Khandoker Ahsan H, Luthra Veena, Abouallaban Yousef, Saha Simanto, Ahmed Khawza I U, Mostafa Raqibul, Chowdhury Nayeefa, Jelinek Herbert F
Department of Biomedical Engineering, Khalifa UniversityAbu Dhabi, United Arab Emirates.
Department of Electrical and Electronic Engineering, University of MelbourneVIC, Australia.
Front Physiol. 2017 Jul 19;8:501. doi: 10.3389/fphys.2017.00501. eCollection 2017.
Physiological and psychological underpinnings of suicidal behavior remain ill-defined and lessen timely diagnostic identification of this subgroup of patients. Arterial stiffness is associated with autonomic dysregulation and may be linked to major depressive disorder (MDD). The aim of this study was to investigate the association between arterial stiffness by photo-plethysmogram (PPG) in MDD with and without suicidal ideation (SI) by applying multiscale tone entropy (T-E) variability analysis. Sixty-one 10-min PPG recordings were analyzed from 29 control, 16 MDD patients with (MDDSI+) and 16 patients without SI (MDDSI-). MDD was based on a psychiatric evaluation and the Mini-International Neuropsychiatric Interview (MINI). Severity of depression was assessed using the Hamilton Depression Rating Scale (HAM-D). PPG features included peak (systole), trough (diastole), pulse wave amplitude (PWA), pulse transit time (PTT) and pulse wave velocity (PWV). Tone (Diastole) at all lags and Tone (PWA) at lags 8, 9, and 10 were found to be significantly different between the MDDSI+ and MDDSI- group. However, Tone (PWA) at all lags and Tone (PTT) at scales 3-10 were also significantly different between the MDDSI+ and CONT group. In contrast, Entropy (Systole), Entropy (Diastole) and Tone (Diastole) were significantly different between MDDSI- and CONT groups. The suicidal score was also positively correlated ( = 0.39 ~ 0.47; < 0.05) with systolic and diastolic entropy values at lags 2-10. Multivariate logistic regression analysis and leave-one-out cross-validation were performed to study the effectiveness of multi-lag T-E features in predicting SI risk. The accuracy of predicting SI was 93.33% in classifying MDDSI+ and MDDSI- with diastolic T-E and lag between 2 and 10. After including anthropometric variables (Age, body mass index, and Waist Circumference), that accuracy increased to 96.67% for MDDSI+/- classification. Our findings suggest that tone-entropy based PPG variability can be used as an additional accurate diagnostic tool for patients with depression to identify SI.
自杀行为的生理和心理基础仍不明确，这使得对这类患者亚组的及时诊断识别变得困难。动脉僵硬度与自主神经调节异常有关，可能与重度抑郁症（MDD）相关。本研究的目的是通过应用多尺度音调熵（T-E）变异性分析，研究伴有和不伴有自杀意念（SI）的MDD患者通过光电容积脉搏波描记法（PPG）测得的动脉僵硬度之间的关联。对来自29名对照组、16名伴有SI的MDD患者（MDDSI+）和16名不伴有SI的患者（MDDSI-）的61份10分钟PPG记录进行了分析。MDD基于精神科评估和迷你国际神经精神病学访谈（MINI）。使用汉密尔顿抑郁量表（HAM-D）评估抑郁严重程度。PPG特征包括峰值（收缩期）、谷值（舒张期）、脉搏波振幅（PWA）、脉搏传输时间（PTT）和脉搏波速度（PWV）。发现MDDSI+组和MDDSI-组之间所有滞后的音调（舒张期）以及滞后8、9和10时的音调（PWA）存在显著差异。然而，MDDSI+组和对照组之间所有滞后的音调（PWA）以及尺度3-10时的音调（PTT）也存在显著差异。相比之下，MDDSI-组和对照组之间的熵（收缩期）、熵（舒张期）和音调（舒张期）存在显著差异。自杀评分也与滞后2-10时的收缩期和舒张期熵值呈正相关（=0.39~0.47；<0.05）。进行多变量逻辑回归分析和留一法交叉验证，以研究多滞后T-E特征在预测SI风险方面的有效性。在使用舒张期T-E和滞后2至10对MDDSI+和MDDSI-进行分类时，预测SI的准确率为93.33%。纳入人体测量变量（年龄、体重指数和腰围）后，MDDSI+/-分类的准确率提高到96.67%。我们的研究结果表明，基于音调熵的PPG变异性可作为抑郁症患者识别SI的一种额外准确诊断工具。
