Leveraging Accelerometry as a Prognostic Indicator for Increase in Opioid Withdrawal Symptoms

• Type of Material: Article
• Authors: Tamara P. Lambert, Georgia Institute of Technology; Asim H. Gazi, Georgia Institute of Technology; Anna B. Harrison, Georgia Institute of Technology; Sevda Gharehbaghi, Georgia Institute of Technology; Michael Chan, Georgia Institute of Technology; Malik Obideen, Emory University; Parvaneh Alavi, Emory University; Nancy Murrah, Emory University; Lucy Shallenberger, Emory University; Emily G. Driggers, Emory University; Rebeca Ortega, Emory University; Brianna Washington, Emory University; Kevin M. Walton, National Institute on Drug Abuse; Yilang Tang, Emory University; Rahul Gupta, Emory University; Jonathon A. Nye, Emory University; Justine Welsh, Emory University; Viola Vaccarino, Emory University; Amit Shah, Emory University; J. Douglas Bremner, Emory University; Omer T. Inan, Georgia Institute of Technology
• Language: English
• Date: 2022-11-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/bios12110924
• Title of Journal or Parent Work: BIOSENSORS-BASEL
• Volume: 12
• Issue: 11
• Grant/Funding Information: This research was funded by the National Institute on Drug Abuse (NIDA), grant number UG3 DA048502. T.P.L. was supported by NIDA UG3 DA048502-01A1S2, R.A.O. was supported by NIDA UG3 DA048502-01A1S1 and A.H.G. was supported by the National Science Foundation Graduate Research Fellowship under Grant No. DGE-2039655.
• Keywords: WEARABLE BIOSENSORS; ANXIETY; Science & Technology; accelerometer; opioid use disorder; vagal nerve stimulation; wearable; Chemistry, Analytical; opioid addiction; spectrograms; opioid withdrawal; Physical Sciences; spectral analysis; Science & Technology - Other Topics; SUBSTANCE USE DISORDERS; BIAS; NALTREXONE; Technology; Nanoscience & Nanotechnology; restlessness; non-invasive therapies; Chemistry; Instruments & Instrumentation
• Research Categories: Chemistry, Pharmaceutical; Health Sciences, Pharmacology

Abstract

Treating opioid use disorder (OUD) is a significant healthcare challenge in the United States. Remaining abstinent from opioids is challenging for individuals with OUD due to withdrawal symptoms that include restlessness. However, to our knowledge, studies of acute withdrawal have not quantified restlessness using involuntary movements. We hypothesized that wearable accelerometry placed mid-sternum could be used to detect withdrawal-related restlessness in patients with OUD. To study this, 23 patients with OUD undergoing active withdrawal participated in a protocol involving wearable accelerometry, opioid cues to elicit craving, and non-invasive Vagal Nerve Stimulation (nVNS) to dampen withdrawal symptoms. Using accelerometry signals, we analyzed how movements correlated with changes in acute withdrawal severity, measured by the Clinical Opioid Withdrawal Scale (COWS). Our results revealed that patients demonstrating sinusoidal–i.e., predominantly single-frequency oscillation patterns in their motion almost exclusively demonstrated an increase in the COWS, and a strong relationship between the maximum power spectral density and increased withdrawal over time, measured by the COWS (R = 0.92, p = 0.029). Accelerometry may be used in an ambulatory setting to indicate the increased intensity of a patient’s withdrawal symptoms, providing an objective, readily-measurable marker that may be captured ubiquitously.