Does childhood experience of attention-deficit hyperactivity disorder symptoms increase sleep/wake cycle disturbances as measured with actigraphy in adult patients with bipolar disorder?

ABSTRACT

Childhood attention-deficit hyperactivity disorder (ADHD) is a common precursor of adult bipolar disorders (BD). Furthermore, actigraphy studies demonstrate that each disorder may be associated with abnormalities in sleep and activity patterns. This study investigates whether the presence or absence of self-reported childhood experiences of ADHD symptoms is associated with different sleep and activity patterns in adults with BD. A sample of 115 euthymic adult patients with BD was assessed for childhood ADHD symptoms using the Wender Utah Rating Scale (WURS) and then completed 21 days of actigraphy monitoring. Actigraphic measures of sleep quantity and variability and daytime activity were compared between BD groups classified as ADHD+ (n = 24) or ADHD? (n = 91), defined according to established cutoff scores for the WURS; then we examined any associations between sleep–wake cycle parameters and ADHD dimensions (using the continuous score on the WURS). Neither approach revealed any statistically significant associations between actigraphy parameters and childhood ADHD categories or dimensions. We conclude that the sleep and activity patterns of adult patients with BD do not differ according to their self-reported history of ADHD symptoms. We discuss the implications of these findings and suggest how future studies might confirm or refute our findings.     

Recurrent neural networks of integrate-and-fire cells simulating short-term memory and wrist movement tasks derived from continuous dynamic networks

Dynamic recurrent neural networks composed of units with continuous activation functions provide a powerful tool for simulating a wide range of behaviors, since the requisite interconnections can be readily derived by gradient descent methods. However, it is not clear whether more realistic integrate-and-fire cells with comparable connection weights would perform the same functions. We therefore investigated methods to convert dynamic recurrent neural networks of continuous units into networks with integrate-and-fire cells. The transforms were tested on two recurrent networks derived by backpropagation. The first simulates a short-term memory task with units that mimic neural activity observed in cortex of monkeys performing instructed delay tasks. The network utilizes recurrent connections to generate sustained activity that codes the remembered value of a transient cue. The second network simulates patterns of neural activity observed in monkeys performing a step-tracking task with flexion/extension wrist movements. This more complicated network provides a working model of the interactions between multiple spinal and supraspinal centers controlling motoneurons. Our conversion algorithm replaced each continuous unit with multiple integrate-and-fire cells that interact through delayed "synaptic potentials". Successful transformation depends on obtaining an appropriate fit between the activation function of the continuous units and the input-output relation of the spiking cells. This fit can be achieved by adapting the parameters of the synaptic potentials to replicate the input-output behavior of a standard sigmoidal activation function (shown for the short-term memory network). Alternatively, a customized activation function can be derived from the input-output relation of the spiking cells for a chosen set of parameters (demonstrated for the wrist flexion/extension network). In both cases the resulting networks of spiking cells exhibited activity that replicated the activity of corresponding continuous units. This confirms that the network solutions obtained through backpropagation apply to spiking networks and provides a useful method for deriving recurrent spiking networks performing a wide range of functions.     

Actigraphic Investigations On The Activity‐Rest Behavior Of Right‐ and Left‐Handed Students

The aim of this study was to explore differences between left‐and right‐handed subjects in sleep duration. Sleep and activity patterns were continuously registered for 12 days using actometers on 20 left‐handed and 20 right‐handed medical students in Berlin. Handedness was determined by a modified version of the Edinburgh handedness inventory. Each participant wore one actometer on each wrist. Actiwatch® Sleep Analysis Software (CNT, UK) was used to evaluate the data, and statistical calculations were performed with a non‐parametric variance analysis. A significant difference in mean sleep duration between left‐handers (7.9 h) and right‐handers (7.3 h) was determined (p=0.025 for measurement made on the dominant hand and p=0.013 for ones made on the non‐dominant hand). In contrast, the maximal phase of daily activity (acrophase) did not show any difference between the two groups. The difference in sleep duration might be caused by either the greater effort required for left‐handers to cope in a right‐handed world or by structural brain differences.     

A musculoskeletal model to estimate the relative changes in wrist strength due to interacting wrist and forearm postures

Wrist rotations about one wrist axis (e.g. flexion/extension) can affect the strength about another wrist axis (e.g. radial/ulnar deviation). This study used a musculoskeletal model of the distal upper extremity, and an optimization approach, to quantify the interaction effects of wrist flexion/extension (FE), radial/ulnar deviation (RUD) and forearm pronation/supination (PS) on wrist strength. Regression equations were developed to predict the relative changes in strength from the neutral posture, so that the changes in strength, due to complex and interacting wrist and forearm rotation postures, can be incorporated within future ergonomics assessments of wrist strength.     

Is disruption of sleep quality a consequence of severe Covid-19 infection? A case-series examination

ABSTRACT

The Covid-19 outbreak put enormous stress on the health system worldwide, and objective data to handle the emergency are still needed. We aimed to objectively assess the consequence of severe symptoms of Covid-19 infection on sleep quality through wrist actigraphy monitoring of four patients during the sub-acute recovery stage of the disease. The sleep of those patients who had experienced the most severe respiratory symptoms and who had needed prolonged intensive care unit (ICU) stay showed lower Sleep Efficiency and Immobility Time and higher Fragmentation Index compared to those patients who had experienced only mild respiratory symptoms and not requiring ICU stay. Wrist actigraphy assessment provided important clinical information about the sleep and activity levels of Covid-19 patients during the post-acute rehabilitation management.     

A rigorous method for evaluation of the 6D compliance of external fixators

External fixators are standard devices to stabilize bone fractures and their compliance aims at producing an interfragmentary motion that promotes rapid and successful healing. While evaluation of their axial compliance is a routine test, the quantification and interpretation of their full 6 × 6 compliance matrix is an extensive and delicate task. In this context, the objective of this study was to develop, validate and demonstrate the potential of a rigorous method to quantify their 6 × 6 compliance matrix. An experimental system was developed to apply six independent static forces and moments to an external fixator in the field of view of two infrared cameras quantifying the induced motion. The system was then tested with a calibration structure which compliance could be calculated analytically and numerically. Finally, the system was applied to compare three configurations of a commercial external wrist fixator. The results of the method proved to be reproducible and highly consistent with the linear elasticity theory in the physiological range of small deformations. A rigorous method for evaluation of the 6D compliance becomes therefore available for research in mechanobiology of fracture healing by external fixation.     

The lorisiform wrist joint and the evolution of "brachiating" adaptations in the hominoidea.

In lorisines (Loris, Nycticebus, Perodicticus, Arctocebus), the tip of the ulna is reduced to the dimensions of a styloid process, a new and more proximal ulnar head is developed, and the pisiform is displaced distally away from its primitive contact with the ulna. In some Nycticebus, intra-articular tissues separate the ulna from the triquetrum. These traits are not seen in other quadrupedal primates, but they are characteristic of extant hominoids. Among hominoids, these features have been interpreted as adaptations to arm-swinging locomotion. Since hominoid-like features of the wrist joint are found in lorisines, but not in New World monkeys that practice arm-swinging locomotion, these features may have been evolved in both lorisines and large hominoids to enhance wrist mobility for cautious arboreal locomotion involving little or no leaping. Most of the other morphological traits characteristic of modern hominoids can be explained as adaptations to cautious quadrupedalism as well as to brachiation, and may have developed for different reasons in different lineages descended from an unspecialized cautious quadruped resembling Alouatta.     

Accuracy of biplane videoradiography for quantifying dynamic wrist kinematics

Accurately assessing the dynamic kinematics of the skeletal wrist could advance our understanding of the normal and pathological wrist. Biplane videoradiography (BVR) has allowed investigators to study dynamic activities in the knee, hip, and shoulder joint; however, currently, BVR has not been utilized for the wrist joint because of the challenges associated with imaging multiple overlapping bones. Therefore, our aim was to develop a BVR procedure and to quantify its accuracy for evaluation of wrist kinematics. BVR was performed on six cadaveric forearms for one neutral static and six dynamic tasks, including flexion-extension, radial-ulnar deviation, circumduction, pronation, supination, and hammering. Optical motion capture (OMC) served as the gold standard for assessing accuracy. We propose a feedforward tracking methodology, which uses a combined model of metacarpals (second and third) for initialization of the third metacarpal (MC3). BVR-calculated kinematic parameters were found to be consistent with the OMC-calculated parameters, and the BVR/OMC agreement had submillimeter and sub-degree biases in tracking individual bones as well as the overall joint’s rotation and translation. All dynamic tasks (except pronation task) showed a limit of agreement within 1.5° for overall rotation, and within 1.3 mm for overall translations. Pronation task had a 2.1° and 1.4 mm limit of agreement for rotation and translation measurement. The poorest precision was achieved in calculating the pronation-supination angle, and radial-ulnar and volar-dorsal translational components, although they were sub-degree and submillimeter. The methodology described herein may assist those interested in examining the complexities of skeletal wrist function during dynamic tasks.     

Identifying tasks to elicit maximum voluntary contraction in the muscles of the forearm

Maximum voluntary contractions (MVCs) are often used for the normalisation of electromyography data to enable comparison of signal patterns within and between study participants. Recommendations regarding the types of tasks that are needed to collect MVCs for the muscles of the forearm have been made, specifically advocating the use of resisted moment tasks to get better estimates of forearm MVCs. However, a protocol detailing which specific tasks to employ has yet to be published. Furthermore, the effects of limb dominance on the collection of MVCs have not been considered previously. Muscle activity was monitored while 23 participants performed nine isometric, resisted tasks. The tasks that are likely to elicit MVC in the flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis, extensor carpi ulnaris, extensor carpi radialis, extensor digitorum communis, and pronator teres were identified. Thus, targeted protocols can be designed to mitigate against fatigue. Hand dominance had limited effect, with differences being found only in the finger flexors and extensors (p< 0.03). Thus, use of the contralateral flexor digitorum superficialis and extensor digitorum communis muscles to obtain baselines for activation levels and patterns may not be appropriate.