Fractal biomarker of daily activity for women with early onset depression
BackgroundDepression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive disorder (MDD) often show disturbed daily rest-activity patterns, but such changes are often confounded by medication intake, comorbidit...
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| Published in | BMJ mental health Vol. 28; no. 1; p. e301321 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BMJ Publishing Group Ltd, Royal College of Psychiatrists and British Psychological Society
10.06.2025
BMJ Publishing Group LTD BMJ Publishing Group |
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| Online Access | Get full text |
| ISSN | 2755-9734 2755-9734 |
| DOI | 10.1136/bmjment-2024-301321 |
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| Abstract | BackgroundDepression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive disorder (MDD) often show disturbed daily rest-activity patterns, but such changes are often confounded by medication intake, comorbidities and disease duration.ObjectiveIn this exploratory analysis, we tested whether there are specific changes in daily rest activity (from wrist-worn actigraphy) in women at the onset of MDD without medication, as compared with age-matched controls.MethodsParticipants from the MDD group (age 19–32, 24.73±5.13 (mean±SD), N=15) and control group (age 20–31, 24.89±3.82, N=9) completed ~7 day ambulatory actigraphy recordings, followed by a stringently controlled circadian laboratory protocol to assess endogenous circadian melatonin levels. We analysed the daily rhythm of mean activity levels and non-linear fractal dynamics in eight 3-hour time bin across the 24 hours, correlating these measures with depressive symptom severity and endogenous melatonin levels.FindingsUsing approaches from non-linear fractal dynamics, we showed that, compared with healthy controls, women at MDD onset had a higher fractal activity correlation (FAC) during the last hours of sleep, indicating more ‘wake-like’ patterns (FAC within 0–3 hour before wake: 0.92±0.64 (SD) in MDD vs 0.77±0.18 in controls, p=0.02). The alteration was independent of mean activity level and wake duration but appeared to be associated with depressive symptom severity (p=0.08). Moreover, there was a trend association for altered FAC with endogenous melatonin levels in the MDD group (for onefold increase in melatonin level in the last 3 hours before wake, the FAC increased by 0.33±0.17 (SE), p=0.08).ConclusionsPre-wake FAC is elevated in unmedicated women at MDD onset and may serve as a potential biomarker associated with symptom severity and circadian physiology.Clinical implicationsThese findings provide proof-of-concept evidence that unique fractal motor activity patterns may support early detection of MDD. |
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| AbstractList | BackgroundDepression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive disorder (MDD) often show disturbed daily rest-activity patterns, but such changes are often confounded by medication intake, comorbidities and disease duration.ObjectiveIn this exploratory analysis, we tested whether there are specific changes in daily rest activity (from wrist-worn actigraphy) in women at the onset of MDD without medication, as compared with age-matched controls.MethodsParticipants from the MDD group (age 19–32, 24.73±5.13 (mean±SD), N=15) and control group (age 20–31, 24.89±3.82, N=9) completed ~7 day ambulatory actigraphy recordings, followed by a stringently controlled circadian laboratory protocol to assess endogenous circadian melatonin levels. We analysed the daily rhythm of mean activity levels and non-linear fractal dynamics in eight 3-hour time bin across the 24 hours, correlating these measures with depressive symptom severity and endogenous melatonin levels.FindingsUsing approaches from non-linear fractal dynamics, we showed that, compared with healthy controls, women at MDD onset had a higher fractal activity correlation (FAC) during the last hours of sleep, indicating more ‘wake-like’ patterns (FAC within 0–3 hour before wake: 0.92±0.64 (SD) in MDD vs 0.77±0.18 in controls, p=0.02). The alteration was independent of mean activity level and wake duration but appeared to be associated with depressive symptom severity (p=0.08). Moreover, there was a trend association for altered FAC with endogenous melatonin levels in the MDD group (for onefold increase in melatonin level in the last 3 hours before wake, the FAC increased by 0.33±0.17 (SE), p=0.08).ConclusionsPre-wake FAC is elevated in unmedicated women at MDD onset and may serve as a potential biomarker associated with symptom severity and circadian physiology.Clinical implicationsThese findings provide proof-of-concept evidence that unique fractal motor activity patterns may support early detection of MDD. Depression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive disorder (MDD) often show disturbed daily rest-activity patterns, but such changes are often confounded by medication intake, comorbidities and disease duration.BACKGROUNDDepression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive disorder (MDD) often show disturbed daily rest-activity patterns, but such changes are often confounded by medication intake, comorbidities and disease duration.In this exploratory analysis, we tested whether there are specific changes in daily rest activity (from wrist-worn actigraphy) in women at the onset of MDD without medication, as compared with age-matched controls.OBJECTIVEIn this exploratory analysis, we tested whether there are specific changes in daily rest activity (from wrist-worn actigraphy) in women at the onset of MDD without medication, as compared with age-matched controls.Participants from the MDD group (age 19-32, 24.73±5.13 (mean±SD), N=15) and control group (age 20-31, 24.89±3.82, N=9) completed ~7 day ambulatory actigraphy recordings, followed by a stringently controlled circadian laboratory protocol to assess endogenous circadian melatonin levels. We analysed the daily rhythm of mean activity levels and non-linear fractal dynamics in eight 3-hour time bin across the 24 hours, correlating these measures with depressive symptom severity and endogenous melatonin levels.METHODSParticipants from the MDD group (age 19-32, 24.73±5.13 (mean±SD), N=15) and control group (age 20-31, 24.89±3.82, N=9) completed ~7 day ambulatory actigraphy recordings, followed by a stringently controlled circadian laboratory protocol to assess endogenous circadian melatonin levels. We analysed the daily rhythm of mean activity levels and non-linear fractal dynamics in eight 3-hour time bin across the 24 hours, correlating these measures with depressive symptom severity and endogenous melatonin levels.Using approaches from non-linear fractal dynamics, we showed that, compared with healthy controls, women at MDD onset had a higher fractal activity correlation (FAC) during the last hours of sleep, indicating more 'wake-like' patterns (FAC within 0-3 hour before wake: 0.92±0.64 (SD) in MDD vs 0.77±0.18 in controls, p=0.02). The alteration was independent of mean activity level and wake duration but appeared to be associated with depressive symptom severity (p=0.08). Moreover, there was a trend association for altered FAC with endogenous melatonin levels in the MDD group (for onefold increase in melatonin level in the last 3 hours before wake, the FAC increased by 0.33±0.17 (SE), p=0.08).FINDINGSUsing approaches from non-linear fractal dynamics, we showed that, compared with healthy controls, women at MDD onset had a higher fractal activity correlation (FAC) during the last hours of sleep, indicating more 'wake-like' patterns (FAC within 0-3 hour before wake: 0.92±0.64 (SD) in MDD vs 0.77±0.18 in controls, p=0.02). The alteration was independent of mean activity level and wake duration but appeared to be associated with depressive symptom severity (p=0.08). Moreover, there was a trend association for altered FAC with endogenous melatonin levels in the MDD group (for onefold increase in melatonin level in the last 3 hours before wake, the FAC increased by 0.33±0.17 (SE), p=0.08).Pre-wake FAC is elevated in unmedicated women at MDD onset and may serve as a potential biomarker associated with symptom severity and circadian physiology.CONCLUSIONSPre-wake FAC is elevated in unmedicated women at MDD onset and may serve as a potential biomarker associated with symptom severity and circadian physiology.These findings provide proof-of-concept evidence that unique fractal motor activity patterns may support early detection of MDD.CLINICAL IMPLICATIONSThese findings provide proof-of-concept evidence that unique fractal motor activity patterns may support early detection of MDD. Background Depression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive disorder (MDD) often show disturbed daily rest-activity patterns, but such changes are often confounded by medication intake, comorbidities and disease duration.Objective In this exploratory analysis, we tested whether there are specific changes in daily rest activity (from wrist-worn actigraphy) in women at the onset of MDD without medication, as compared with age-matched controls.Methods Participants from the MDD group (age 19–32, 24.73±5.13 (mean±SD), N=15) and control group (age 20–31, 24.89±3.82, N=9) completed ~7 day ambulatory actigraphy recordings, followed by a stringently controlled circadian laboratory protocol to assess endogenous circadian melatonin levels. We analysed the daily rhythm of mean activity levels and non-linear fractal dynamics in eight 3-hour time bin across the 24 hours, correlating these measures with depressive symptom severity and endogenous melatonin levels.Findings Using approaches from non-linear fractal dynamics, we showed that, compared with healthy controls, women at MDD onset had a higher fractal activity correlation (FAC) during the last hours of sleep, indicating more ‘wake-like’ patterns (FAC within 0–3 hour before wake: 0.92±0.64 (SD) in MDD vs 0.77±0.18 in controls, p=0.02). The alteration was independent of mean activity level and wake duration but appeared to be associated with depressive symptom severity (p=0.08). Moreover, there was a trend association for altered FAC with endogenous melatonin levels in the MDD group (for onefold increase in melatonin level in the last 3 hours before wake, the FAC increased by 0.33±0.17 (SE), p=0.08).Conclusions Pre-wake FAC is elevated in unmedicated women at MDD onset and may serve as a potential biomarker associated with symptom severity and circadian physiology.Clinical implications These findings provide proof-of-concept evidence that unique fractal motor activity patterns may support early detection of MDD. Depression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive disorder (MDD) often show disturbed daily rest-activity patterns, but such changes are often confounded by medication intake, comorbidities and disease duration. In this exploratory analysis, we tested whether there are specific changes in daily rest activity (from wrist-worn actigraphy) in women at the onset of MDD without medication, as compared with age-matched controls. Participants from the MDD group (age 19-32, 24.73±5.13 (mean±SD), N=15) and control group (age 20-31, 24.89±3.82, N=9) completed ~7 day ambulatory actigraphy recordings, followed by a stringently controlled circadian laboratory protocol to assess endogenous circadian melatonin levels. We analysed the daily rhythm of mean activity levels and non-linear fractal dynamics in eight 3-hour time bin across the 24 hours, correlating these measures with depressive symptom severity and endogenous melatonin levels. Using approaches from non-linear fractal dynamics, we showed that, compared with healthy controls, women at MDD onset had a higher fractal activity correlation (FAC) during the last hours of sleep, indicating more 'wake-like' patterns (FAC within 0-3 hour before wake: 0.92±0.64 (SD) in MDD vs 0.77±0.18 in controls, p=0.02). The alteration was independent of mean activity level and wake duration but appeared to be associated with depressive symptom severity (p=0.08). Moreover, there was a trend association for altered FAC with endogenous melatonin levels in the MDD group (for onefold increase in melatonin level in the last 3 hours before wake, the FAC increased by 0.33±0.17 (SE), p=0.08). Pre-wake FAC is elevated in unmedicated women at MDD onset and may serve as a potential biomarker associated with symptom severity and circadian physiology. These findings provide proof-of-concept evidence that unique fractal motor activity patterns may support early detection of MDD. |
| Author | Hu, Kun Ulsa, Ma Cherrysse Chellappa, Sarah Laxhmi Münch, Mirjam Yang, Hui-Wen Birchler-Pedross, Angelina Knoblauch, Vera Cajochen, Christian Frey, Sylvia Li, Peng Gaba, Arlen |
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| Keywords | Depression Depression & mood disorders Sleep |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Additional supplemental material is published online only. To view, please visit the journal online (https://doi.org/10.1136/bmjment-2024-301321). SLC, CC and KH are joint senior authors. CC has had the following commercial interests related to lighting: honoraria, travel, accommodation and/or meals for invited keynote lectures, conference presentations or teaching from Toshiba Materials, Velux, Firalux, Lighting Europe, Electrosuisse, Novartis, Roche, Elite, Servier, and WIR Bank. CC and MM are members of the Daylight Academy. These disclosures are not related to the current work. HWY, MM, MCU, AG, SLC, AB-P, SF, VK, PL and KH report no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise. |
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| Snippet | BackgroundDepression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major... Depression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major depressive... Background Depression is a major health issue in adolescence and young adulthood, emphasising the need for early risk identification. Patients with major... |
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| SubjectTerms | Actigraphy Activities of Daily Living Adult Adult Mental Health Age Biomarkers Case-Control Studies Circadian rhythm Circadian Rhythm - physiology Depression Depression & mood disorders Depressive Disorder, Major - diagnosis Depressive Disorder, Major - physiopathology Female Fractals Health care Humans Laboratories Melatonin Melatonin - metabolism Mental depression Mental disorders Original Research Psychologists Sleep Sleep deprivation Teenagers Womens health Young Adult Young adults |
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| Title | Fractal biomarker of daily activity for women with early onset depression |
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