Smart helmet: wearable multichannel ECG & EEG

Modern wearable technologies have enabled continuous recording of vital signs, however, for activities such as cycling, motor-racing, or military engagement, a helmet with embedded sensors would provide maximum convenience and the opportunity to monitor simultaneously both the vital signs and the electroencephalogram (EEG). To this end, we investigate the feasibility of recording the electrocardiogram (ECG), respiration, and EEG from face-lead locations, by embedding multiple electrodes within a standard helmet. The electrode positions are at the lower jaw, mastoids, and forehead, while for validation purposes a respiration belt around the thorax and a reference ECG from the chest serve as ground truth to assess the performance. The within-helmet EEG is verified by exposing the subjects to periodic visual and auditory stimuli and screening the recordings for the steady-state evoked potentials in response to these stimuli. Cycling and walking are chosen as real-world activities to illustrate how to deal with the so-induced irregular motion artifacts, which contaminate the recordings. We also propose a multivariate R-peak detection algorithm suitable for such noisy environments. Recordings in real-world scenarios support a proof of concept of the feasibility of recording vital signs and EEG from the proposed smart helmet

Resolving ambiguities in the LF/HF Ratio: LF-HF scatter plots for the categorization of mental and physical stress from HRV

It is generally accepted that the activities of the autonomic nervous system (ANS), which consists of the sympathetic (SNS) and parasympathetic nervous systems (PNS), are reflected in the low- (LF) and high-frequency (HF) bands in heart rate variability (HRV)—while, not without some controversy, the ratio of the powers in those frequency bands, the so called LF-HF ratio (LF/HF), has been used to quantify the degree of sympathovagal balance. Indeed, recent studies demonstrate that, in general: (i) sympathovagal balance cannot be accurately measured via the ratio of the LF- and HF- power bands; and (ii) the correspondence between the LF/HF ratio and the psychological and physiological state of a person is not unique. Since the standard LF/HF ratio provides only a single degree of freedom for the analysis of this 2D phenomenon, we propose a joint treatment of the LF and HF powers in HRV within a two-dimensional representation framework, thus providing the required degrees of freedom. By virtue of the proposed 2D representation, the restrictive assumption of the linear dependence between the activity of the autonomic nervous system (ANS) and the LF-HF frequency band powers is demonstrated to become unnecessary. The proposed analysis framework also opens up completely new possibilities for a more comprehensive and rigorous examination of HRV in relation to physical and mental states of an individual, and makes possible the categorization of different stress states based on HRV. In addition, based on instantaneous amplitudes of Hilbert-transformed LF- and HF-bands, a novel approach to estimate the markers of stress in HRV is proposed and is shown to improve the robustness to artifacts and irregularities, critical issues in real-world recordings. The proposed approach for resolving the ambiguities in the standard LF/HF-ratio analyses is verified over a number of real-world stress-invoking scenarios

Hearables: feasibility of recording cardiac rhythms from head and in-ear locations

Mobile technologies for the recording of vital signs and neural signals are envisaged to underpin the operation of future health services. For practical purposes, unobtrusive devices are favoured, such as those embedded in a helmet or incorporated onto an earplug. However, these locations have so far been underexplored, as the comparably narrow neck impedes the propagation of vital signals from the torso to the head surface. To establish the principles behind electrocardiogram (ECG) recordings from head and ear locations, we first introduce a realistic three-dimensional biophysics model for the propagation of cardiac electric potentials to the head surface, which demonstrates the feasibility of head-ECG recordings. Next, the proposed biophysics propagation model is verified over comprehensive real-world experiments based on head- and in-ear-ECG measurements. It is shown both that the proposed model is an excellent match for the recordings, and that the quality of head- and ear-ECG is sufficient for a reliable identification of the timing and shape of the characteristic P-, Q-, R-, S- and T-waves within the cardiac cycle. This opens up a range of new possibilities in the identification and management of heart conditions, such as myocardial infarction and atrial fibrillation, based on 24/7 continuous in-ear measurements. The study therefore paves the way for the incorporation of the cardiac modality into future ‘hearables’, unobtrusive devices for health monitoring

Stage Call: Cardiovascular Reactivity to Audition Stress in Musicians

Auditioning is at the very center of educational and professional life in music and is associated with significant psychophysical demands. Knowledge of how these demands affect cardiovascular responses to psychosocial pressure is essential for developing strategies to both manage stress and understand optimal performance states. To this end, we recorded the electrocardiograms (ECGs) of 16 musicians (11 violinists and 5 flutists) before and during performances in both low- and high-stress conditions: with no audience and in front of an audition panel, respectively. The analysis consisted of the detection of R-peaks in the ECGs to extract heart rate variability (HRV) from the notoriously noisy real-world ECGs. Our data analysis approach spanned both standard (temporal and spectral) and advanced (structural complexity) techniques. The complexity science approaches—namely, multiscale sample entropy and multiscale fuzzy entropy—indicated a statistically significant decrease in structural complexity in HRV from the low- to the high-stress condition and an increase in structural complexity from the pre-performance to performance period, thus confirming the complexity loss theory and a loss in degrees of freedom due to stress. Results from the spectral analyses also suggest that the stress responses in the female participants were more parasympathetically driven than those of the male participants. In conclusion, our findings suggest that interventions to manage stress are best targeted at the sensitive pre-performance period, before an audition begins

A multivariate multiscale fuzzy entropy algorithm with application to uterine EMG complexity analysis

The recently introduced multivariate multiscale entropy (MMSE) has been successfully used to quantify structural complexity in terms of nonlinear within- and cross-channel correlations as well as to reveal complex dynamical couplings and various degrees of synchronization over multiple scales in real-world multichannel data. However, the applicability of MMSE is limited by the coarse-graining process which defines scales, as it successively reduces the data length for each scale and thus yields inaccurate and undefined entropy estimates at higher scales and for short length data. To that cause, we propose the multivariate multiscale fuzzy entropy (MMFE) algorithm and demonstrate its superiority over the MMSE on both synthetic as well as real-world uterine electromyography (EMG) short duration signals. Based on MMFE features, an improvement in the classification accuracy of term-preterm deliveries was achieved, with a maximum area under the curve (AUC) value of 0.99

The ClassA framework: HRV based assessment of SNS and PNS dynamics without LF-HF controversies

The powers of the low frequency (LF) and high frequency (HF) components of heart rate variability (HRV) have become the de facto standard metrics in the assessment of the stress response, and the related activities of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). However, the widely adopted physiological interpretations of the LF and HF components in SNS /PNS balance are now questioned, which puts under serious scrutiny stress assessments which employ the LF and HF components. To avoid these controversies, we here introduce the novel Classification Angle (ClassA) framework, which yields a family of metrics which quantify cardiac dynamics in three-dimensions. This is achieved using a finite-difference plot of HRV, which displays successive rates of change of HRV, and is demonstrated to provide sufficient degrees of freedom to determine cardiac deceleration and/or acceleration. The robustness and accuracy of the novel ClassA framework is verified using HRV signals from ten males, recorded during standardized stress tests, consisting of rest, mental arithmetic, meditation, exercise and further meditation. Comparative statistical testing demonstrates that unlike the existing LF-HF metrics, the ClassA metrics are capable of distinguishing both the physical and mental stress epochs from the epochs of no stress, with statistical significance (Bonferroni corrected p-value ≤ 0.025); HF was able to distinguish physical stress from no stress, but was not able to identify mental stress. The ClassA results also indicated that at moderate levels of stress, the extent of parasympathetic withdrawal was greater than the extent of sympathetic activation. Finally, the analyses and the experimental results provide conclusive evidence that the proposed nonlinear approach to quantify cardiac activity from HRV resolves three critical obstacles to current HRV stress assessments: (i) it is not based on controversial assumptions of balance between the LF and HF powers; (ii) its temporal resolution when estimating parasympathetic dominance is as little as 10 s of HRV data, while only 60 s to estimate sympathetic dominance; (iii) unlike LF and HF analyses, the ClassA framework does not require the prohibitive assumption of signal stationarity. The ClassA framework is unique in offering HRV based stress analysis in three-dimensions

Discrimination of emotional states from scalp- and intracranial EEG using multiscale Renyi entropy

A data-adaptive, multiscale version of Rényi’s quadratic entropy (RQE) is introduced for emotional state discrimination from EEG recordings. The algorithm is applied to scalp EEG recordings of 30 participants watching 4 emotionally-charged video clips taken from a validated public database. Krippendorff’s inter-rater statistic reveals that multiscale RQE of the mid-frontal scalp electrodes best discriminates between five emotional states. Multiscale RQE is also applied to joint scalp EEG, amygdala- and occipital pole intracranial recordings of an implanted patient watching a neutral and an emotionally charged video clip. Unlike for the neutral video clip, the RQEs of the mid-frontal scalp electrodes and the amygdala-implanted electrodes are observed to coincide in the time range where the crux of the emotionally-charged video clip is revealed. In addition, also during this time range, phase synchrony between the amygdala and mid-frontal recordings is maximal, as well as our 30 participants’ inter-rater agreement on the same video clip. A source reconstruction exercise using intracranial recordings supports our assertion that amygdala could contribute to mid-frontal scalp EEG. On the contrary, no such contribution was observed for the occipital pole’s intracranial recordings. Our results suggest that emotional states discriminated from mid-frontal scalp EEG are likely to be mirrored by differences in amygdala activations in particular when recorded in response to emotionally-charged scenes