Data-driven classification of bipolar I disorder from longitudinal course of mood.

The Diagnostic and Statistical Manual of Mental Disorder (DSM) classification of bipolar disorder defines categories to reflect common understanding of mood symptoms rather than scientific evidence. This work aimed to determine whether bipolar I can be objectively classified from longitudinal mood data and whether resulting classes have clinical associations. Bayesian nonparametric hierarchical models with latent classes and patient-specific models of mood are fit to data from Longitudinal Interval Follow-up Evaluations (LIFE) of bipolar I patients (N=209). Classes are tested for clinical associations. No classes are justified using the time course of DSM-IV mood states. Three classes are justified using the course of subsyndromal mood symptoms. Classes differed in attempted suicides (P=0.017), disability status (P=0.012) and chronicity of affective symptoms (P=0.009). Thus, bipolar I disorder can be objectively classified from mood course, and individuals in the resulting classes share clinical features. Data-driven classification from mood course could be used to enrich sample populations for pharmacological and etiological studies.

Modeling and validating chronic pharmacological manipulation of circadian rhythms.

Circadian rhythms can be entrained by a light-dark (LD) cycle and can also be reset pharmacologically, for example, by the CK1δ/ε inhibitor PF-670462. Here, we determine how these two independent signals affect circadian timekeeping from the molecular to the behavioral level. By developing a systems pharmacology model, we predict and experimentally validate that chronic CK1δ/ε inhibition during the earlier hours of a LD cycle can produce a constant stable delay of rhythm. However, chronic dosing later during the day, or in the presence of longer light intervals, is not predicted to yield an entrained rhythm. We also propose a simple method based on phase response curves (PRCs) that predicts the effects of a LD cycle and chronic dosing of a circadian drug. This work indicates that dosing timing and environmental signals must be carefully considered for accurate pharmacological manipulation of circadian phase.CPT: Pharmacometrics & Systems Pharmacology (2013) 2, e57; doi:10.1038/psp.2013.34; published online 17 July 2013.

Reversible protein phosphorylation regulates circadian rhythms.

Protein phosphorylation regulates the period of the circadian clock within mammalian cells. Circadian rhythms are an approximately 24-hour cycle that regulates key biological processes. Daily fluctuations of wakefulness, stress hormones, lipid metabolism, immune function, and the cell division cycle are controlled by the molecular clocks that function throughout our bodies. Mutations in regulatory components of the clock can shorten or lengthen the timing of the rhythms and have significant physiological consequences. The clock is formed by a negative feedback loop of transcription, translation, and inhibition of transcription. The precision of clock timing is controlled by protein kinases and phosphatases. Casein kinase Iepsilon is a protein kinase that regulates the circadian clock by periodic phosphorylation of the proteins PER1 and PER2, controlling their stability and localization. The role of phosphorylation in regulating PER function in the clock has been explored in detail. Quantitative modeling has proven to be very useful in making important predictions about how changes in phosphorylation alter the clock's behavior. Quantitative data from biological studies can be used to refine the quantitative model and make additional testable predictions. A detailed understanding of how reversible protein phosphorylation regulates circadian rhythms and a detailed quantitative model that makes clear, testable, and accurate predictions about the clock and how we may manipulate it can have important benefits for human health. Pharmacological manipulation of rhythms could mitigate stress from jet lag, shift work, and perhaps even seasonal affective disorder.

Revised limit cycle oscillator model of human circadian pacemaker.

In 1990, Kronauer proposed a mathematical model of the effects of light on the human circadian pacemaker. This study presents several refinements to Kronauer's original model of the pacemaker that enable it to predict more accurately the experimental results from a number of different studies of the effects of the intensity, timing, and duration of light stimuli on the human circadian pacemaker. These refinements include the following: The van der Pol oscillator from Kronauer's model has been replaced with a higher order limit cycle oscillator so that the system's amplitude recovery is slower near the singularity and faster near the limit cycle; the phase and amplitude of the circadian rhythm in sensitivity to light from Kronauer's model has been refined so that the peak sensitivity to light on the limit cycle now occurs approximately 4 h before the core body temperature minimum (CBTmin) and is three times as great as the minimum sensitivity on the limit cycle; the critical phase (at which type 1 phase response curves [PRCs] can be distinguished from type 0 PRCs) that occurs at CBT,n now corresponds to 0.8 h after the minimum of x (x(min) in this refined model rather than to the exact timing of x(min) as in Kronauer's model; a direct effect of light on circadian period was incorporated into the model such that as light intensity increases, the period decreases, which is in accordance with Aschoff's rule.

Quantifying human circadian pacemaker response to brief, extended, and repeated light stimuli over the phototopic range.

The authors' previous models have been able to describe accurately the effects of extended (approximately 5 h) bright-light (>4000 lux) stimuli on the phase and amplitude of the human circadian pacemaker, but they are not sufficient to represent the surprising human sensitivity to both brief pulses of bright light and light of more moderate intensities. Therefore, the authors have devised a new model in which a dynamic stimulus processor (Process L) intervenes between the light stimuli and the traditional representation of the circadian pacemaker as a self-sustaining limit-cycle oscillator (Process P). The overall model incorporating Process L and Process P is intended to allow the prediction of phase shifts to photic stimuli of any temporal pattern (extended and brief light episodes) and any light intensity in the photopic range. Two time constants emerge in the Process L model: the characteristic duration for necessary bright-light pulses to achieve their full effect (5-10 min) and the characteristic stimulus-free (dark) interval that can be tolerated without incurring an excessive penalty in phase shifting (30-80 min). The effect of reducing light intensity is incorporated in Process L as an extension of the time necessary for the light pulse to be fully realized (a power-law relation between time and intensity). This new model generates a number of new testable hypotheses, including the surprising prediction that 24-h cycles consisting of 8 h of darkness and 16 h of only approximately 3.5 lux would be capable of entraining a large fraction of the adult population (approximately 45%). Experimental data on the response of the human circadian system to lower light intensities and briefer stimuli are needed to allow for further refinement and validation of the model proposed here.

A simpler model of the human circadian pacemaker.

Numerous studies have used the classic van der Pol oscillator, which contains a cubic nonlinearity, to model the effect of light on the human circadian pacemaker. Jewett and Kronauer demonstrated that Aschoff's rule could be incorporated into van der Pol type models and used a van der Pol type oscillator with higher order nonlinearities. Kronauer, Forger, and Jewett have proposed a model for light preprocessing, Process L, representing a biochemical process that converts a light signal into an effective drive on the circadian pacemaker. In the paper presented here, the authors use the classic van der Pol oscillator with Process L and Jewett and Kronauer's model of Aschoff's rule to model the human circadian pacemaker. This simpler cubic model predicts the results of a three-pulse human phase response curve experiment and a two-pulse amplitude reduction study with as much, or more, accuracy as the models of Jewett and Kronauer and Kronauer, Forger, and Jewett, which both employ a nonlinearity of degree 7. This suggests that this simpler cubic model should be considered as a potential alternative to other models of the human circadian system currently available.