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Ernst H, Scherpf M, Pannasch S, Helmert JR, Malberg H, Schmidt M. Assessment of the human response to acute mental stress-An overview and a multimodal study. PLoS One 2023; 18:e0294069. [PMID: 37943894 PMCID: PMC10635557 DOI: 10.1371/journal.pone.0294069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023] Open
Abstract
Numerous vital signs are reported in association with stress response assessment, but their application varies widely. This work provides an overview over methods for stress induction and strain assessment, and presents a multimodal experimental study to identify the most important vital signs for effective assessment of the response to acute mental stress. We induced acute mental stress in 65 healthy participants with the Mannheim Multicomponent Stress Test and acquired self-assessment measures (Likert scale, Self-Assessment Manikin), salivary α-amylase and cortisol concentrations as well as 60 vital signs from biosignals, such as heart rate variability parameters, QT variability parameters, skin conductance level, and breath rate. By means of statistical testing and a self-optimizing logistic regression, we identified the most important biosignal vital signs. Fifteen biosignal vital signs related to ventricular repolarization variability, blood pressure, skin conductance, and respiration showed significant results. The logistic regression converged with QT variability index, left ventricular work index, earlobe pulse arrival time, skin conductance level, rise time and number of skin conductance responses, breath rate, and breath rate variability (F1 = 0.82). Self-assessment measures indicated successful stress induction. α-amylase and cortisol showed effect sizes of -0.78 and 0.55, respectively. In summary, the hypothalamic-pituitary-adrenocortical axis and sympathetic nervous system were successfully activated. Our findings facilitate a coherent and integrative understanding of the assessment of the stress response and help to align applications and future research concerning acute mental stress.
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Affiliation(s)
- Hannes Ernst
- Institute of Biomedical Engineering, TU Dresden, Dresden, Germany
| | - Matthieu Scherpf
- Institute of Biomedical Engineering, TU Dresden, Dresden, Germany
| | - Sebastian Pannasch
- Chair of Engineering Psychology and Applied Cognitive Research, TU Dresden, Dresden, Germany
| | - Jens R. Helmert
- Chair of Engineering Psychology and Applied Cognitive Research, TU Dresden, Dresden, Germany
| | - Hagen Malberg
- Institute of Biomedical Engineering, TU Dresden, Dresden, Germany
| | - Martin Schmidt
- Institute of Biomedical Engineering, TU Dresden, Dresden, Germany
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Fleischhauer V, Bruhn J, Rasche S, Zaunseder S. Photoplethysmography upon cold stress-impact of measurement site and acquisition mode. Front Physiol 2023; 14:1127624. [PMID: 37324389 PMCID: PMC10267461 DOI: 10.3389/fphys.2023.1127624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Photoplethysmography (PPG) allows various statements about the physiological state. It supports multiple recording setups, i.e., application to various body sites and different acquisition modes, rendering the technique a versatile tool for various situations. Owing to anatomical, physiological and metrological factors, PPG signals differ with the actual setup. Research on such differences can deepen the understanding of prevailing physiological mechanisms and path the way towards improved or novel methods for PPG analysis. The presented work systematically investigates the impact of the cold pressor test (CPT), i.e., a painful stimulus, on the morphology of PPG signals considering different recording setups. Our investigation compares contact PPG recorded at the finger, contact PPG recorded at the earlobe and imaging PPG (iPPG), i.e., non-contact PPG, recorded at the face. The study bases on own experimental data from 39 healthy volunteers. We derived for each recording setup four common morphological PPG features from three intervals around CPT. For the same intervals, we derived blood pressure and heart rate as reference. To assess differences between the intervals, we used repeated measures ANOVA together with paired t-tests for each feature and we calculated Hedges' g to quantify effect sizes. Our analyses show a distinct impact of CPT. As expected, blood pressure shows a highly significant and persistent increase. Independently of the recording setup, all PPG features show significant changes upon CPT as well. However, there are marked differences between recording setups. Effect sizes generally differ with the finger PPG showing the strongest response. Moreover, one feature (pulse width at half amplitude) shows an inverse behavior in finger PPG and head PPG (earlobe PPG and iPPG). In addition, iPPG features behave partially different from contact PPG features as they tend to return to baseline values while contact PPG features remain altered. Our findings underline the importance of recording setup and physiological as well as metrological differences that relate to the setups. The actual setup must be considered in order to properly interpret features and use PPG. The existence of differences between recording setups and a deepened knowledge on such differences might open up novel diagnostic methods in the future.
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Affiliation(s)
- Vincent Fleischhauer
- Laboratory for Advanced Measurements and Biomedical Data Analysis, Faculty of Information Technology, FH Dortmund, Dortmund, Germany
| | - Jan Bruhn
- Laboratory for Advanced Measurements and Biomedical Data Analysis, Faculty of Information Technology, FH Dortmund, Dortmund, Germany
| | - Stefan Rasche
- Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Sebastian Zaunseder
- Laboratory for Advanced Measurements and Biomedical Data Analysis, Faculty of Information Technology, FH Dortmund, Dortmund, Germany
- Professorship for Diagnostic Sensing, Faculty of Applied Computer Science, University Augsburg, Augsburg, Germany
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Linschmann O, Uguz DU, Romanski B, Baarlink I, Gunaratne P, Leonhardt S, Walter M, Lueken M. A Portable Multi-Modal Cushion for Continuous Monitoring of a Driver's Vital Signs. SENSORS (BASEL, SWITZERLAND) 2023; 23:4002. [PMID: 37112341 PMCID: PMC10144144 DOI: 10.3390/s23084002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/02/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
With higher levels of automation in vehicles, the need for robust driver monitoring systems increases, since it must be ensured that the driver can intervene at any moment. Drowsiness, stress and alcohol are still the main sources of driver distraction. However, physiological problems such as heart attacks and strokes also exhibit a significant risk for driver safety, especially with respect to the ageing population. In this paper, a portable cushion with four sensor units with multiple measurement modalities is presented. Capacitive electrocardiography, reflective photophlethysmography, magnetic induction measurement and seismocardiography are performed with the embedded sensors. The device can monitor the heart and respiratory rates of a vehicle driver. The promising results of the first proof-of-concept study with twenty participants in a driving simulator not only demonstrate the accuracy of the heart (above 70% of medical-grade heart rate estimations according to IEC 60601-2-27) and respiratory rate measurements (around 30% with errors below 2 BPM), but also that the cushion might be useful to monitor morphological changes in the capacitive electrocardiogram in some cases. The measurements can potentially be used to detect drowsiness and stress and thus the fitness of the driver, since heart rate variability and breathing rate variability can be captured. They are also useful for the early prediction of cardiovascular diseases, one of the main reasons for premature death. The data are publicly available in the UnoVis dataset.
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Affiliation(s)
- Onno Linschmann
- Medical Information Technology, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany
| | - Durmus Umutcan Uguz
- Medical Information Technology, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany
| | - Bianca Romanski
- Medical Information Technology, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany
| | - Immo Baarlink
- Medical Information Technology, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany
| | - Pujitha Gunaratne
- Toyota Collaborative Safety Research Center, Toyota Motors Corporation, Ann Arbor, MI 48105, USA
| | - Steffen Leonhardt
- Medical Information Technology, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany
| | - Marian Walter
- Medical Information Technology, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany
| | - Markus Lueken
- Medical Information Technology, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany
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Hammer A, Scherpf M, Schmidt M, Ernst H, Malberg H, Matschke K, Dragu A, Martin J, Bota O. Camera-based assessment of cutaneous perfusion strength in a clinical setting. Physiol Meas 2022; 43. [PMID: 35168227 DOI: 10.1088/1361-6579/ac557d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/15/2022] [Indexed: 01/03/2023]
Abstract
Objective. After skin flap transplants, perfusion strength monitoring is essential for the early detection of tissue perfusion disorders and thus to ensure the survival of skin flaps. Camera-based photoplethysmography (cbPPG) is a non-contact measurement method, using video cameras and ambient light, which provides spatially resolved information about tissue perfusion. It has not been researched yet whether the measurement depth of cbPPG, which is limited by the penetration depth of ambient light, is sufficient to reach pulsatile vessels and thus to measure the perfusion strength in regions that are relevant for skin flap transplants.Approach. We applied constant negative pressure (compared to ambient pressure) to the anterior thighs of 40 healthy subjects. Seven measurements (two before and five up to 90 minutes after the intervention) were acquired using an RGB video camera and photospectrometry simultaneously. We investigated the performance of different algorithmic approaches for perfusion strength assessment, including the signal-to-noise ratio (SNR), its logarithmic components logS and logN, amplitude maps, and the amplitude height of alternating and direct signal components.Main results. We found strong correlations of up tor=0.694 (p<0.001) between photospectrometric measurements and all cbPPG parameters except SNR when using the green color channel. The transfer of cbPPG signals to POS, CHROM, and O3C did not lead to systematic improvements. However, for direct signal components, the transformation to O3C led to correlations of up tor=0.744 (p<0.001) with photospectrometric measurements.Significance. Our results indicate that a camera-based perfusion strength assessment in tissue with deep-seated pulsatile vessels is possible.
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Affiliation(s)
- Alexander Hammer
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, Dresden, 01307, GERMANY
| | - Matthieu Scherpf
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, Dresden, 01307, GERMANY
| | - Martin Schmidt
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, Dresden, 01307, GERMANY
| | - Hannes Ernst
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, Dresden, 01307, GERMANY
| | - Hagen Malberg
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, Dresden, 01307, GERMANY
| | - Klaus Matschke
- Department of Cardiac Surgery, University Heart Center Dresden, TU Dresden, Fetscherstr. 76, Dresden, 01307, GERMANY
| | - Adrian Dragu
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, Dresden, 01307, GERMANY
| | - Judy Martin
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, Dresden, 01037, GERMANY
| | - Olimpiu Bota
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, Dresden, 01307, GERMANY
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