MEASUREMENT OF BASIC HEMODYNAMICS DURING MULTIPOST TRANSCUTANEOUS EXTERNAL EAR STIMULATION: A TWO-CASE STUDY

  • Janez Rozman Center for Implantable Technology and Sensors, ITIS d. o. o. Ljubljana
  • Katarina Miklavec Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
  • Ingrid Rozman The Family Study and Research Centre, Dvor 12, 1210 Ljubljana-Šentvid, Republic of Slovenia
  • Anja Emri Medical Chamber of Slovenia, Dunajska cesta 162, 1000 Ljubljana, Republic of Slovenia
  • Tomislav Mirković Department of Anaesthesiology and Surgical Intensive Therapy, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Republic of Slovenia
  • Samo Ribarič Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Republic of Slovenia
Keywords: external ear stimulation, hemodynamics, measurement, signal acquisition

Abstract

The objectives of the investigation were to assess the short-term responses of the cardio-vascular system on the multipost transcutaneous stimulation (tANS) of the external ear (EE). The scope was to measure the forefinger photopleths (FPPG), toe photopleths (TPPG), aortic phonocardiogram (APCG), mitral phonocardiogram (MPCG) and brachial arterial blood pressure (BABP), assuming that they could be altered with the tANS. For the tANS, stimulator, two silicone ear plugs with four platinum electrodes each, and a large common electrode (CE), were used. Trials were carried out with two female volunteers, aged 25 years and 28 years. To capture the heart sounds, two customized electronic stethoscopes (transducers) were used. BABP was measured using a pressure transducer and blood-pressure appliance. To measure the FPPGs, a pulse oximeter and SpO2 finger clip were used. To measure the TPPGs, another pulse oximeter and customized SpO2 foot clip was used. Signals were gathered using a high-performance data-acquisition system. An offline analysis was made just before and just after the start of the tANS. To record the pulsations in the right brachial artery, the 2D ultrasound mode (B) of the ultrasound device was used before and during the tANS. Then, diagrams showing the vein cross-sectional area over time were constructed. The results show that vascular time intervals between heart sounds S1 and S2, captured as APCG and systolic peaks of the FPPG in the second volunteer, were slightly larger during the separate tANS of the left white (LW) and (RW) EE post than before the tANS. Furthermore, vascular time intervals between the heart sounds S1 and S2, captured as MPCG and systolic peaks of the TPPG in the second volunteer, were slightly smaller during the separate tANS of LW and RW EE post than before the tANS. Finally, tANS of the LW post elicited a slightly lower heart rate than the one measured when LW was not stimulated. In contrast, the tANS of the RW post elicited a slightly higher heart rate than the one measured when RW was not stimulated. It was also shown that the pattern of the vein cross-sectional area over time with tANS was different compared to both the FPPG and TPPG.

References

1. J. T. Mortimer, N. Bhadra, Fundamentals of Electrical Stimulation, In: Krames ES, Peckham PH, Rezai Ali R, editors, Neuromodulation, Academic Press; 2009, 109-121. https://doi.org/10.1016/B978-0-12-374248-3.00012-4

2. J. Ellrich, Transcutaneous vagus nerve stimulation, Eur. Neurol. Rev., 6 (2011) 4, 254–6, doi:10.17925/ENR.2011.06.04.254

3. W-P, Teo, M. Muthalib, S. Yamin, A. M. Hendy, K. Bramstedt, E. Kotsopoulos, S. Perrey, H. Ayaz, Does a combination of virtual reality, neuromodulation and neuroimaging provide a comprehensive platform for neurorehabilitation? A narrative review of the literature, Frontiers in Human Neuroscience, 10 (2016) 284, https://doi.org/10.3389/fnhum.2016.00284

4. B. W. Badran, L. T. Dowdle, O. J. Mithoefer, N. T. LaBate, J. Coatsworth, J. C. Brown, W. H. DeVries, C. W. Austelle, L. M. McTeague, M. S. George, Neurophysiologic effects of transcutaneous auricular vagus nerve stimulation (taVNS) via electrical stimulation of the tragus: A concurrent taVNS/fMRI study and review, Brain Stimul., 11 (2018) 3, 492-500, doi: 10.1016/j.brs.2017.12.009

5. B. W. Badran, O. J. Mithoefer, C. E. Summer, N. T. LaBate, C. E. Glusman, A. W. Badran, W. H. DeVries, P. M. Summers, C. W. Austelle, L. M. McTeague, J. J. Borckardt, M. S. George, Short trains of transcutaneous auricular vagus nerve stimulation (taVNS) have parameter-specific effects on heart rate, Brain Stimul., 11 (2018) 4, 699-708, doi: 10.1016/j.brs.2018.04.004

6. M. A. A. Hamid, M. Abdullah, N. A. Khan, Y. M. A. AL-Zoom, Biotechnical System for Recording Phonocardiography, International Journal of Advanced Computer Science and Applications (IJACSA), 10 (2019) 8, http://dx.doi.org/10.14569/IJACSA.2019.0100864

7. A. Ramović, L. Bandić, J. Kevrić, E. Germović, A. Subasi, Wavelet and Teager energy operator (TEO) for heart sound processing and identification, In: CMBEBIH 2017, Springer; 2017, 495-502. https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/heart-sounds

8. Learn The Heart. Cardiology Review, Topic Reviews A-Z, Heart Sounds Topic Review, https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/heart-sounds, 20.06.2023

9. V. N. Varghees, K. I. Ramachandran, A novel heart sound activity detection framework for automated heart sound analysis, Biomedical Signal Processing and Control, 13 (2014), 174–188, doi:10.1016/j.bspc.2014.05.002

10. T. H. Chowdhury, K. N. Poudel, Y. Hu, Time-Frequency Analysis, Denoising, Compression, Segmentation, and Classification of PCG Signals, IEEE Access, 8 (2020) 160882-160890, doi: 10.1109/ACCESS.2020.3020806

11. Y. Henderson, F. E. Johnson, Two modes of closure of the heart valves, Heart, 4 (1912), 69-82

12. X. Hu, Q. Zhao, X. Ye, Autonomic regulation of mechanical properties in porcine mitral valve cusps, Arq. Bras. Cardiol., 98 (2012) 4, 321-8, doi: 10.1590/s0066-782x2012000400006. PMID: 22735910

13. A. Jubran, Pulse oximetry, Crit Care, 19 (2015) 1, 272, doi:10.1186/s13054-015-0984-8

14. M. Elgendi, R. Fletcher, Y. Liang, N. Howard, N. H. Lovell, D. Abbott, K. Lim, R. Ward, The use of photoplethysmography for assessing hypertension, npj Digit. Med. 2 (2019) 60, doi.org/10.1038/s41746-019-0136-7

15. P. Bonham, Measuring toe pressures using a portable photoplethysmograph to detect arterial disease in high-risk patients: an overview of the literature, Ostomy Wound Manage, 57 (2011) 11, 36-44

16. Cleveland Clinic. Hemodynamic Test, https://my.clevelandclinic.org/health/diagnostics/17094-hemodynamic-test, 20.06.2023

17. J. P. Jamison, A. Campbell, C. Devlin, C. D. Johnson, Brachial artery blood flow by vascular ultrasound in education, Adv. Physiol. Educ., 46 (2022), 498–506, doi:10.1152/advan.00157.2021

18. A. Bhaskar, A simple electronic stethoscope for recording and playback of heart sounds, Adv. Physiol. Educ., 36 (2012), 360–362, doi:10.1152/advan.00073.2012

19. A. M. Noor, M. F. Shadi, The heart auscultation. From sound to graphical, Journal of Engineering and Technology (JET), 4 (2013) 2, 73-84

20. C. N. Gupta, R. Palaniappan, S. Rajan, S. Swaminathan, S. M. Krishnan, Segmentation and classification of heart sounds, Proc. of the Can. Conf. Electrical Comput. Eng., Saskatoon 2005, 1674–1677, doi:10.1109/CCECE.2005.1557305

21. M. Nitzan, B. Khanokh, Y. Slovik, The difference in pulse transit time to the toe and finger measured by photoplethysmography, Physiol. Meas., 23 (2002) 1, 85-93. doi: 10.1088/0967-3334/23/1/308

22. B. W. Badran, J. C. Brown, L. T. Dowdle, O. J. Mithoefer, N. T. LaBate, J. Coatsworth, W. H. DeVries, C. W. Austelle, L. M. McTeague, A. Yu, M. Bikson, D. D. Jenkins, M. S. George, Tragus or cymba conchae? Investigating the anatomical foundation of transcutaneous auricular vagus nerve stimulation (taVNS), Brain Stimul., 11 (2018) 4, 947-948, doi: 10.1016/j.brs.2018.06.003

23. B. W. Badran, A. B. Yu, D. Adair, G. Mappin, W. H. DeVries, D. D. Jenkins, M. S. George, M. Bikson, Laboratory Administration of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS): Technique, Targeting, and Considerations, J. Vis. Exp., 143 (2019), e58984, https://doi.org/10.3791/58984

24. M. Elgendi, TERMA Framework for Biomedical Signal Analysis: An Economic-Inspired Approach, Biosensors, 55 (2016) 6(4), doi.org/10.3390/bios6040055

25. T. Rahman, A. T. Adams, M. Zhang, E. Cherry, B. Zhou, H. Peng, T. Choudhury, BodyBeat: a mobile system for sensing nonspeech body sounds, Proc. of the 12th annual international conference on Mobile systems, applications, and services, Bretton Woods 2014, 2–13, doi.org/10.1145/2594368.2594386

26. M. McGregor, M. B. Rappaport, H. B. Sprague, A. L. Friedlich, The calibration of heart sound intensity, Circulation, 13 (1956) 2, 252-256., doi:10.1161/01.cir.13.2.252

27. W. C. Kao, C. C. Wei, Automatic phonocardiograph signal analysis for detecting heart valve disorders, Expert Systems with Applications, 38 (2011) 6, 6458-6468, doi.org/10.1016/j.eswa.2010.11.100

28. A. Subasi, Chapter 2-Biomedical Signals, Editor(s): Abdulhamit Subasi, Practical Guide for Biomedical Signals Analysis Using Machine Learning Techniques, Academic Press, 2019, 27-87, https://doi.org/10.1016/B978-0-12-817444-9.00002-7

29. J. A. Clancy, D. A. Mary, K. K. Witte, J. P. Greenwood, S. A. Deuchars, J. Deuchars, Non-invasive vagus nerve stimulation in healthy humans reduces sympathetic nerve activity, Brain Stimul., 7 (2014) 6, 871-7, doi:10.1016/j.brs.2014.07.031

30. L. V. Borovikova, S. Ivanova, M. Zhang, H. Yang, G. I. Botchkina, L. R. Watkins, H. Wang, N. Abumrad, J. W. Eaton, K. J. Tracey, Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin, Nature, 405 (2000) 6785), 458-62, doi:10.1038/35013070
Published
2024-05-31
How to Cite
1.
Rozman J, Miklavec K, Rozman I, Emri A, Mirković T, Ribarič S. MEASUREMENT OF BASIC HEMODYNAMICS DURING MULTIPOST TRANSCUTANEOUS EXTERNAL EAR STIMULATION: A TWO-CASE STUDY. MatTech [Internet]. 2024May31 [cited 2024Sep.7];58(3):309–319. Available from: https://mater-tehnol.si/index.php/MatTech/article/view/1032