Rest-activity rhythm phenotypes in adults with epilepsy and intellectual disability

Area of Science:

• Neuroscience
• Chronobiology
• Epileptology

Background:

• Rest-activity rhythms (RARs) are frequently disrupted in neuropsychiatric conditions.
• Intellectual disability (ID) and epilepsy often co-occur, potentially impacting circadian regulation.

Purpose of the Study:

• To characterize RAR perturbations in adults with epilepsy and intellectual disability (E+ID) using wrist actigraphy.
• To investigate correlations between RAR phenotypes and epilepsy severity, adaptive function, and psychopathology.

Main Methods:

• A cross-sectional case-control study involving 46 E+ID subjects.
• Wrist actigraphy was used to record RARs for at least ten days.
• Standardized surveys assessed epilepsy severity, adaptive function (ABAS-3), and psychopathology (ABCL).

Main Results:

• E+ID subjects exhibited significantly lower RAR amplitude, robustness, and interdaily stability (IS), with higher intradaily variability (IV) and total sleep time compared to controls.
• K-means clustering identified three RAR phenotypes within the E+ID cohort: hypoactive/hypersomnic, intermediate, and hyper-robust/high amplitude.
• These clusters did not differ in age, BMI, antiseizure medication (ASM) polytherapy, adaptive function, or psychopathology scores.

Conclusions:

• Adults with E+ID display a diverse range of RAR phenotypes.
• RAR disruptions in this population do not strongly correlate with adaptive function or epilepsy severity.
• Further prospective studies are needed to monitor chronobiological changes over time.