A Synthetic Multi-Modal Variable to Capture Cardiovascular Responses to Acute Mental Stress and Transcutaneous Median Nerve Stimulation

Yuanyuan Zhou, Jesse D. Parreira, Sina Masoumi Shahrbabak, Jesus Antonio Sanchez-Perez, Farhan N. Rahman, Asim Hossain Gazi, Omer T. Inan, Jin-Oh Hahn

Abstract: Objective: To develop a novel synthetic multi-modal variable capable of capturing cardiovascular responses to acute mental stress and the stress-mitigating effect of transcutaneous median nerve stimulation (TMNS), as an initial step toward the overarching goal of enabling closed-loop controlled mitigation of the physiological response to acute mental stress. Methods: Using data collected from 40 experiments in 20 participants involving acute mental stress and TMNS, we examined the ability of six plausibly explainable physio-markers to capture cardiovascular responses to acute mental stress and TMNS. Then, we developed a novel synthetic multi-modal variable by fusing the six physio-markers based on numerical optimization and compared its ability to capture cardiovascular responses to acute mental stress and TMNS against the six physio-markers in isolation. Results: The synthetic multi-modal variable showed explainable responses to acute mental stress and TMNS in more experiments (24 vs ≤19). It also exhibited superior consistency, balanced sensitivity, and robustness compared to individual physio-markers. Conclusion: The results showed the promise of the synthetic multi-modal variable as a means to measure cardiovascular responses to acute mental stress and TMNS. However, the results also suggested the potential necessity to develop a personalized synthetic multi-modal variable. Significance: The findings of this work may inform the realization of TMNS-enabled closed-loop control systems for the mitigation of sympathetic arousal to acute mental stress by leveraging physiological measurements that can readily be implemented in wearable form factors.