Actigraphy in agitated patients with dementia

Mahlberg, Richard; Walther, Sebastian

doi:10.1007/s00391-007-0420-z

Cited by 86 publications

(54 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the duration of immobility and the MI were found to be independent of the type and dosage of antipsychotic drugs and therefore may reflect intrinsic motor features of schizophrenia. Actigraphy does not distress patients and may help better understand schizophrenia-specific movement disorders and evaluate the treatment outcome, as has been previously shown in dementia [49] .…”

Section: Discussionmentioning

confidence: 99%

Quantitative Motor Activity Differentiates Schizophrenia Subtypes

et al. 2009

View full text Add to dashboard Cite

Background: Motor symptoms are frequent in schizophrenia and relevant to the diagnosis of subtypes. However, the assessment has been limited to observations recorded in scales and experimental designs. The aim of this study was to use wrist actigraphy to obtain motor activity data in 3 schizophrenia subtypes. Methods: In total, 60 patients with schizophrenia (35 paranoid, 12 catatonic, 13 disorganized) were investigated using continuous wrist actigraphy over 24 h in an inpatient setting on average 38 days after admission. Data of the wakeful hours of the day were analyzed. Results: The activity level was predicted by schizophrenia subtype and by the type of antipsychotic medication. The movement index and mean duration of uninterrupted immobility were found to be predicted only by the schizophrenia subtype. Age, gender, duration of illness and chlorpromazine equivalents did not contribute to the variance of the activity data. A MANOVA demonstrated the significant differences in the 3 parameters between schizophrenia subtypes (p = 0.001). Patients with catatonic schizophrenia had lower activity levels, a lower movement index and a longer duration of immobility than those with paranoid schizophrenia. Conclusions: Schizophrenia subtypes can be differentiated using objective measures of quantitative motor activity. The increased duration of immobility appears to be the special feature of catatonic schizophrenia.

show abstract

Section: Discussionmentioning

confidence: 99%

Quantitative Motor Activity Differentiates Schizophrenia Subtypes

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Similarly, Mahlberg and Walther [38] investigated the effects of dronabinol for the treatment of night-time agitation in seven patients diagnosed with probable dementia of the AD type. Agitation and circadian disturbances were assessed using continuous wrist actigraphy, which calculated the nocturnal motor activity overnight.…”

Section: Cannabinoid Treatment For Agitation and Aggression In Dementmentioning

confidence: 98%

“…All trials included synthetic analogs of delta-9-tetrahydrocannabinol (THC), either administering dronabinol [36][37][38][39][40] or nabilone [41]. A significant portion of all participants had used or were using psychoactive medication to manage their symptoms.…”

Section: Cannabinoid Treatment For Agitation and Aggression In Dementmentioning

confidence: 99%

Cannabinoids for the Treatment of Agitation and Aggression in Alzheimer’s Disease

et al. 2015

View full text Add to dashboard Cite

Alzheimer's disease (AD) is frequently associated with neuropsychiatric symptoms (NPS) such as agitation and aggression, especially in the moderate to severe stages of the illness. The limited efficacy and high-risk profiles of current pharmacotherapies for the management of agitation and aggression in AD have driven the search for safer pharmacological alternatives. Over the past few years, there has been a growing interest in the therapeutic potential of medications that target the endocannabinoid system (ECS). The behavioural effects of ECS medications, as well as their ability to modulate neuroinflammation and oxidative stress, make targeting this system potentially relevant in AD. This article summarizes the literature to date supporting this rationale and evaluates clinical studies investigating cannabinoids for agitation and aggression in AD. Letters, case studies, and controlled trials from four electronic databases were included. While findings from six studies showed significant benefits from synthetic cannabinoids—dronabinol or nabilone—on agitation and aggression, definitive conclusions were limited by small sample sizes, short trial duration, and lack of placebo control in some of these studies. Given the relevance and findings to date, methodologically rigorous prospective clinical trials are recommended to determine the safety and efficacy of cannabinoids for the treatment of agitation and aggression in dementia and AD.

show abstract

“…Among the many promising approaches are computerized handwriting analysis, 27,28 balance assessments, 29 motion sensors, and actigraphy. 30 Researchers also continue work with industry to develop validated smartphone applications. 31 In terms of translational applications, it is noteworthy that these approaches can be implemented and scored quickly primary-care settings without specialized training.…”

mentioning

confidence: 99%

Cross-Cutting Advancements Usher in a New Era for Motor Research in Psychosis

Mittal

2016

SCHBUL

View full text Add to dashboard Cite

As gesture serves as an interaction point between motor, language, and sensory-integration processes, an intersection also implicated in psychosis, schizophrenia researchers have recently turned toward this area as well. 1 The findings of Walther et al 2 move our understanding of this nascent field significantly ahead, with results indicating that deficits in gesture performance and perception are closely tied with clinical and functional outcome in individuals with schizophrenia over a 6-month period. More broadly, this article suggests that a test of hand gesture may provide a viable method for predicting clinical course and potentially highlighting a novel vulnerability subtype in schizophrenia patients. Given the importance of these findings, and the relative ease of such assessments, the questions remain-why are we not seeing more studies like this, and where are the translational applications? Further, in addition to aberrant gesture, schizophrenia has been linked with a range of motor signs including delays in developmental milestones, clumsiness, poor coordination, abnormalities in gait, posture and neuromusculature, diffuse neurological soft signs, catatonia, psychomotor slowing, and both medication-induced and spontaneous hyper/hypo dyskinesias spanning muscle groups throughout the body. Despite the broad array of affected behaviors and characteristics, and the long history of movement and motor research in this area, 3 the question remains, why is this such a neglected area in our field?There are several factors that have been impeding more widespread use of motor variables in cuttingedge research. First, rigid intradisciplinary boundaries between neurology and psychiatry have historically kept abnormalities in movement and socio-emotional behavior distinct. In a related issue, until recently, key relevant target structures such as the basal ganglia and cerebellum have been viewed primarily as a motor centers and related movement behaviors have not been linked into the sophisticated comprehensive models or etiological theories that are often necessary generate enthusiasm about a domain or target. Second, the advent of first-generation antipsychotic medications, which produce characteristic movement disorders in some patients, contributed to further confusion about etiology of movement signs. More broadly, both generations of neuroleptics have also continued to serve as a tricky barrier for definitive research in this area. 4 Third, empirical studies have relied almost entirely on drug-induced motor abnormality assessments, 5 or scales designed to follow diffuse markers (eg, neurological soft signs). 6 While these instruments can be reliable at a particular site, they require highly specialized training, miss more subtle movements, and can press investigators to impose subjective categories on continuous phenotypes. Fourth, although it has been clear for some time that there are motor abnormalities present in psychosis, the translational relevance of these markers is uncertain. Finally, motor behaviors...

show abstract

Actigraphy in agitated patients with dementia

Cited by 86 publications

References 35 publications

Quantitative Motor Activity Differentiates Schizophrenia Subtypes

Quantitative Motor Activity Differentiates Schizophrenia Subtypes

Cannabinoids for the Treatment of Agitation and Aggression in Alzheimer’s Disease

Cross-Cutting Advancements Usher in a New Era for Motor Research in Psychosis

Contact Info

Product

Resources

About