title: Using Actiwatch to monitor circadian rhythm disturbance in Huntington' disease: A cautionary note.
abstract: Huntington's disease (HD) is an inherited neurodegenerative disorder that is well recognised as producing progressive deterioration of motor function, including dyskinetic movements, as well as deterioration of cognition and ability to carry out activities of daily living. However, individuals with HD commonly suffer from a wide range of additional symptoms, including weight loss and sleep disturbance, possibly due to disruption of circadian rhythmicity. Disrupted circadian rhythms have been reported in mice models of HD and in humans with HD. One way of assessing an individual's circadian rhythmicity in a community setting is to monitor their sleep/wake cycles, and a convenient method for recording periods of wakefulness and sleep is to use accelerometers to discriminate between varied activity levels (including sleep) during daily life. Here we used Actiwatch(®) Activity monitors alongside ambulatory EEG and sleep diaries to record wake/sleep patterns in people with HD and normal volunteers. We report that periods of wakefulness during the night, as detected by activity monitors, agreed poorly with EEG recordings in HD subjects, and unsurprisingly sleep diary findings showed poor agreement with both EEG recordings and activity monitor derived sleep periods. One explanation for this is the occurrence of 'break through' involuntary movements during sleep in the HD patients, which are incorrectly assessed as wakeful periods by the activity monitor algorithms. Thus, care needs to be taken when using activity monitors to assess circadian activity in individuals with movement disorders.
authors.affiliation: The Cardiff University Brain Repair Group, Life Sciences Building, School of Biosciences, Museum Avenue, Cardiff CF10 3AX, United Kingdom.
authors.forename: Jenny
authors.initials: J
authors.lastname: Townhill
authors.affiliation: Neuroscience and Mental Health Research Institute, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff CF24 4HQ, United Kingdom.
authors.forename: Alis C
authors.initials: AC
authors.lastname: Hughes
authors.affiliation: Dept Neurolophysiology, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom.
authors.forename: Benny
authors.initials: B
authors.lastname: Thomas
authors.affiliation: School of Healthcare Sciences, Cardiff University, 35-43 Newport Road, Cardiff CF24 OAB, United Kingdom.
authors.forename: Monica E
authors.initials: ME
authors.lastname: Busse
authors.affiliation: The Cardiff University Brain Repair Group, Life Sciences Building, School of Biosciences, Museum Avenue, Cardiff CF10 3AX, United Kingdom.
authors.forename: Kathy
authors.initials: K
authors.lastname: Price
authors.affiliation: The Cardiff University Brain Repair Group, Life Sciences Building, School of Biosciences, Museum Avenue, Cardiff CF10 3AX, United Kingdom.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Dunnett
authors.affiliation: MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Francis Crick Avenue, Cambridge CB2 0QH, United Kingdom.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Hastings
authors.affiliation: The Cardiff University Brain Repair Group, Life Sciences Building, School of Biosciences, Museum Avenue, Cardiff CF10 3AX, United Kingdom; Neuroscience and Mental Health Research Institute, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff CF24 4HQ, United Kingdom. Electronic address: rosserae@cf.ac.uk.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Rosser
mesh_terms: D056044:Actigraphy / Q000295:instrumentation*; D000328:Adult; D001921:Brain / Q000503:physiopathology; D002940:Circadian Rhythm / Q000502:physiology; D034201:Computers, Handheld; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis / Q000503:physiopathology*; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D012463:Saliva / Q000378:metabolism; D012890:Sleep / Q000502:physiology; D014851:Wakefulness / Q000502:physiology
chemical_list: D006854:Hydrocortisone
keywords: Actimetry; Actiwatch; EEG; Huntington's disease; Sleep circadian