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Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls.

ABSTRACT: Distinguishing pediatric bipolar disorder (BD) from attention-deficit hyperactivity disorder (ADHD) can be challenging. Hyperactivity is a core feature of both disorders, but severely disturbed sleep and circadian dysregulation are more characteristic of BD, at least in adults. We tested the hypothesis that objective measures of activity, sleep, and circadian rhythms would help differentiate pediatric subjects with BD from ADHD and typically developing controls.Unmedicated youths (N = 155, 97 males, age 5-18) were diagnosed using DSM-IV criteria with Kiddie-SADS PL/E. BD youths (n = 48) were compared to typically developing controls (n = 42) and children with ADHD (n = 44) or ADHD plus comorbid depressive disorders (n = 21). Three-to-five days of minute-to-minute belt-worn actigraph data (Ambulatory Monitoring Inc.), collected during the school week, were processed to yield 28 metrics per subject, and assessed for group differences with analysis of covariance. Cross-validated machine learning algorithms were used to determine the predictive accuracy of a four-parameter model, with measures reflecting sleep, hyperactivity, and circadian dysregulation, plus Indic's bipolar vulnerability index (VI).There were prominent group differences in several activity measures, notably mean 5 lowest hours of activity, skewness of diurnal activity, relative circadian amplitude, and VI. A predictive support vector machine model discriminated bipolar from non-bipolar with mean accuracy of 83.1 ± 5.4%, ROC area of 0.781 ± 0.071, kappa of 0.587 ± 0.136, specificity of 91.7 ± 5.3%, and sensitivity of 64.4 ± 13.6%.Objective measures of sleep, circadian rhythmicity, and hyperactivity were abnormal in BD. Wearable sensor technology may provide bio-behavioral markers that can help differentiate children with BD from ADHD and healthy controls.

SUBMITTER: Faedda GL

PROVIDER: S-EPMC4873411 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls.

Faedda Gianni L GL Ohashi Kyoko K Hernandez Mariely M McGreenery Cynthia E CE Grant Marie C MC Baroni Argelinda A Polcari Ann A Teicher Martin H MH

Journal of child psychology and psychiatry, and allied disciplines 20160122 6

<h4>Background</h4>Distinguishing pediatric bipolar disorder (BD) from attention-deficit hyperactivity disorder (ADHD) can be challenging. Hyperactivity is a core feature of both disorders, but severely disturbed sleep and circadian dysregulation are more characteristic of BD, at least in adults. We tested the hypothesis that objective measures of activity, sleep, and circadian rhythms would help differentiate pediatric subjects with BD from ADHD and typically developing controls.<h4>Methods</h4 ...[more]

PMID: 26799153

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Project description:Just as typical development of anatomical asymmetries in the human brain has been linked with normal lateralization of motor and cognitive functions, disruption of asymmetry has been implicated in the pathogenesis of neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD). No study has examined the development of cortical asymmetry using longitudinal neuroanatomical data.To delineate the development of cortical asymmetry in children with and without ADHD.Longitudinal study.Government Clinical Research Institute.A total of 218 children with ADHD and 358 typically developing children, from whom 1133 neuroanatomical magnetic resonance images were acquired prospectively.Cortical thickness was estimated at 40 962 homologous points in the left and right hemispheres, and the trajectory of change in asymmetry was defined using mixed-model regression.In right-handed typically developing individuals, a mean (SE) increase in the relative thickness of the right orbitofrontal and inferior frontal cortex with age of 0.011 (0.0018) mm per year (t(337) = 6.2, P < .001) was balanced against a relative left-hemispheric increase in the occipital cortical regions of 0.013 (0.0015) mm per year (t(337) = 8.1, P < .001). Age-related change in asymmetry in non-right-handed typically developing individuals was less extensive and was localized to different cortical regions. In ADHD, the posterior component of this evolving asymmetry was intact, but the prefrontal component was lost.These findings explain the way that, in typical development, the increased dimensions of the right frontal and left occipital cortical regions emerge in adulthood from the reversed pattern of childhood cortical asymmetries. Loss of the prefrontal component of this evolving asymmetry in ADHD is compatible with disruption of prefrontal function in the disorder and demonstrates the way that disruption of typical processes of asymmetry can inform our understanding of neurodevelopmental disorders.

Project description:A growing number of studies support the theory that physical activity can effectively foster the cognitive function of children with attention-deficit hyperactivity disorder (ADHD). The present study examines the effect of acute moderate physical activity on the executive functions and attention performance of (1) typically developing children (without psychological, psychiatric or neurological diagnosis and/or associated treatment stated in their medical history); (2) treatment-naïve ADHD children; and (3) medicated children with ADHD. In the current study, a total sample of 150 (50 non-medicated, 50 medicated, and 50 typically developing) children between the ages of 6 and 12 took part in the experiment. The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was used to measure ADHD and the child version of the Test of Attentional Performance (KiTAP) was applied to evaluate the children's attentional and executive function performance before and after two types of intervention. In order to compare the effects of physical activity and control intervention, half of the children from each group (25 participants) took part in a 20-min long, moderately intense physical activity session on the 60-80% of their maximum heart rate, while watching a cartoon video. In the control condition, the other half of the children (25 participants) from each group watched the same cartoon video for 20 min while seated. Physical activity (compared to the just video watching control condition) had a significantly positive influence on 2 out of 15 measured parameters (median reaction time in the alertness task and error rates in the divided attention task) for the medicated group and on 2 out of the 15 measured variables (number of total errors and errors when distractor was presented, both in the distractibility task) regarding the treatment-naïve group. Future studies should focus on finding the optimal type, intensity, and duration of physical activity that could be a potential complementary intervention in treating deficits regarding ADHD in children.

Dataset Information

Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls.

Publications

Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls.

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