Monitoring of Circadian Rhythms of Heart Rate, Locomotor Activity, and Temperature for Diagnosis and Evaluation of Response to Treatment in an Animal Model of Depression

The blues and rhythm

Most organisms, including humans, show daily rhythms in many aspects of physiology and behavior, and abnormalities in the rhythms are potential risk factors for various diseases. Mood disorders such as depression are no exception. Accumulating evidence suggests strong associations between circadian disturbances and the development of depression. Numerous studies have shown that interventions to circadian rhythms trigger depression-like phenotypes in human cases and animal models. Conversely, mood changes can affect circadian rhythms as symptoms of depression. Our preliminary data suggest that the phosphorylation signal pathway of the clock protein may act as a common pathway for mood and clock regulation. We hypothesize that mood regulation and circadian rhythms may influence each other and may share a common regulatory mechanism. This review provides an overview of circadian disturbances in animal models and human patients with depression.

A translationally informed approach to vital signs for psychiatry: a preliminary proof of concept

The nature of data obtainable from the commercial smartphone - bolstered by a translational model emphasizing the impact of social and physical zeitgebers on circadian rhythms and mood - offers the possibility of scalable and objective vital signs for major depression. Our objective was to explore associations between passively sensed behavioral smartphone data and repeatedly measured depressive symptoms to suggest which features could eventually lead towards vital signs for depression. We collected continuous behavioral data and bi-weekly depressive symptoms (PHQ-8) from 131 psychiatric outpatients with a lifetime DSM-5 diagnosis of depression and/or anxiety over a 16-week period. Using linear mixed-effects models, we related depressive symptoms to concurrent passively sensed behavioral summary features (mean and variability of sleep, activity, and social engagement metrics), considering both between- and within-person associations. Individuals with more variable wake-up times across the study reported higher depressive symptoms relative to individuals with less variable wake-up times (B [95% CI] = 1.53 [0.13, 2.93]). On a given week, having a lower step count (-0.16 [-0.32, -0.01]), slower walking rate (-1.46 [-2.60, -0.32]), lower normalized location entropy (-3.01 [-5.51, -0.52]), more time at home (0.05 [0.00, 0.10]), and lower distances traveled (-0.97 [-1.72, -0.22]), relative to one's own typical levels, were each associated with higher depressive symptoms. With replication in larger samples and a clear understanding of how these components are best combined, a behavioral composite measure of depression could potentially offer the kinds of vital signs for psychiatric medicine that have proven invaluable to assessment and decision-making in physical medicine. Clinical Trials Registration: The data that form the basis of this report were collected as part of clinical trial number NCT03152864.

Effects of stressor controllability on diurnal physiological rhythms

Disruptions in circadian and diurnal rhythms are associated with stress-related psychiatric disorders and stressor exposure can disrupt these rhythms. The controllability of the stressor can modulate various behavioral and neurochemical responses to stress. Uncontrollable, but not controllable, stress produces behaviors in rats that resemble symptoms of anxiety and depression. Whether acute stress-induced disruptions in physiological rhythms are sensitive to controllability of the stressor, however, remains unknown. To examine the role of controllability in diurnal rhythm disruption, adult male Sprague-Dawley rats were implanted with Data Sciences International (DSI) biotelemetry devices. Real-time measurements were obtained before, during and after exposure to a controllable or yoked uncontrollable stressor. Controllable and uncontrollable stress equally disrupted diurnal rhythms of locomotor activity and body temperature but not heart rate. The diurnal heart rate the day following stressor exposure was flattened to a greater extent and was significantly higher in rats with control over stress suggesting a relationship between stressor controllability and the heart rate response. Our results are consistent with the conclusion that acute stress-induced disruptions in diurnal physiological rhythms likely contribute little to the behavioral and affective consequences of stress that are sensitive to stressor controllability.

Neonatal autoimmune diseases: a critical review

Neonatal autoimmune diseases are distinctly rare. Most neonatal autoimmune diseases result from the transplacental transfer of maternal antibodies directed against fetal or neonatal antigens in various tissues. In neonatal lupus, the heart seems to be particularly susceptible. Primary autoimmunity in newborns, with the exception of familial autoinflammatory diseases, is virtually non-existent. The pathophysiologic basis for the development of neonatal autoimmunity is not entirely clear, but differences in the neonatal immune system compared with the adult immune system, as well as unique characteristics of target antigens in the newborn period may be important factors. Neonatal lupus is the most common presentation of autoimmunity in the newborn. But the characteristics defining neonatal lupus are not well defined and the presentation of neonatal lupus differs from that of classical lupus. Other neonatal autoimmune diseases involving the interaction between maternal antibodies and fetal/neonatal antigens include neonatal anti-phospholipid syndrome, Behcet's disease, neonatal autoimmune thyroid disease, neonatal polymyositis and dermatomyositis, neonatal scleroderma and neonatal type I diabetes mellitus. While autoantibodies have been detected in patients with neonatal autoimmune disease, the pathogenic role of autoantibodies has not been well defined. Other mechanisms may play a role in the development of neonatal autoimmunity, including fetal/maternal microchimerism and aberrant apoptosis of fetal cells. The autoinflammatory syndromes are a completely different category, but are also included in discussion of neonatal autoimmune diseases. The autoinflammatory syndromes include the cryopyrin associated periodic syndromes (CAPS) - familial cold autoinflammatory syndrome (FCAS), neonatal onset multisystem inflammatory disease (NOMID) and Muckle-Wells syndrome, which all share a common pathophysiologic mechanism.

Circadian rhythms and mood regulation: insights from pre-clinical models

Affective disorders such as major depression, bipolar disorder, and seasonal affective disorder are associated with major disruptions in circadian rhythms. Indeed, altered sleep/wake cycles are a critical feature for diagnosis in the DSM IV and several of the therapies used to treat these disorders have profound effects on rhythm length and stabilization in human populations. Furthermore, multiple human genetic studies have identified polymorphisms in specific circadian genes associated with these disorders. Thus, there appears to be a strong association between the circadian system and mood regulation, although the mechanisms that underlie this association are unclear. Recently, a number of studies in animal models have begun to shed light on the complex interactions between circadian genes and mood-related neurotransmitter systems, the effects of light manipulation on brain circuitry, the impact of chronic stress on rhythms, and the ways in which antidepressant and mood-stabilizing drugs alter the clock. This review will focus on the recent advances that have been gleaned from the use of pre-clinical models to further our understanding of how the circadian system regulates mood.

Circadian rhythms and depression: human psychopathology and animal models

Most organisms (including humans) developed daily rhythms in almost every aspect of their body. It is not surprising that rhythms are also related to affect in health and disease. In the present review we present data that demonstrate the evidence for significant interactions between circadian rhythms and affect from both human studies and animal models research. A number of lines of evidence obtained from human and from animal models research clearly demonstrate relationships between depression and circadian rhythms including (1) daily patterns of depression; (2) seasonal affective disorder; (3) connections between circadian clock genes and depression; (4) relationship between sleep disorders and depression; (5) the antidepressant effect of sleep deprivation; (6) the antidepressant effect of bright light exposure; and (7) the effects of antidepressant drugs on sleep and circadian rhythms. The integration of data suggests that the relationships between the circadian system and depression are well established but the underlying biology of the interactions is far from being understood. We suggest that an important factor hindering research into the underlying mechanisms is the lack of good animal models and we propose that additional efforts in that area should be made. One step in that direction could be the attempt to develop models utilizing diurnal animals which might have a better homology to humans with regard to their circadian rhythms. This article is part of a Special Issue entitled 'Anxiety and Depression'.