Novel Technologies for the Diagnosis and Treatment of Posttraumatic Stress Disorder

The brain and the heart share an active and reciprocal dialogue, continuously modulating each other's function. For individuals who have experienced traumatic events, the reminders of these events affect both the brain and heart due to this intimate relationship, and can later develop into posttraumatic stress disorder (PTSD) due to the repeated activation of trauma-related neuropathways and autonomic imbalance. Electrical stimulation of the vagus nerve —the longest cranial nerve, which regulates the autonomic state—using an implantable device is a potential treatment method to address such imbalance. Noninvasive vagal nerve stimulation (nVNS) devices offer inexpensive and low-risk alternatives to surgical implants, but their effects on the physiology are not well understood. Real-time, noninvasively obtained biomarkers are required to tailor therapy and to close the loop for automated delivery. This dissertation focuses on identifying and developing noninvasive technologies for nVNS in the context of PTSD. Identification of noninvasive measures that can diagnose and treat PTSD is imperative for at-home usage and for developing closed-loop systems. This research first focuses on how noninvasive sensing modalities could be instrumented and used in conjunction with signal processing and machine learning methods to quantify an individual’s autonomic state. Second, a mechanistic, sham-controlled, randomized, double blind study on the use of nVNS for dampening stress response is investigated in multiple dimensions: downstream physiological effects and biochemical biomarkers, with a particular focus on real-time physiological biomarkers and their potential for closing the loop for machine learning guided personalized neuromodulation. The broader impacts of this research cover accessible, low-cost diagnosis and treatment options for patients with stress-related neuropsychiatric disorders, which are important public health problems and projected to increase due to COVID-19 pandemic. The sensing modalities, algorithms, biomarkers, and methodologies detailed in this dissertation lay the groundwork for future efforts to objectively diagnose and treat neuropsychiatric disorders remotely, outside of clinical settings.Ph.D

Sensor Technologies to Manage the Physiological Traits of Chronic Pain: A Review

Non-oncologic chronic pain is a common high-morbidity impairment worldwide and acknowledged as a condition with significant incidence on quality of life. Pain intensity is largely perceived as a subjective experience, what makes challenging its objective measurement. However, the physiological traces of pain make possible its correlation with vital signs, such as heart rate variability, skin conductance, electromyogram, etc., or health performance metrics derived from daily activity monitoring or facial expressions, which can be acquired with diverse sensor technologies and multisensory approaches. As the assessment and management of pain are essential issues for a wide range of clinical disorders and treatments, this paper reviews different sensor-based approaches applied to the objective evaluation of non-oncological chronic pain. The space of available technologies and resources aimed at pain assessment represent a diversified set of alternatives that can be exploited to address the multidimensional nature of pain.Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) PI15/00306Junta de Andalucía PIN-0394-2017Unión Europea "FRAIL

Brain and Human Body Modeling

This open access book describes modern applications of computational human modeling with specific emphasis in the areas of neurology and neuroelectromagnetics, depression and cancer treatments, radio-frequency studies and wireless communications. Special consideration is also given to the use of human modeling to the computational assessment of relevant regulatory and safety requirements. Readers working on applications that may expose human subjects to electromagnetic radiation will benefit from this book’s coverage of the latest developments in computational modelling and human phantom development to assess a given technology’s safety and efficacy in a timely manner. Describes construction and application of computational human models including anatomically detailed and subject specific models; Explains new practices in computational human modeling for neuroelectromagnetics, electromagnetic safety, and exposure evaluations; Includes a survey of modern applications for which computational human models are critical; Describes cellular-level interactions between the human body and electromagnetic fields

Brain and Human Body Modeling

This open access book describes modern applications of computational human modeling with specific emphasis in the areas of neurology and neuroelectromagnetics, depression and cancer treatments, radio-frequency studies and wireless communications. Special consideration is also given to the use of human modeling to the computational assessment of relevant regulatory and safety requirements. Readers working on applications that may expose human subjects to electromagnetic radiation will benefit from this book’s coverage of the latest developments in computational modelling and human phantom development to assess a given technology’s safety and efficacy in a timely manner. Describes construction and application of computational human models including anatomically detailed and subject specific models; Explains new practices in computational human modeling for neuroelectromagnetics, electromagnetic safety, and exposure evaluations; Includes a survey of modern applications for which computational human models are critical; Describes cellular-level interactions between the human body and electromagnetic fields