Identifying biomarkers of drug use recurrence using wearable device technologies and phone applications.

BACKGROUND: Identifying predictors of drug use recurrence (DUR) is critical to combat the addiction epidemic. Wearable devices and phone-based applications for obtaining self-reported assessments in the patient's natural environment (e.g., ecological momentary assessment; EMA) have been used in various healthcare settings. However, the utility of combining these technologies to predict DUR in substance use disorder (SUD) has not yet been explored. This study investigates the combined use of wearable technologies and EMA as a potential mechanism for identifying physiological/behavioral biomarkers of DUR. METHODS: Participants, recruited from an SUD treatment program, were provided with a commercially available wearable device that continuously monitors biometric signals (e.g., heart rate/variability [HR/HRV], sleep characteristics). They were also prompted daily to complete an EMA via phone-based application (EMA-APP) that included questionnaires regarding mood, pain, and craving. RESULTS: Seventy-seven participants are included in this pilot study (34 participants experienced a DUR during enrollment). Wearable technologies revealed that physiological markers were significantly elevated in the week prior to DUR relative to periods of sustained abstinence (p<0.001). Results from the EMA-APP revealed that those who experienced a DUR reported greater difficulty concentrating, exposure to triggers associated with substance use, and increased isolation the day prior to DUR (p<0.001). Compliance with study procedures during the DUR week was lower than any other period of measurement (p<0.001). CONCLUSIONS: These results suggest that data acquired via wearable technologies and the EMA-APP may serve as a method of predicting near-term DUR, thereby potentially prompting intervention before drug use occurs.

Deep brain stimulation for psychiatric disorders and behavioral/cognitive-related indications: Review of the literature and implications for treatment.

While pharmacological and/or behavioral treatments are effective in managing symptoms for many patients with psychiatric diagnoses and disorders with behavioral/cognitive manifestations, a subset of individuals are treatment-refractory, unable to achieve appreciable benefit or symptom relief from traditional methods. In recent years, neuromodulation has gained momentum as an adjunctive treatment for improving outcomes in patients who are treatment-refractory. One form of neuromodulation, deep brain stimulation (DBS), has been investigated for the treatment of various psychiatric disorders and behavioral/cognitive symptoms. The following article provides a review of DBS investigations for several psychiatric and behavioral-related disorders, including depression, obsessive-compulsive disorder, substance use disorder, Alzheimer's disease, anorexia, obesity, schizophrenia, and posttraumatic stress disorder. PubMed, PsycINFO, Scopus, Ovid MEDLINE, and Web of Science were used to identify published articles, and Clinicaltrials.gov was used to identify currently ongoing or planned studies. Findings revealed the potential utility of DBS in improving outcomes for various psychiatric and behavioral/cognitive-related disorders. While promising, there are several limitations present in the available literature, and further well-designed clinical trials are necessary before conclusive decisions regarding the utility of DBS for the treatment of these psychiatric/behavioral/cognitive-related disorders can be made. Regardless, the studies included in this review demonstrate positive preliminary findings for the potential benefit of DBS for treatment of a variety of psychiatric disorders, and further research is warranted to better determine the potential utility of DBS for those who are treatment-refractory and unable to achieve symptom relief with standard care.

The accuracy of fitness watches for the measurement of heart rate and energy expenditure during moderate intensity exercise.

BACKGROUND: As new technology emerges and updated fitness watches are released to the market, it is important to examine their accuracy. The aim of the current study was to examine the accuracy of three commercially available activity trackers in assessing heart rate (HR) and energy expenditure (EE) during moderate intensity exercise. METHODS: Twenty healthy participants (Age: 20.5±0.7 yrs., Ht: 173.4±10.8 cm, BM: 72.8±13.9 kg, BMI: 24.0±2.5 kg/m2) wore two fitness watches (FB: Fitbit VersaTM, San Francisco, CA, USA; and PI: Polar IgniteTM, Polar Electro Oy, Kempele, Finland) and a chest-worn HR monitor (PTP: Polar TeamPro SensorTM, Polar Electro) during a 12-minute exercise protocol at incremental speeds. An electrocardiogram (ECG) and indirect calorimetry were used as criterion measures for HR and EE. Mean absolute percentage error (MAPE) was calculated to determine measurement error. RESULTS: The MAPE values for HR were 11.6±8.7% for the FB, 11.0±10.0% for the PI, and 6.3±5.2% for the PTP. For EE, MAPE values were 9.6±7.2% for the FB, 16.7±19.6% for the PI and 13.8±13.0% for the PTP. CONCLUSIONS: Fitness watches relying on optical measures of HR underestimate HR compared to criterion measures during moderate intensity exercise. Despite providing a more accurate measure of HR, a chest-worn monitor does not provide a more accurate estimate of EE compared to fitness watches. The Fitbit provided the most accurate measure of EE when compared to the Polar Ignite watch and chest-worn device.