Actigraphic correlates of neuropsychiatric symptoms in adults with focal epilepsy.
Actigraphic correlates of neuropsychiatric symptoms in adults with focal epilepsy.
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癫痫患者（PWE）的残疾是多因素的：除了癫痫发作频率/严重程度外，PWE还容易发生一系列神经精神、认知和躯体共病，这些共病显著影响生活质量。在这里，我们探讨了癫痫发作严重程度的变化和自我报告的躯体/神经精神症状的负担如何与24小时活动模式（静息-活动节律[RAR]）的中断相关，通过腕部加速度计/活动记录仪确定。从59例局灶性癫痫成年患者（44%为男性，年龄18-72岁）中获得了多日腕动记录，这些患者同时对经验证的心理测量仪器做出反应，以测量焦虑、抑郁、嗜睡和躯体症状。我们对来自拉丁美洲人研究（SOL）Sueño Ancillary研究的1747名西班牙裔受试者（35%男性，年龄18-65岁）的公开数据集进行了类似的计算机心理测量-活动记录相关性。通过S形变换余弦模型（量化幅度、陡度、顶相和稳健性）和非参数测量来分析RAR，以估计RAR稳定性、碎片化和睡眠。与匹配的SOL受试者相比，PWE受试者的RAR具有显著较低的振幅，较宽的休息期和显著更多的每日总睡眠。在PWE中，类似的RAR失真与癫痫发作顽固性和/或抗惊厥药物综合治疗相关，而高焦虑、抑郁和躯体症状评分与较低的RAR稳健性和顶相延迟相关。我们应用SOL数据集训练逻辑回归模型，使用人口统计学和RAR参数对主观焦虑、抑郁和嗜睡症状进行二分分类。当对PWE进行测试时，这些模型预测了普遍的焦虑和抑郁症状负担（准确率约为70%），但未能预测主观嗜睡。总之，这些结果表明，RAR功能可能编码局灶性癫痫患者的普遍抑郁和焦虑症状，可能为辅助临床护理和药物/器械试验提供可穿戴衍生终点。通过更大的PWE特异性活动描记-心理测量数据集，我们可以识别RAR特征，这些特征可能与不同的癫痫发作频率、抗惊厥治疗负担和普遍的情绪/焦虑症状更精确地相关。
Disability in patients with epilepsy (PWEs) is multifactorial: beyond seizure frequency/severity, PWEs are prone to a range of neuropsychiatric, cognitive, and somatic comorbidities that significantly affect quality of life. Here, we explored how variations in seizure severity and the burden of self-reported somatic/neuropsychiatric symptoms correlate with disruptions to 24 h activity patterns (rest-activity rhythms [RARs]), determined through wrist accelerometry/actigraphy. Multiday wrist-actigraphy recordings were obtained from 59 adult patients with focal epilepsy (44% male, ages 18–72), who contemporaneously responded to validated psychometric instruments to measure anxiety, depression, sleepiness, and somatic symptoms. We conducted a similar in silico psychometric-actigraphic correlation in a publicly available data set of 1747 Hispanic subjects (35% male, ages 18–65) from the Study of Latinos (SOL) Sueño Ancillary Study. RARs were analyzed via a sigmoidally-transformed cosine model (quantifying amplitude, steepness, acrophase, and robustness) and nonparametric measures to estimate RAR stability, fragmentation, and sleep. Compared with matched SOL subjects, RARs from PWE subjects featured a significantly lower amplitude, a wider rest phase, and significantly more total daily sleep. Within PWEs, similar RAR distortions were associated with seizure intractability and/or anticonvulsant polytherapy, whereas high anxiety, depression, and somatic symptom scores were associated with lower RAR robustness and acrophase delay. We applied the SOL data set to train logistic regression models to dichotomously classify subjective anxiety, depression, and sleepiness symptoms using demographic and RAR parameters. When tested on PWEs, these models predicted prevalent anxiety and depression symptom burden (accuracy ~70%) but failed to predict subjective sleepiness. Together these results demonstrate that RAR features may encode prevalent depression and anxiety symptoms in patients with focal epilepsy, potentially offering wearable-derived endpoints to adjunct clinical care and drug/device trials. With larger PWE-specific actigraphic-psychometric data sets, we may identify RAR signatures that may more precisely correlate with varying seizure frequency, the burden of anticonvulsant therapy, and prevalent mood/anxiety symptoms.
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影响因子：
7.2
作者：
Hou WK;Lai FT;Ben-Ezra M;Goodwin R
通讯作者：
Goodwin R
影响因子：
5.6
作者：
Hesdorffer DC;Beck V;Begley CE;Bishop ML;Cushner-Weinstein S;Holmes GL;Shafer PO;Sirven JI;Austin JK
通讯作者：
Austin JK
影响因子：
2.6
作者：
Chen, Baibing;Choi, Hyunmi;Detyniecki, Kamil
通讯作者：
Detyniecki, Kamil
影响因子：
3
作者：
Chen, Baibing;Choi, Hyunmi;Detyniecki, Kamil
通讯作者：
Detyniecki, Kamil
影响因子：
9.9
作者：
Gilliam, FG;Fessler, AJ;Attarian, H
通讯作者：
Attarian, H