The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.
School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.
Biosensors (Basel). 2022 Oct 26;12(11):924. doi: 10.3390/bios12110924.
Treating opioid use disorder (OUD) is a significant healthcare challenge in the United States. Remaining abstinent from opioids is challenging for individuals with OUD due to withdrawal symptoms that include restlessness. However, to our knowledge, studies of acute withdrawal have not quantified restlessness using involuntary movements. We hypothesized that wearable accelerometry placed mid-sternum could be used to detect withdrawal-related restlessness in patients with OUD. To study this, 23 patients with OUD undergoing active withdrawal participated in a protocol involving wearable accelerometry, opioid cues to elicit craving, and non-invasive Vagal Nerve Stimulation (nVNS) to dampen withdrawal symptoms. Using accelerometry signals, we analyzed how movements correlated with changes in acute withdrawal severity, measured by the Clinical Opioid Withdrawal Scale (COWS). Our results revealed that patients demonstrating sinusoidal-i.e., predominantly single-frequency oscillation patterns in their motion almost exclusively demonstrated an increase in the COWS, and a strong relationship between the maximum power spectral density and increased withdrawal over time, measured by the COWS (R = 0.92, = 0.029). Accelerometry may be used in an ambulatory setting to indicate the increased intensity of a patient's withdrawal symptoms, providing an objective, readily-measurable marker that may be captured ubiquitously.
治疗阿片类药物使用障碍（OUD）是美国面临的重大医疗挑战。由于戒断症状包括不安，因此患有 OUD 的个体很难保持戒断状态。然而，据我们所知，对急性戒断的研究尚未使用非自愿运动来量化不安。我们假设放置在胸骨中部的可穿戴加速度计可用于检测患有 OUD 的患者与戒断相关的不安。为了研究这一点，23 名正在经历主动戒断的 OUD 患者参与了一项涉及可穿戴加速度计、阿片类药物线索诱发渴求以及非侵入性迷走神经刺激（nVNS）以减轻戒断症状的方案。使用加速度计信号，我们分析了运动与急性戒断严重程度变化的相关性，急性戒断严重程度通过临床阿片类戒断量表（COWS）进行测量。我们的结果表明，在运动中表现出正弦波的患者，即主要表现为单一频率的振动模式的患者，几乎无一例外地表现出 COWS 的增加，以及最大功率谱密度与 COWS 测量的戒断时间之间的强烈关系（R = 0.92， = 0.029）。加速度计可能会在非卧床环境中用于指示患者戒断症状的强度增加，提供一种客观、易于测量的标志物，可以广泛捕获。
