Characterization and processing of novel neck photoplethysmography signals for cardiorespiratory monitoring

Epilepsy is a neurological disorder causing serious brain seizures that severely affect the patients' quality of life. Sudden unexpected death in epilepsy (SUDEP), for which no evident decease reason is found after post-mortem examination, is a common cause of mortality. The mechanisms leading to SUDEP are uncertain, but, centrally mediated apneic respiratory dysfunction, inducing dangerous hypoxemia, plays a key role. Continuous physiological monitoring appears as the only reliable solution for SUDEP prevention. However, current seizure-detection systems do not show enough sensitivity and present a high number of intolerable false alarms. A wearable system capable of measuring several physiological signals from the same body location, could efficiently overcome these limitations. In this framework, a neck wearable apnea detection device (WADD), sensing airflow through tracheal sounds, was designed. Despite the promising performance, it is still necessary to integrate an oximeter sensor into the system, to measure oxygen saturation in blood (SpO2) from neck photoplethysmography (PPG) signals, and hence, support the apnea detection decision. The neck is a novel PPG measurement site that has not yet been thoroughly explored, due to numerous challenges. This research work aims to characterize neck PPG signals, in order to fully exploit this alternative pulse oximetry location, for precise cardiorespiratory biomarkers monitoring. In this thesis, neck PPG signals were recorded, for the first time in literature, in a series of experiments under different artifacts and respiratory conditions. Morphological and spectral characteristics were analyzed in order to identify potential singularities of the signals. The most common neck PPG artifacts critically corrupting the signal quality, and other breathing states of interest, were thoroughly characterized in terms of the most discriminative features. An algorithm was further developed to differentiate artifacts from clean PPG signals. Both, the proposed characterization and classification model can be useful tools for researchers to denoise neck PPG signals and exploit them in a variety of clinical contexts. In addition to that, it was demonstrated that the neck also offered the possibility, unlike other body parts, to extract the Jugular Venous Pulse (JVP) non-invasively. Overall, the thesis showed how the neck could be an optimum location for multi-modal monitoring in the context of diseases affecting respiration, since it not only allows the sensing of airflow related signals, but also, the breathing frequency component of the PPG appeared more prominent than in the standard finger location. In this context, this property enabled the extraction of relevant features to develop a promising algorithm for apnea detection in near-real time. These findings could be of great importance for SUDEP prevention, facilitating the investigation of the mechanisms and risk factors associated to it, and ultimately reduce epilepsy mortality.Open Acces

Methods and systems for extracting venous pulsation and respiratory information from photoplethysmographs

A system and method for separating a venous component and an arterial component from a red signal and an infrared signal of a PPG sensor is provided. The method uses the second order statistics of venous and arterial signals to separate the venous andarterial signals. After reliable separation of the venous and thearterial component signals,the component signals can be used for different purposes. In a preferred embodiment, the respiratory signal, pattern, and rate are extracted from the separated venous component and a reliable ?ratio of ratios? is extracted for SpO, using only the arterial component of the PPG signals. The disclosed embodiments enable real-time continuous monitoring of respiration pattern/rate and site-independentarterial oxygen saturation.Board of Regents, University of Texas Syste

Implementation of Accelerometer-Based Adaptive Noise Cancellation in a Wireless Wearable Pulse Oximeter Platform for Remote Physiological Monitoring and Triage

A wireless wearable battery-operated pulse oximeter has been developed in our laboratory for field triage applications. The wearable pulse oximeter, which uses a forehead-mounted sensor to provide arterial oxygen saturation (SpO2) and heart rate (HR) information, would enable field medics to monitor vital physiological information following critical injuries, thereby helping to prioritize life saving medical interventions. This study was undertaken to investigate if accelerometry (ACC)-based adaptive noise cancellation (ANC) is effective in minimizing SpO2 and HR errors induced during jogging to simulate certain motion artifacts expected to occur in the field. Preliminary tests confirmed that processing the motion corrupted photoplethysmographic (PPG) signals by simple Least-Mean-Square (LMS) and Recursive Least-Squares (RLS) ANC algorithms can help to improve the signal-to-noise ratio of motion-corrupted PPG signals, thereby reducing SpO2 and HR errors during jogging. The study showed also that the degree of improvement depends on filter order. In addition, we found that it would be more feasible to implement an LMS adaptive filter within an embedded microcontroller environment since the LMS algorithm requires significantly less operations

Investigating the Effects of Sensor Mass, Applied Heat, and Applied Pressure on Motion Artifact in Photoplethysmography within a Military Transport Environment

Despite the wide use of pulse oximetry as a clinical monitoring device for non-invasive measurement of hemoglobin oxygen saturation and heart rate, reports have shown its high sensitivity to motion artifact, rendering the device less accurate and reliable during field applications such as in military environments or ambulatory transport. This paper investigates the effects of sensor weight, localized heating and locally applied pressure on measurement accuracy of a prototype forehead pulse oximeter during a simulated military transport environment. The results yielded that increased sensor weight led to measurement errors and more severe signal corruption, while increased heat (up to 42oC) and pressure (up to 60mmHg) decreased errors and improved signal fidelity

Physiological Parameter Sensing with Wearable Devices and Non-Contact Dopper Radar.

M.S. Thesis. University of Hawaiʻi at Mānoa 2017

Novel Methods for Weak Physiological Parameters Monitoring.

M.S. Thesis. University of Hawaiʻi at Mānoa 2017

Adaptive motion artefact reduction in respiration and ECG signals for wearable healthcare monitoring systems

Wearable healthcare monitoring systems (WHMSs) have received significant interest from both academia and industry with the advantage of non-intrusive and ambulatory monitoring. The aim of this paper is to investigate the use of an adaptive filter to reduce motion artefact (MA) in physiological signals acquired by WHMSs. In our study, a WHMS is used to acquire ECG, respiration and triaxial accelerometer (ACC) signals during incremental treadmill and cycle ergometry exercises. With these signals, performances of adaptive MA cancellation are evaluated in both respiration and ECG signals. To achieve effective and robust MA cancellation, three axial outputs of the ACC are employed to estimate the MA by a bank of gradient adaptive Laguerre lattice (GALL) filter, and the outputs of the GALL filters are further combined with time-varying weights determined by a Kalman filter. The results show that for the respiratory signals, MA component can be reduced and signal quality can be improved effectively (the power ratio between the MA-corrupted respiratory signal and the adaptive filtered signal was 1.31 in running condition, and the corresponding signal quality was improved from 0.77 to 0.96). Combination of the GALL and Kalman filters can achieve robust MA cancellation without supervised selection of the reference axis from the ACC. For ECG, the MA component can also be reduced by adaptive filtering. The signal quality, however, could not be improved substantially just by the adaptive filter with the ACC outputs as the reference signals.Municipal Science & Technology Commission. Beijing Natural Science Foundation (Grants 3102028 and 3122034)General Logistics Science Foundation (Grant CWS11C108)National Institutes of Health (U.S.) (National Institute of General Medical Sciences (U.S.). Grant R01- EB001659)National Institutes of Health (U.S.) (National Institute for Biomedical Imaging and Bioengineering (U.S.) Cooperative Agreement U01- EB-008577

Data-driven methods for analyzing ballistocardiograms in longitudinal cardiovascular monitoring

Cardiovascular disease (CVD) is the leading cause of death in the US; about 48% of American adults have one or more types of CVD. The importance of continuous monitoring of the older population, for early detection of changes in health conditions, has been shown in the literature, as the key to a successful clinical intervention. We have been investigating environmentally-embedded in-home networks of non-invasive sensing modalities. This dissertation concentrates on the signal processing techniques required for the robust extraction of morphological features from the ballistocardiographs (BCG), and machine learning approaches to utilize these features in non-invasive monitoring of cardiovascular conditions. At first, enhancements in the time domain detection of the cardiac cycle are addressed due to its importance in the estimation of heart rate variability (HRV) and sleep stages. The proposed enhancements in the energy-based algorithm for BCG beat detection have shown at least 50% improvement in the root mean square error (RMSE) of the beat to beat heart rate estimations compared to the reference estimations from the electrocardiogram (ECG) R to R intervals. These results are still subject to some errors, primarily due to the contamination of noise and motion artifacts caused by floor vibration, unconstrained subject movements, or even the respiratory activities. Aging, diseases, breathing, and sleep disorders can also affect the quality of estimation as they slightly modify the morphology of the BCG waveform.Includes bibliographical reference

The 2023 wearable photoplethysmography roadmap

Photoplethysmography is a key sensing technology which is used in wearable devices such as smartwatches and fitness trackers. Currently, photoplethysmography sensors are used to monitor physiological parameters including heart rate and heart rhythm, and to track activities like sleep and exercise. Yet, wearable photoplethysmography has potential to provide much more information on health and wellbeing, which could inform clinical decision making. This Roadmap outlines directions for research and development to realise the full potential of wearable photoplethysmography. Experts discuss key topics within the areas of sensor design, signal processing, clinical applications, and research directions. Their perspectives provide valuable guidance to researchers developing wearable photoplethysmography technology