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Fractal biomarker of activity in patients with bipolar disorder

Published online by Cambridge University Press:  01 April 2020

Stefan E. Knapen Open the ORCID record for Stefan E. Knapen [Opens in a new window] ,
Peng Li ,
Rixt F. Riemersma-van der Lek ,
Sanne Verkooijen ,
Marco P. M. Boks ,
Robert A. Schoevers ,
Frank A. J. L. Scheer  and
Kun Hu
Stefan E. Knapen*
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
Peng Li
Affiliation:
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
Rixt F. Riemersma-van der Lek
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
Sanne Verkooijen
Affiliation:
Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
Marco P. M. Boks
Affiliation:
Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
Robert A. Schoevers
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
Frank A. J. L. Scheer
Affiliation:
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
Kun Hu
Affiliation:
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
*
Author for correspondence: Stefan E. Knapen, E-mail: stefanknapen@gmail.com
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Abstract

Background

The output of many healthy physiological systems displays fractal fluctuations with self-similar temporal structures. Altered fractal patterns are associated with pathological conditions. There is evidence that patients with bipolar disorder have altered daily behaviors.

Methods

To test whether fractal patterns in motor activity are altered in patients with bipolar disorder, we analyzed 2-week actigraphy data collected from 106 patients with bipolar disorder type I in a euthymic state, 73 unaffected siblings of patients, and 76 controls. To examine the link between fractal patterns and symptoms, we analyzed 180-day actigraphy and mood symptom data that were simultaneously collected from 14 patients.

Results

Compared to controls, patients showed excessive regularity in motor activity fluctuations at small time scales (<1.5 h) as quantified by a larger scaling exponent (α1 > 1), indicating a more rigid motor control system. α1 values of siblings were between those of patients and controls. Further examinations revealed that the group differences in α1 were only significant in females. Sex also affected the group differences in fractal patterns at larger time scales (>2 h) as quantified by scaling exponent α2. Specifically, female patients and siblings had a smaller α2 compared to female controls, indicating more random activity fluctuations; while male patients had a larger α2 compared to male controls. Interestingly, a higher weekly depression score was associated with a lower α1 in the subsequent week.

Conclusions

Our results show sex- and scale-dependent alterations in fractal activity regulation in patients with bipolar disorder. The mechanisms underlying the alterations are yet to be determined.

Keywords

Actigraphybipolar disorderfractal patternsmood disorderscale invariancesleep–wake rhythm
Type
Original Articles
Information
Psychological Medicine , Volume 51 , Issue 9 , July 2021 , pp. 1562 - 1569
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

Shared senior authorship.

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