalized marker of intra-individual activity patterns in different phases of BD. To our knowledge, this is the first case series that provides an objective assessment of non-linear dynamics in within-person activity patterns during acute BD episodes. RESULTS: We report on three cases of bipolar I disorder with 24-h actigraphy recordings undertaken during the first few days of two or more separate admissions for an acute illness episode, including admissions for individuals in different phases of BD, or with different levels of severity in the same phase of illness. For each recording, we calculated mean activity levels over 24 h, but especially focused on key measures of variability and complexity in activity. Intra-individual activity patterns were found to be different according to phase of illness, but showed consistency within the same phase. With increasing psychotic symptoms, there was evidence of a lower overall level and greater irregularity in activity. As such, sample entropy (a measure of irregularity) may have particular utility in characterizing mania and psychotic symptoms, while assessment of the distribution of rest versus activity over 24 h may distinguish between phases of BD within an individual. CONCLUSIONS: This case series indicates that objective, intra-individual, real-time recordings of patterns of activity may have clinical impact as a valuable adjunct to clinical observation and symptom ratings. We suggest that actigraphy combined with detailed mathematical analysis provides a biological variable that could become an important tool for developing a personalized approach to diagnostics and treatment monitoring in BD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40345-017-0115-3) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2018-03-07 /pmc/articles/PMC6161984/ /pubmed/29511876 http://dx.doi.org/10.1186/s40345-017-0115-3 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Krane-Gartiser, Karoline
Asheim, Andreas
Fasmer, Ole Bernt
Morken, Gunnar
Vaaler, Arne E.
Scott, Jan
Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series
title Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series
title_full Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series
title_fullStr Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series
title_full_unstemmed Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series
title_short Actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series
title_sort actigraphy as an objective intra-individual marker of activity patterns in acute-phase bipolar disorder: a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161984/
https://www.ncbi.nlm.nih.gov/pubmed/29511876
http://dx.doi.org/10.1186/s40345-017-0115-3
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