Postgraduate Education CornerContemporary Reviews in Sleep MedicineWrist Actigraphy

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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An Examination of Psychomotor Disturbance in Current and Remitted MDD: An RDoC Study.

Self-reported eveningness has been previously associated with depressed mood among adults and adolescents. Here, we study how circadian indicators based on actigraphic data differ between depressed and healthy adolescent boys. Our sample consisted of 17 medication-free adolescent boys, aged 14.5 to 17.5 years, of which eight had depressive disorder and were currently depressed and nine were healthy comparison participants. Psychiatric assessment was conducted by diagnostic interviews and complemented with observer-rating and self-rating scales. Actigraphic data were collected with wrist actigraphs for a minimum period of 25 consecutive days (range of 25 to 44 days). The behavioral trait of morningness–eveningness was measured with the 19-item Horne-Ostberg Morningness–Eveningness Questionnaire. Based on the self-report, the depressed boys were more prone to eveningness than healthy controls, but based on the actigraphic data, they had earlier phases especially on school days and lower activity lev...

/pdf/advanced-phases-and-reduced-amplitudes-are-suggested-to-1p732xzats.pdf

Advanced phases and reduced amplitudes are suggested to characterize the daily rest-activity cycles in depressed adolescent boys.

Recent research suggested that daily pattern of physical activity (PA) may have an important association with depression, but findings are limited and contradictory. Our aim was to conduct a systematic review of the literature to summarize the literature evidence on the association between timing of PA and depression. A comprehensive search of PubMed/Medline and Scopus databases has been performed, and a total of five manuscripts have been thoroughly reviewed. The performed descriptive analysis shows lower levels of PA among individuals with depression or depressive symptoms, although evidence on the 24 h pattern of PA and depression is limited. An interesting finding is the association between lower PA during the morning, higher PA late in the evening (night), and depression or depressive symptoms. However, definitive conclusions could not be drawn due to the observational nature of the studies, their limited number, the high heterogeneity in the sample populations, and the studies’ differing outcome definitions and exposure assessments. Future studies considering not only the level of PA but also its daily variability might be important to further explore this novel area of research.

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Association between Daily Pattern of Physical Activity and Depression: A Systematic Review

Background: Individuals with mild cognitive impairment (MCI) may exhibit changes in motor activity in conducting their activities of daily living. Depression, one of the most frequent neuropsychiatric symptoms, might affect motor activity in MCI. Objective: To assess motor activity in MCI subjects carrying out short functional activity tasks using ambulatory actigraphy. Secondly, we sought to investigate the influence of depressive symptoms on motor activity. Methods: 20 MCI and 14 healthy subjects carried out a 30-minute standardized scenario while wearing a chest actigraph. The protocol consisted of directed activities (execution of motor tasks), semi-directed activities (execution of Instrumental Activities of Daily Living, IADL), and undirected 'free' activities. Several common assessment scales (GDS, MADRS, and NPI) were used to diagnose depression. Results: MCI subjects had significantly reduced mean motor activity while carrying out directed and semi-directed activities, compared to healthy control subjects. No difference was found in motor activity between MCI subjects with or without depression. Conclusion: Actigraphic measurement of motor activity during the evaluation of IADLs and motor tasks is a potential objective tool in detecting early changes in MCI. Depressive symptoms seem not to be associated with motor activity in MCI subjects. © 2014 - IOS Press and the authors. All rights reserved.

Actigraphic motor activity in mild cognitive impairment patients carrying out short functional activity tasks: comparison between mild cognitive impairment with and without depressive symptoms.

Objectives: The present study investigated the association between motor activity and severity of depression in 6 depressed adolescent outpatients. Method: Motor activity was assessed by actigraphy and the severity of depression was assessed weekly using the CDRS-R. The levels of motor activity were analyzed by considering activity parameters. Results: Among the parameters of motor activity studied, the mean total activity, the mean 24-hour activity levels, the mean waking activity, and the mean activity level between 12:00 and 18:00 h were inversely correlated with severity of depression. The means of the 10 most active hours tended toward a negative correlation with the depressive severity score. Conclusion: The results seem to suggest an association between motor activity level and severity of depression in adolescents. Nevertheless, in order to reach a more conclusive understanding, it would be necessary to replicate this study using a larger number of individuals as well as a longer observation period.

Motor Activity and Depression Severity in Adolescent Outpatients

The familial pattern of spontaneous preterm birth: a case control study

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Motor Activity and Depression Severity in Adolescent Outpatients

The familial pattern of spontaneous preterm birth: a case control study