Importance of polysomnographic parameters as biomarkers of depression

Thesis (M.A.)--Boston UniversityDepression is a common mental disorder that does not discriminate between age, gender, or race. Depression occurs when extreme feelings of sadness, accompanied by other physical symptoms, such as sleep difficulties, prevent functioning at normal daily activities. Previous studies have established a bilateral relationship between depression and insomnia that support a clinical importance in using insomnia screenings as an additional component to recognizing depression. This study analyzed which PSG parameters, from previous studies on depression, have the most common trend with depressed subjects compared to normal controls. A literature search on MEDLINE was utilized to gather the sleep studies that focused on depression and PSG parameters. The data was compiled to determine the common PSG parameters that provided significant evidence to support a trend between depressed and normal participants. This study identified nine parameters with trends that were commonly found in the studies: sleep latency, sleep efficiency, WASO, TST/TSA, duration in N2, SWS, delta sleep ratio, REM latency, and REM density. Of these parameters, sleep latency, amount of SWS, REM latency, delta sleep ratio, and alpha-delta sleep warranted further investigation in a clinical setting. An experimental component has been developed to investigate clinically the importance of the PSG parameters gathered from this study. The research will focus on determining PSG parameter trends in a clinical setting of a sleep lab. A BDI-II will be administered before a baseline sleep PSG is acquired. The BDI-II score will be analyzed in relation to the PSG obtained for each subject. The clinical study is in the BUMC IRB approval process and has been conditionally approved pending amendments to the original application

A systematic evidence synthesis of the changes observed in the brain of people diagnosed with a personality disorder in Black, Asian and ethnic minority communities

Preface: The path of this research stemmed from a passion and curiosity for mental health and neuroscience and in addition to this how prevalence, aetiology, diagnosis and treatment differs for people from Black, Asian and ethnic minority groups (BAME), being from this community myself. This study was meant to be an empirical study retrieving data from several mental health units in London, who agreed access, only to withdraw it at the last minute. We then planned for outpatients to come to LSBU to have the EEG scans necessary for data collection, but Covid-19 arrived and all face-to-face contact for research purposes halted before any data could be collected. The team concluded, that in order to keep the MRes ‘on the road’ and with no foreseeable end in sight to the CV-19-related lockdown, that a systematic evidence synthesis was feasible. Hence the work being reported here. This Evidence synthesis has been benchmarked against the PRIMSA statement . The associated PRISMA checklist was used to ensure that all relevant PRISMA items were addressed in the review paper, the student’s assessment of this can be found in appendix

Modern Views of Machine Learning for Precision Psychiatry

In light of the NIMH's Research Domain Criteria (RDoC), the advent of functional neuroimaging, novel technologies and methods provide new opportunities to develop precise and personalized prognosis and diagnosis of mental disorders. Machine learning (ML) and artificial intelligence (AI) technologies are playing an increasingly critical role in the new era of precision psychiatry. Combining ML/AI with neuromodulation technologies can potentially provide explainable solutions in clinical practice and effective therapeutic treatment. Advanced wearable and mobile technologies also call for the new role of ML/AI for digital phenotyping in mobile mental health. In this review, we provide a comprehensive review of the ML methodologies and applications by combining neuroimaging, neuromodulation, and advanced mobile technologies in psychiatry practice. Additionally, we review the role of ML in molecular phenotyping and cross-species biomarker identification in precision psychiatry. We further discuss explainable AI (XAI) and causality testing in a closed-human-in-the-loop manner, and highlight the ML potential in multimedia information extraction and multimodal data fusion. Finally, we discuss conceptual and practical challenges in precision psychiatry and highlight ML opportunities in future research

Examining the Effects of Casual Video Gameplay as an Intervention to Alleviate Symptoms of Depression on both Subjective and Objective Measures

Depression can be a debilitating illness that affects more than 300 million people worldwide. Although there are successful treatments for depression with pharmaceuticals and behavioral approaches such as psychotherapy, these approaches are often very costly and may carry a stigma of treatment for some individuals. The purpose of this dissertation study was to compare results of previously collected data that examine whether a prescribed regimen of casual videogame play (CVG) could reduce symptoms associated with depression. This dissertation specifically focused on comparing results of a study group and a comparison group on the self-report instrument, the Patient Health Questionnaire-9 (PHQ-9) as well as objectively measured changes in alpha wave, Electroencephalogram (EEG) data. Participants in the original study were screened for depression using the PHQ-9. There were a total of 57 participants who met the study inclusion criteria. Each participant that met the inclusion criteria was then randomized into either the comparison group (n=29) or the study group (n=28). Experimental group participants were prescribed to play one of three CVGs three times per week (with 24 hours between each session). This process occurred for 30 minutes each session, over a 1-month period. Comparison group participants reviewed the National Institute of Mental Health's webpage on depression during a pre-test and a post-test session. The participants in this group did not engage in any intervention over the one-month period of time between the pre-test and post-test sessions. A repeated-measures analysis of covariance (ANCOVA) was completed to examine three research questions between subjects at Time 1 and Time 3 to compare changes in depression symptoms on both subjective, self-report (PHQ-9) and objective alpha wave EEG measures. The CVGs used as the intervention factor were either Peggle, Bejeweled or Bookworm Adventure. Study analysis revealed significant decreases in depression symptoms reported in the study group on the PHQ-9 self-report scale. Results along the objective, EEG alpha wave scale revealed non-statistically significant changes. Potential reasons for the non-significant findings along with recommendations for future research are also discussed. Conclusions from this study found that a prescribed regimen of CVG may have potential as an intervention to help reduce symptoms of depression as measured on the PHQ-9 scale. Further research should consider examining intricacies of CVG play as a potential intervention to address symptoms related to depression. Findings also revealed that while EEG findings were not statistically significant, participants self-report responses were significant and may underscore the importance of individual's subjective feelings in the therapeutic process

Movement in Mind: Dance, Self-Awareness and Sociality - An Investigation of Dance as Treatment/Therapy

Dance has always occupied a central place in human culture. Why humans dance, however, and the role of dance in health, are questions that have yet to be fully addressed. Research to this point has been challenged by limitations in study design, differences in qualitative/quantitative evaluations, and dualistic perceptions of body and mind. This study proposes a shift in explanatory framework and research methods for the examination of dance in therapeutic contexts. Incorporating methods and views from neurobiology, dance/movement therapy, embodied cognition, and somatic education, this interdisciplinary project presents an innovative study design and novel perspective on the role of dance as a treatment for conditions that may be understood as mental/physical or both. It concludes that the practice of dance is essential to human flourishing, and may best be understood as a behaviour that nurtures our human capacity to adapt and thrive

The developmental course of attention-deficit/hyperactivity disorder : persistence, remission and emergence of symptoms from childhood to adulthood

Attention-deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that affects children, adolescents and adults. Several adverse outcomes have been consistently associated with a diagnosis of ADHD at any point in life. In this thesis, we were dedicated to the study of the course of ADHD from childhood to adulthood focusing on three perspectives. First, we discuss the age at onset of ADHD. Historically, ADHD has first been identified and described in children. Prospective clinical studies of children with ADHD found that the disorder might persist throughout adulthood, and the concept of adult ADHD remained tied to a childhood-onset disorder. Diagnostic manuals included age at onset in childhood as a core criterion for a valid ADHD diagnosis in adolescence and adulthood. However, recent studies challenged the validity of this criterion, suggesting that many ADHD cases in adulthood might have had a late onset. In this thesis, we present our contribution to the field with original data from a longitudinal birth cohort in Brazil and a theoretical discussion on the evidence so far available on the matter. Second, our research tried to parse out children who are at high risk for either persisting with ADHD throughout adolescence (for those already affected) or developing ADHD during their development into young adulthood. While many risk factors are already known, the literature is heterogeneous, findings are sometimes contradictory, and there is little clinical translation from the evidence. We reviewed and meta-analyzed the evidence available on risk factors for ADHD persistence, providing summary estimates for several known risk factors. We then developed and validated a multivariable risk calculator that aggregated several of these risk factors into one accurate individualized risk prediction. This tool is intended for research and clinical use, and available on-line. Third, we investigated the relative immaturity effect, by which children who are born later in the school calendar year present are more frequently diagnosed with ADHD. We did so by reviewing and meta-analyzing the evidence available, and by analyzing data from three large community-based cohorts placed in Brazil. The effect of relative immaturity is a conceptual demonstration of the importance of developmental adaptations in the genesis or worsening of ADHD symptoms, which might influence its emergence along childhood, adolescence and adulthood.O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) é um transtorno comum do neurodesenvolvimento que afeta crianças, adolescentes e adultos. O diagnóstico de TDAH estão consistentemente associados com desfechos adversos em qualquer idade. Nesta tese, nós nos dedicamos ao estudo do curso do TDAH da infância até a idade adulta, focando em três perspectivas. Primeiro, discutimos a idade de início do TDAH. Historicamente, o TDAH foi identificado e descrito pela primeira vez em crianças. Estudos clínicos prospectivos de crianças com TDAH descobriram que o transtorno pode persistir até a idade adulta, e o conceito de TDAH adulto permaneceu conectado a um transtorno de início na infância. Manuais diagnósticos incluíram idade de início na infância como um critério central para um diagnóstico válido de TDAH na adolescência e idade adulta. Entretanto, estudos recentes desafiaram a validade empírica deste critério, sugerindo que muitos casos de TDAH na idade adulta podem ter um início tardio. Nesta tese, apresentamos nossa contribuição nesta área com dados originais de uma coorte de nascimento no Brasil, e uma discussão teórica a respeito da evidência disponível sobre o assunto. Na segunda perspectiva, nossa pesquisa tentou identificar crianças que estão em risco para persistir com TDAH ao longo da adolescência (para aquelas já afetadas pelo transtorno) ou desenvolver TDAH ao longo do seu desenvolvimento até o início da idade adulta. Embora diversos fatores de risco sejam conhecidos, a literatura é heterogênea, os achados são por vezes contraditórios, e existe pouca tradução da evidência para a clínica. Nós revisamos e meta-analisamos a evidência disponível em fatores de risco para a persistência de TDAH, produzindo assim estimativas sumarizadas de risco para diversos fatores conhecidos. Em um segundo estudo, desenvolvemos e validamos uma calculadora de risco multivariada que agrega vários destes fatores em uma predição de risco individualizada e acurada. Esta ferramenta está disponível gratuitamente on-line, e pode ser usada em contextos clínicos e de pesquisa. Na terceira perspectiva, investigamos o efeito da imaturidade relativa, pelo qual crianças que nasceram mais tarde no ano letivo são mais frequentemente diagnosticadas com TDAH. Nós revisamos e meta-analisamos a evidência disponível, e analisando dados de três grandes coortes comunitárias no Brasil. O efeito da imaturidade relativa é uma demonstração conceitual da importância de adaptações desenvolvimentais na gênese de sintomas de TDAH, que podem influenciar sua emergência ao longo da infância, adolescência ou idade adulta