双相障碍的皮肤电活动：在真实临床环境中使用可穿戴设备评估发作期与临床缓解期的差异。

Electrodermal activity in bipolar disorder: Differences between mood episodes and clinical remission using a wearable device in a real-world clinical setting.

机构信息

Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Digital Innovation Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Catalonia, Spain.

出版信息

J Affect Disord. 2024 Jan 15;345:43-50. doi: 10.1016/j.jad.2023.10.125. Epub 2023 Oct 21.

DOI:10.1016/j.jad.2023.10.125

PMID:37865347

Abstract

BACKGROUND

Bipolar disorder (BD) lacks objective measures for illness activity and treatment response. Electrodermal activity (EDA) is a quantitative measure of autonomic function, which is altered in manic and depressive episodes. We aimed to explore differences in EDA (1) inter-individually: between patients with BD on acute mood episodes, euthymic states and healthy controls (HC), and (2) intra-individually: longitudinally within patients during acute mood episodes of BD and after clinical remission.

METHODS

A longitudinal observational study. EDA was recorded using a research-grade wearable in patients with BD during acute manic and depressive episodes and at clinical remission. Euthymic BD patients and HC were recorded during a single session. We compared EDA parameters derived from the tonic (mean EDA, mEDA) and phasic components (EDA peaks per minute, pmEDA, and EDA peaks mean amplitude, pmaEDA). Inter- and intra-individual comparisons were computed respectively with ANOVA and paired t-tests.

RESULTS

49 patients with BD (15 manic, 9 depressed, and 25 euthymic), and 19 HC were included. Patients with bipolar depression showed significantly reduced mEDA (p = 0.003) and pmEDA (p = 0.001), which increased to levels similar to euthymia or HC after clinical remission (mEDA, p = 0.011; pmEDA, p < 0.001; pmaEDA, p < 0.001). Manic patients showed no differences compared to euthymic patients and HCs, but a significant reduction of tonic and phasic EDA parameters after clinical remission (mEDA, p = 0.035; pmEDA, p = 0.004).

LIMITATIONS

Limited sample size, high inter-individual variability of EDA parameters, limited comparability to previous studies and non-adjustment for medication.

CONCLUSION

EDA ecological monitoring might provide several opportunities for early detection of depressive symptoms, and might aid at assessing early response to treatments in mania and bipolar depression.

摘要

背景

双相情感障碍（BD）缺乏疾病活动和治疗反应的客观指标。皮肤电活动（EDA）是自主功能的定量测量，在躁狂和抑郁发作期间会发生改变。我们旨在探索 EDA 在个体间（1）的差异：BD 患者在急性情绪发作、缓解期和健康对照组（HC）之间，以及（2）个体内：BD 患者在急性情绪发作期间和临床缓解后进行纵向比较。

方法

一项纵向观察性研究。使用研究级可穿戴设备在 BD 患者急性躁狂和抑郁发作期间以及临床缓解期记录 EDA。在单次就诊期间记录缓解期 BD 患者和 HC 的 EDA。我们分别使用方差分析和配对 t 检验比较源于紧张（平均 EDA，mEDA）和相成分（每分钟 EDA 峰值，pmEDA 和 EDA 峰值平均振幅，pmaEDA）的 EDA 参数。

结果

共纳入 49 名 BD 患者（15 名躁狂，9 名抑郁，25 名缓解）和 19 名 HC。双相抑郁患者的 mEDA（p=0.003）和 pmEDA（p=0.001）显著降低，在临床缓解后增加到与缓解期或 HC 相似的水平（mEDA，p=0.011；pmEDA，p<0.001；pmaEDA，p<0.001）。与缓解期患者和 HC 相比，躁狂患者没有差异，但在临床缓解后，紧张和相 EDA 参数显著降低（mEDA，p=0.035；pmEDA，p=0.004）。