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19 pages, 1342 KB  
Review
Cardiovascular Exercise Physiology Under Hypoxia, Microgravity, and Heat Stress: A Review with Public Health Implications
by Ryan Dumais, Emmett Suckow, Ibrahim Ainab, Francis Zirille, Lindsay M. Forbes, Justin S. Lawley and William K. Cornwell
Int. J. Environ. Res. Public Health 2026, 23(5), 594; https://doi.org/10.3390/ijerph23050594 - 1 May 2026
Abstract
Aerobic exercise capacity, best quantified by maximal oxygen uptake (VO2max), varies between individuals and is dependent on cardiac output (CO) and oxygen uptake in the periphery (a-vO2 diff). Environmental stressors like hypoxia, microgravity, and heat negatively impact these parameters, thereby [...] Read more.
Aerobic exercise capacity, best quantified by maximal oxygen uptake (VO2max), varies between individuals and is dependent on cardiac output (CO) and oxygen uptake in the periphery (a-vO2 diff). Environmental stressors like hypoxia, microgravity, and heat negatively impact these parameters, thereby reducing aerobic exercise capacity. However, in response to acute and chronic exposures to these environments, compensatory processes serve to counteract reductions in VO2max. In hypoxic environments, reduced oxygen partial pressure (PO2) leads to hypoxic pulmonary vasoconstriction (HPV) and a diffusion limitation at the level of the lungs and skeletal muscle, resulting in a reduction in VO2max. Microgravity environments reduce VO2max through cardiac and skeletal muscle deconditioning, as well as reductions in plasma volume (PV), resulting in an increase in sympathetic nerve activity through baroreceptor-mediated pathways. In heat stress environments, increases in skin perfusion upon acute exposure hinder exercise performance, whereas compensatory PV expansion mitigates further decreases in VO2max. As humans are increasingly exposed to austere environments and environmental extremes, it is critical to understand how these environments impact cardiovascular exercise physiology so that effective strategies and protocols ensuring proper aerobic functioning may be implemented. Full article
(This article belongs to the Special Issue Exercise in Living Environments: A Healthy Lifestyle)
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11 pages, 927 KB  
Article
Homeostatic Responses to Subsystolic Arterial Occlusive Pressure in Glabrous and Non-Glabrous Skin Circulation
by Joana Caetano, Pedro de la Villa Polo, José Delgado Alves and Luis Monteiro Rodrigues
Biomedicines 2026, 14(4), 888; https://doi.org/10.3390/biomedicines14040888 - 13 Apr 2026
Viewed by 414
Abstract
Background: Reactive hyperemia (RH) is used to assess microcirculatory function in vivo and has traditionally been interpreted as a local, ischemia-driven vasodilatory response following arterial occlusion. However, perfusion changes consistently observed in contralateral, non-challenged limbs question the exclusively local nature of RH. Objective: [...] Read more.
Background: Reactive hyperemia (RH) is used to assess microcirculatory function in vivo and has traditionally been interpreted as a local, ischemia-driven vasodilatory response following arterial occlusion. However, perfusion changes consistently observed in contralateral, non-challenged limbs question the exclusively local nature of RH. Objective: This study aimed to characterize reactive hyperemic responses elicited by subsystolic cuff pressures, below arterial occlusion pressure (AOP), and to investigate their effects on glabrous and non-glabrous skin microcirculation and on global hemodynamics. Methods: Seven healthy women underwent a standardized protocol consisting of baseline stabilization, a 2 min subsystolic cuff inflation (70–80% of resting AOP) in one arm, and a recovery period. Microvascular perfusion was simultaneously assessed in both hands using laser Doppler flowmetry (LDF) on glabrous skin and polarized light spectroscopy (PSp) on non-glabrous dorsal skin. Hemodynamic indicators were continuously monitored using CNAP (Continuous Non-invasive Arterial Pressure) technology. Ipsilateral and contralateral responses were compared across experimental phases. Results: Subsystolic cuff inflation induced significant perfusion changes not only in the challenged limb but also in the contralateral limb, despite the absence of a complete arterial occlusion. Conclusions: These findings confirm the adaptive nature of RH emphasizing the major role for the sympathetic nervous system in glabrous skin. In glabrous (palmar) skin, a similar perfusion profile is shown in both hands but significant differences could only be found in the ipsilateral hand. In contrast, non-glabrous (dorsal) skin demonstrated region-specific increases in perfusion, again evident in the ipsilateral hand, suggesting venous stasis. No changes in global hemodynamic variables were observed throughout the protocol. Further studies in larger, more diverse populations are needed to confirm these observations and refine the mechanistic understanding of reactive hyperemia. Full article
(This article belongs to the Special Issue Advances in Biomarker Discovery for Cardiovascular Disease)
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14 pages, 617 KB  
Article
Fear of Sleep in the Acute Aftermath of Trauma Predicts Future Posttraumatic Stress Disorder: The Moderating Role of Community Violence Exposure
by Anthony N. Reffi, Tanja Jovanovic, David A. Kalmbach, Kristi E. Pruiksma, David A. Moore, Lily Jankowiak, Hsing-Fang Hsieh, Philip Cheng, Sattvik Basarkod and Christopher L. Drake
Behav. Sci. 2026, 16(3), 443; https://doi.org/10.3390/bs16030443 - 18 Mar 2026
Viewed by 622
Abstract
Research suggests fear of sleep (FoS) may be an important consequence of trauma that increases risk for posttraumatic stress disorder (PTSD), especially among patients experiencing ongoing threat after their trauma has ended. Community violence exposure may reinforce perceptions of threat, compounding the pathogenic [...] Read more.
Research suggests fear of sleep (FoS) may be an important consequence of trauma that increases risk for posttraumatic stress disorder (PTSD), especially among patients experiencing ongoing threat after their trauma has ended. Community violence exposure may reinforce perceptions of threat, compounding the pathogenic effect of FoS after trauma. The current study investigated whether FoS increases within the acute aftermath of trauma, and if such increases in FoS predict future PTSD severity. Further, we tested whether community violence exposure moderates the prospective relationship between FoS and PTSD. We recruited patients from an urban Level I trauma center (N = 88; Mage = 39.53 ± SD 14.31, 67.0% male, 67.0% Black). Patients reported FoS within one week of trauma (T1) and again one month later (T2), and PTSD symptoms two months later (T3). We operationalized community violence exposure as the frequency of hearing gunshots in the 90 days prior to trauma. FoS significantly increased from T1 (M = 8.80) to T2 (M = 11.98), p = 0.015, g = 0.28. Change in FoS significantly predicted PTSD symptoms at T3, and this effect was most pronounced among patients who frequently heard gunshots in their community (β = 0.61, SE = 0.35, p = 0.005). Exploratory analyses in a subsample of patients revealed preliminary associations between skin conductance reactivity and sleep fears at T1, tentatively suggesting heightened sympathetic activation as a corollary of fear of sleep. This study provides novel evidence that FoS increases in response to acute trauma exposure and, in turn, predicts future PTSD severity. Moreover, patients exposed to community violence may be especially vulnerable to these effects, perhaps due in part to continued threats to safety. Acute trauma patients who develop sleep fears may be vulnerable to PTSD, particularly those returning to neighborhoods marked by high levels of community violence. Full article
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36 pages, 5882 KB  
Systematic Review
Beyond EDA: A Systematic Review of Multimodal Sympathetic Nervous System Arousal Classification for Stress Detection
by Santiago Sosa, Adam K. Fontecchio, Evangelia G. Chrysikou and Jennifer S. Atchison
Sensors 2026, 26(5), 1584; https://doi.org/10.3390/s26051584 - 3 Mar 2026
Viewed by 1110
Abstract
Electrodermal activity (EDA) is a powerful anchor for assessing human sympathetic nervous system (SNS) arousal. However, EDA alone is only one facet of physiological response. Researchers have increasingly moved away from single-sensor analysis to multimodal wearable systems, integrating EDA with other signals such [...] Read more.
Electrodermal activity (EDA) is a powerful anchor for assessing human sympathetic nervous system (SNS) arousal. However, EDA alone is only one facet of physiological response. Researchers have increasingly moved away from single-sensor analysis to multimodal wearable systems, integrating EDA with other signals such as heart rate variability (HRV), photoplethysmography (PPG), skin temperature (SKT), blood oxygen (SpO2) and more. This critical shift in methodology is not yet reflected in current reviews of the literature. Existing surveys thoroughly cover EDA as a standalone measure, but the combination of sensor technologies has been largely unexamined. In this context, multimodal refers to integrating EDA with complementary biosignals (HRV, PPG, SKT, SpO2, etc.) commonly captured by modern wearable platforms. This review provides a comprehensive analysis focused on multimodal systems for assessing SNS arousal. A total of 58 studies met the inclusion criteria. We map the landscape, from single signal methods to complex sensor-fusion, and highlight advances in multimodal sensor models, physiological modeling, and context-aware sensing. We also examine recent advances in signal processing and machine learning that enhance multimodal SNS arousal inference, outlining current capabilities and identifying open directions for future work. By providing a framework of this emerging field, this paper serves as a resource for all researchers aiming to build and deploy the next generation of context-aware SNS arousal-sensing technology. Full article
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15 pages, 1098 KB  
Article
Quantifying Bilateral Synchrony and Asymmetry of Neurovascular Responses to Post-Occlusive Reactive Hyperemia
by Henrique Silva, Nicole Lavrador and Hugo Alexandre Ferreira
Appl. Sci. 2025, 15(22), 12142; https://doi.org/10.3390/app152212142 - 16 Nov 2025
Viewed by 616
Abstract
Post-occlusive reactive hyperemia (PORH) is widely used to assess microvascular reactivity, but its systemic impact on contralateral neurovascular function remains unclear. This study quantified bilateral synchrony and asymmetry of cutaneous signals during unilateral PORH in healthy subjects using a novel multidimensional framework of [...] Read more.
Post-occlusive reactive hyperemia (PORH) is widely used to assess microvascular reactivity, but its systemic impact on contralateral neurovascular function remains unclear. This study quantified bilateral synchrony and asymmetry of cutaneous signals during unilateral PORH in healthy subjects using a novel multidimensional framework of inter-limb coherence. Twelve young adults underwent a standard suprasystolic occlusion (5 min at 200 mmHg) on the upper limb, while photoplethysmography (PPG), skin temperature, and electrodermal activity (EDA) were recorded bilaterally in the fingers. Coherence was characterized by profile similarity (Cross-Signal Similarity Index, CSSI), temporal lag (τ*), magnitude asymmetry (Bilateral Magnitude Difference Index, BDMI), directional concordance (Signal Direction Index, SDI; Directional Concordance Index, DCI), and integrated indices (IBIL, IBIS). At baseline, all signals showed high bilateral synchrony (CSSI ≈ 0.9; τ* < 20 ms). Occlusion markedly reduced CSSI for blood flow (0.89 to 0.07, p = 0.002) and temperature (0.93 to −0.03, p = 0.06), while EDA coherence remained preserved (0.95 to 0.82). Integrated indices decreased significantly (IBIL 0.84 to 0.17, p = 0.005; IBIS 0.84 to 0.18, p = 0.004) and recovered only partially during hyperemia (IBIL 0.20, p = 0.003). Directional concordance was heterogeneous: during hyperemia, 9 of 12 subjects showed concordant EDA changes but only 7 of 12 for perfusion. BDMI was largest for perfusion (≈0.8), moderate for temperature (≈0.5), and minimal for EDA (≈0.3). Unilateral PORH thus induces a marked loss of bilateral coherence in microvascular signals, whereas sympathetic-driven responses remain strongly synchronized. This dissociation reveals that occlusion evokes systemic autonomic adjustments beyond local hemodynamics. The proposed framework captures hidden aspects of neurovascular integration and may provide new markers for autonomic imbalance or perfusion asymmetry. Full article
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19 pages, 1046 KB  
Review
Roles of Peripheral Nerves in Tumor Initiation and Progression
by Claudia Giampietri, Elisa Pizzichini, Francesca Somma, Simonetta Petrungaro, Elena De Santis, Siavash Rahimi, Antonio Facchiano and Cinzia Fabrizi
Int. J. Mol. Sci. 2025, 26(15), 7064; https://doi.org/10.3390/ijms26157064 - 22 Jul 2025
Cited by 1 | Viewed by 3429
Abstract
In recent years, a long list of relevant studies has highlighted the engagement of the nervous system in the fine-tuning of tumor development and progression. Several authors have shown that different types of nerve fibres (sympathetic, parasympathetic/vagal or somatosensory fibres) may contribute to [...] Read more.
In recent years, a long list of relevant studies has highlighted the engagement of the nervous system in the fine-tuning of tumor development and progression. Several authors have shown that different types of nerve fibres (sympathetic, parasympathetic/vagal or somatosensory fibres) may contribute to tumor innervation affecting cancer initiation, progression and metastasis. A large presence of nerve fibres is frequently observed in tumors with respect to the corresponding healthy tissues. In this regard, it is worth noting that in some cases a reduced innervation may associate with slow tumor growth in a tissue-specific manner. Current studies have begun to shed light over the role played in this specific process by Schwann cells (SCs), the most abundant glial cells of the peripheral nervous system. SCs observed in cancer tissues share strong similarities with repair SCs that appear after nerve injury. A large body of research indicates that SCs may have a role in shaping the microenvironment of tumors by regulating the immune response and influencing their invasiveness. In this review, we summarize data relevant to the role of peripheral innervation in general, and of SCs in particular, in defining the progression of different tumors: melanoma that originate in the skin with mainly sensory innervation; pancreatic and liver-derived tumors (e.g., pancreatic adenocarcinoma and cholangiocarcinoma) with mainly autonomous innervation. We conclude by summarizing data regarding hepatocarcinoma (with anatomical predominance of small autonomic nerve fibres) in which the potential relationship between innervation and tumor progression has been little explored, and largely remains to be defined. Full article
(This article belongs to the Special Issue Advances in Peripheral Nerve Regeneration)
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19 pages, 2312 KB  
Article
Improvement of Blood Flow and Epidermal Temperature in Cold Feet Using Far-Infrared Rays Emitted from Loess Balls Manufactured by Low-Temperature Wet Drying Method: A Randomized Trial
by Yong Il Shin, Min Seok Kim, Yeong Ae Yang, Yun Jeong Lee, Gye Rok Jeon, Jae Ho Kim, Yeon Jin Choi, Woo Cheol Choi and Jae Hyung Kim
Biomedicines 2025, 13(7), 1759; https://doi.org/10.3390/biomedicines13071759 - 18 Jul 2025
Viewed by 5130
Abstract
Background: Cold feet syndrome is characterized by hypersensitivity of sympathetic nerves to cold stimuli, resulting in vasoconstriction and reduced peripheral blood flow. This condition causes an intense cold sensation, particularly in the extremities. Although hormonal changes (e.g., during childbirth or menopause) and psychological [...] Read more.
Background: Cold feet syndrome is characterized by hypersensitivity of sympathetic nerves to cold stimuli, resulting in vasoconstriction and reduced peripheral blood flow. This condition causes an intense cold sensation, particularly in the extremities. Although hormonal changes (e.g., during childbirth or menopause) and psychological stress have been implicated, the mechanisms and effective treatments remain unclear. Methods: Ninety adult volunteers were randomized into three groups based on the type of heating mat applied to the feet, with surface temperatures gradually increased from 20 °C to 50 °C. Group A (control) used non-FIR electric mats, Group B used carbon FIR mats, and Group C used loess bio-ball FIR mats. Blood flow (mL/min/100 g) and epidermal temperature (°C) in the left big toe (LBT) and right big toe (RBT) were measured before and after heating or FIR exposure using laser Doppler flowmetry and infrared thermometers. Results: No significant changes in blood flow or skin temperature were observed in Group A. In Group B, blood flow increased by 15.07 mL/min/100 g in the LBT (from 4.12 ± 2.22 to 19.19 ± 5.44) and by 14.55 mL/min/100 g in the RBT (from 4.26 ± 2.29 to 18.81 ± 4.29). In Group C, blood flow increased by 32.86 mL/min/100 g in the LBT (from 4.23 ± 1.64 to 37.09 ± 6.04) and by 32.63 mL/min/100 g in the RBT (from 4.20 ± 1.61 to 36.83 ± 6.48). Epidermal temperature also increased significantly in Group C. All changes in Groups B and C were statistically significant (p < 0.05), with Group C showing the most prominent enhancement. Conclusions: The loess bio-ball mat significantly increased both peripheral blood flow and epidermal temperature compared to the electric and carbon mats. These findings suggest that FIR emitted from loess bio-balls may enhance peripheral circulation through hypothalamus thermogenic response and nitric oxide (NO)-dependent pathways and could serve as a complementary and non-invasive intervention for individuals with poor blood flow. Full article
(This article belongs to the Section Biomedical Engineering and Materials)
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16 pages, 3151 KB  
Article
Experimental Study on the Effects of Cockpit Noise on Physiological Indicators of Pilots
by Haiming Shen, Meiqing Hao, Jiawei Ren, Kun Chen and Yang Gao
Sensors 2025, 25(13), 4175; https://doi.org/10.3390/s25134175 - 4 Jul 2025
Cited by 2 | Viewed by 1677
Abstract
Cockpit noise, as a critical environmental factor affecting flight safety, may impair pilots’ cognitive functions, leading to a decreased operational performance and decision-making errors, thereby posing potential threats to aviation safety. In order to reveal the relationship between the cockpit noise sound pressure [...] Read more.
Cockpit noise, as a critical environmental factor affecting flight safety, may impair pilots’ cognitive functions, leading to a decreased operational performance and decision-making errors, thereby posing potential threats to aviation safety. In order to reveal the relationship between the cockpit noise sound pressure level and pilot physiological indicators, and provide a scientific basis for cockpit noise airworthiness standards, this experiment takes pilot trainees as the research subject. Based on the principle of multimodal data synchronization, a sound field reconstruction system is used to reconstruct the cockpit sound field. Electroencephalogram (EEG), electrocardiogram (ECG), and electrodermal activity (EDA) measurements are carried out in different sound pressure level noise operating environments. The results show that with the increase in the sound pressure level, the significant suppression of α-wave activity in the occipital and parietal regions suggests that the cortical resting state is lifted and visual attention is enhanced; the enhancement of the β-wave in the frontal regions reflects the enhancement of alertness and prefrontal executive control, and the suppression of θ-wave activity in the frontal and temporal regions may indicate that cognitive tuning is suppressed, which reflects the brain’s rapid adaptive response to external noise stimuli in a high-noise environment; noise exposure triggers sustained sympathetic nerve hyperactivity, which is manifested by a significant acceleration of the heart rate and a significant increase in the mean value of skin conductance when the noise sound pressure level exceeds 70 dB(A). The correlation analysis between physiological indicators shows that cockpit noise has a multi-system synergistic effect on human physiological indicators. The experimental results indicate that noise has a significant impact on EEG, ECG, and EDA indicators. Full article
(This article belongs to the Section Biomedical Sensors)
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24 pages, 2358 KB  
Article
Classifying Emotionally Induced Pain Intensity Using Multimodal Physiological Signals and Subjective Ratings: A Pilot Study
by Eun-Hye Jang, Young-Ji Eum, Daesub Yoon and Sangwon Byun
Appl. Sci. 2025, 15(13), 7149; https://doi.org/10.3390/app15137149 - 25 Jun 2025
Cited by 2 | Viewed by 2440
Abstract
We explore the feasibility of classifying perceived pain intensity—despite the stimulus being identical—using multimodal physiological signals and self-reported emotional ratings. A total of 112 healthy participants watched the same anger-inducing video, yet reported varying pain intensities (5, 6, or 7 on a 7-point [...] Read more.
We explore the feasibility of classifying perceived pain intensity—despite the stimulus being identical—using multimodal physiological signals and self-reported emotional ratings. A total of 112 healthy participants watched the same anger-inducing video, yet reported varying pain intensities (5, 6, or 7 on a 7-point scale). We recorded electrocardiogram, skin conductance (SC), respiration, photoplethysmogram results, and finger temperature, extracting 12 physiological features. Participants also rated their valence and arousal. Using a random forest model, we classified pain versus baseline and distinguished intensity levels. Compared to baseline, the painful stimulus altered heart rate variability, SC, respiration, and pulse transit time (PTT). Higher perceived pain correlated with more negative valence, higher arousal, and elevated SC, suggesting stronger sympathetic activation. The classification of baseline versus pain using SC and respiratory features reached an F1 score of 0.83. For intensity levels 6 versus 7, including PTT and skin conductance response along with valence achieved an F1 score of 0.73. These findings highlight distinct psychophysiological patterns that reflect perceived intensity under the same stimulus. SC features emerged as key biomarkers, while valence and arousal offered complementary insights, supporting the development of personalized, psychologically informed pain assessment systems. Full article
(This article belongs to the Special Issue Monitoring of Human Physiological Signals)
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16 pages, 277 KB  
Article
Personality Type D and Psychophysiological Stress Reactivity During Mental Stress in Young Healthy Individuals
by Alexey N. Sumin, Natalia N. Zagorskaya, Anna V. Shcheglova, Anatoly A. Shipilov, Daniil Z. Kostylbaev, Elena A. Shikanova and Ingrid Y. Prokashko
Behav. Sci. 2025, 15(7), 852; https://doi.org/10.3390/bs15070852 - 24 Jun 2025
Cited by 2 | Viewed by 1319
Abstract
Persons with personality type D are characterized by an “unhealthy lifestyle”, which is manifested by low physical activity, less healthy eating behavior, and failure to comply with doctors’ recommendations. Persons with personality type D have an inadequate response of hemodynamic parameters to psychoemotional [...] Read more.
Persons with personality type D are characterized by an “unhealthy lifestyle”, which is manifested by low physical activity, less healthy eating behavior, and failure to comply with doctors’ recommendations. Persons with personality type D have an inadequate response of hemodynamic parameters to psychoemotional stress; the response of other parameters has not been sufficiently studied. The aim of this study was to investigate the association of personality type D with various psychophysiological parameters of the body during mental stress in healthy individuals. Material and Methods: The study involved 79 students of Kemerovo State Medical University aged 18 to 32 years (mean age 20.7 ± 2.4 years). Psychophysiological diagnostics was carried out using the BOSLAB complex; electromyogram, electrocardiogram, body temperature, respiration, galvanic skin response, and photoplethysmogram data were recorded. The stress testing protocol included cognitive tasks and recovery phases. Additionally, the presence of personality type D in students was assessed using the DS-14 questionnaire. The results of stress tests were compared in groups with the presence/absence of type D. Results: The frequency of detection of type D was high (54.4%). When examining the response of psychophysiological parameters, the most pronounced response to stress tests with mental load was noted for heart rate variability and respiratory system parameters. Individuals with type D personality showed more pronounced sympathetic activation in response to mental stress and a slower recovery at rest. Among the studied parameters, association with personality type D was noted for the following indicators during the mental arithmetic test: heart rate (p = 0.022), the Baevsky strain index (p = 0.004), respiratory rate (p = 0.020), and an indicator of regulatory process adequacy (p < 0.001). Conclusion: In the present study, we found differences in the reaction of psychophysiological parameters to mental stress in healthy individuals depending on the presence or absence of personality type D. These data can be useful for developing stress resistance programs and biofeedback training. The possibility of using the above psychophysiological parameters in biofeedback training programs for individuals with personality type D requires further research. Full article
(This article belongs to the Special Issue The Impact of Psychosocial Factors on Health Behaviors)
17 pages, 488 KB  
Systematic Review
Dysautonomia in Alzheimer’s Disease: A Systematic Review
by Marianna Papadopoulou, Maria-Ioanna Stefanou, Eleni Bakola, Christos Moschovos, Athanasia Athanasaki, Evdoxia Tsigkaropoulou, Ioannis Michopoulos, George P. Paraskevas, Rossetos Gournellis and Georgios Tsivgoulis
Brain Sci. 2025, 15(5), 502; https://doi.org/10.3390/brainsci15050502 - 14 May 2025
Cited by 4 | Viewed by 3343
Abstract
Background: Alzheimer’s disease (AD) is the most common cause of dementia. In addition to cognitive decline, non-cognitive symptoms, including dysautonomia, have been reported, although these symptoms are rarely acknowledged by patients. Dysautonomia in AD is thought to arise from either cholinergic deficits [...] Read more.
Background: Alzheimer’s disease (AD) is the most common cause of dementia. In addition to cognitive decline, non-cognitive symptoms, including dysautonomia, have been reported, although these symptoms are rarely acknowledged by patients. Dysautonomia in AD is thought to arise from either cholinergic deficits or hypothalamic involvement. A wide range of tests has been used to investigate the role of the autonomic nervous system; however, the results have been inconsistent. Aim: To systematically review all published research investigating autonomic nervous system (ANS) involvement in patients with AD. A comprehensive literature search was conducted in December 2024 across the following databases: PubMed, Cochrane Library, ScienceDirect, and Scopus. Results: A total of 1422 records were identified, of which 30 studies fulfilled the inclusion criteria and were included in the review. Several autonomic tests were employed, with Heart Rate Variability (HRV) being the most frequently used. Other tests included assessments of orthostatic hypotension (OH), postprandial hypotension (PPH), sympathetic skin response (SSR), the tilt test, 123I-MIBG cardiac scintigraphy, norepinephrine (NE) measurements in serum and cerebrospinal fluid, and baroreflex sensitivity. In most studies, AD patients were compared to either healthy controls or patients with other types of dementia. Discussion: The primary finding of this review is that, although patients with AD rarely report dysautonomic symptoms, they frequently exhibit abnormal results on various autonomic tests. In some cases, these findings were sufficient to differentiate AD patients from healthy controls as well as from patients with Diffuse Lewy Body disease (DLB). The inconsistency in reporting symptoms, along with the variability in test results, suggests that autonomic dysfunction in AD may be under-recognized and warrants further investigation. Conclusions: The heterogeneity of the included studies limits the generalizability of the results. However, given the potential impact of dysautonomia on both quality of life and mortality, it is recommended that AD patients be systematically assessed for autonomic dysfunction. Even in the absence of overt symptoms, appropriate treatment should be considered where indicated to mitigate potential risks. Full article
(This article belongs to the Special Issue Aging-Related Changes in Memory and Cognition)
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19 pages, 1153 KB  
Article
Prefrontal Cortical Near-Infrared Spectroscopy for Acute Pain Assessment in Infants: A Feasibility Study
by Matthias Nissen and Ralf-Bodo Tröbs
J. Clin. Med. 2025, 14(7), 2525; https://doi.org/10.3390/jcm14072525 - 7 Apr 2025
Cited by 2 | Viewed by 2146
Abstract
Background: Assessing pain in infants is challenging due to their inability to communicate discomfort. Accurate pain evaluation is essential, as unaddressed pain might lead to long-term neurological consequences. This study investigates the use of conventional two-site near-infrared spectroscopy (NIRS) to evaluate hemodynamic responses [...] Read more.
Background: Assessing pain in infants is challenging due to their inability to communicate discomfort. Accurate pain evaluation is essential, as unaddressed pain might lead to long-term neurological consequences. This study investigates the use of conventional two-site near-infrared spectroscopy (NIRS) to evaluate hemodynamic responses in the prefrontal cortex during nociceptive stimuli. Methods: Data were prospectively collected from ten infants undergoing elective heel lance/squeeze (HLS) after surgery. Continuous bilateral NIRS oxygenation monitoring was performed alongside cardiorespiratory and behavioral (Children’s and Infant’s Postoperative Pain Score (CHIPPS)) pain assessments before, during, and after HLS. The primary outcome was the correlation between NIRS response and CHIPPS. Results: The average gestational and postnatal ages were 39 weeks and 49 days. No significant changes in prefrontal oxygenation levels (left, right, combined, ipsilateral, contralateral) were observed during the first ten seconds of HLS compared with baseline. Although CHIPPS and heart rates increased, oxygenation levels remained unchanged throughout the entire HLS event. Significant fluctuations in oxygenation levels from baseline were recorded across all optode configurations, with changes in the lowest oxygenation levels at the contralateral and left hemispheres inversely correlated with CHIPPS and HR changes. Conclusions: While there were subtle alterations in NIRS signals suggesting potential nociceptive-evoked changes, these were inconclusive. By design, the utilized two-site conventional NIRS system may not effectively detect acute pain. Future studies on prefrontal cortical pain processing could benefit from confirmatory NIRS signals from the primary somatosensory and motor regions. Integrating data from fNIRS, fMRI, EEG, along with sympathetic indicators like skin conductance and heart rate variability, would improve the quantification of cortical pain processing in non-verbal infants. Full article
(This article belongs to the Special Issue Targeted Medicine in Postoperative Pain Management)
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11 pages, 894 KB  
Article
Optimizing Sensor Locations for Electrodermal Activity Monitoring Using a Wearable Belt System
by Riley Q. McNaboe, Youngsun Kong, Wendy A. Henderson, Xiaomei Cong, Aolan Li, Min-Hee Seo, Ming-Hui Chen, Bin Feng and Hugo F. Posada-Quintero
J. Sens. Actuator Netw. 2025, 14(2), 31; https://doi.org/10.3390/jsan14020031 - 18 Mar 2025
Cited by 2 | Viewed by 3575
Abstract
Wearable devices for continuous health monitoring in humans are constantly evolving, yet the signal quality may be improved by optimizing electrode placement. While the commonly used locations to measure electrodermal activity (EDA) are at the fingers or the wrist, alternative locations, such as [...] Read more.
Wearable devices for continuous health monitoring in humans are constantly evolving, yet the signal quality may be improved by optimizing electrode placement. While the commonly used locations to measure electrodermal activity (EDA) are at the fingers or the wrist, alternative locations, such as the torso, need to be considered when applying an integrated multimodal approach of concurrently recording multiple bio-signals, such as the monitoring of visceral pain symptoms like those related to irritable bowel syndrome (IBS). This study aims to quantitatively determine the EDA signal quality at four torso locations (mid-chest, upper abdomen, lower back, and mid-back) in comparison to EDA signals recorded from the fingers. Concurrent EDA signals from five body locations were collected from twenty healthy participants as they completed a Stroop Task and a Cold Pressor task that elicited salient autonomic responses. Mean skin conductance (meanSCL), non-specific skin conductance responses (NS.SCRs), and sympathetic response (TVSymp) were derived from the torso EDA signals and compared with signals from the fingers. Notably, TVSymp recorded from the mid-chest location showed significant changes between baseline and Stroop phase, consistent with the TVSymp recorded from the fingers. A high correlation (0.77–0.83) was also identified between TVSymp recorded from the fingers and three torso locations: mid-chest, upper abdomen, and lower back locations. While the fingertips remain the optimal site for EDA measurement, the mid-chest exhibited the strongest potential as an alternative recording site, with the upper abdomen and lower back also demonstrating promising results. These findings suggest that torso-based EDA measurements have the potential to provide reliable measurement of sympathetic neural activities and may be incorporated into a wearable belt system for multimodal monitoring. Full article
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12 pages, 3297 KB  
Article
Electrodermal Activity Analysis at Different Body Locations
by Patricia Gamboa, Rui Varandas, Katrin Mrotzeck, Hugo Plácido da Silva and Cláudia Quaresma
Sensors 2025, 25(6), 1762; https://doi.org/10.3390/s25061762 - 12 Mar 2025
Cited by 6 | Viewed by 5966
Abstract
Electrodermal activity (EDA) reflects the variation in the electrical conductance of the skin in response to sweat secretion, constituting a non-invasive measure of the sympathetic nervous system. This system intervenes in reactions to stress and is strongly activated in emotional states. In most [...] Read more.
Electrodermal activity (EDA) reflects the variation in the electrical conductance of the skin in response to sweat secretion, constituting a non-invasive measure of the sympathetic nervous system. This system intervenes in reactions to stress and is strongly activated in emotional states. In most cases, EDA signals are collected from the hand (fingers or palms), which is not an ideal location for a sensor when the participant has to use their hands during tasks or activities. This study aims to explore alternative locations for retrieving EDA signals (e.g., the chest, back, and forehead). EDA signals from 25 healthy participants were collected using a protocol involving different physical stimuli that have been reported to induce an electrodermal response. The features extracted included the Skin Conductance Response (SCR) height, SCR amplitude, and peak prominence. An analysis of these features and the analysis of the correlation between the standard position with the different locations suggested that the chest, while a possible alternative for EDA signal collection, presents some weak results, and further evaluation of this site is needed. Additionally, the forehead should be excluded as an alternative site, at least in short-term measurements. Full article
(This article belongs to the Special Issue Sensors for Physiological Monitoring and Digital Health)
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16 pages, 1390 KB  
Article
Revisiting the Venoarteriolar Reflex–Further Insights from Upper Limb Dependency in Healthy Subjects
by Henrique Silva and Carlota Rezendes
Biology 2024, 13(9), 715; https://doi.org/10.3390/biology13090715 - 12 Sep 2024
Cited by 5 | Viewed by 2478
Abstract
The venoarteriolar reflex (VAR) is described as a vasoconstriction occurring in response to an increase in venous transmural pressure. Its underlying mechanisms are still not clarified, particularly the neural pathway that supposedly evokes this reflex. In addition, recent studies have shown that the [...] Read more.
The venoarteriolar reflex (VAR) is described as a vasoconstriction occurring in response to an increase in venous transmural pressure. Its underlying mechanisms are still not clarified, particularly the neural pathway that supposedly evokes this reflex. In addition, recent studies have shown that the postural maneuvers that evoke VAR also produce a decrease in contralateral perfusion, which is also poorly understood. Our study aimed to explore the contralateral response to unilateral upper limb dependency and its underlying mechanisms. Fifteen young, healthy subjects (24.1 ± 5.8 y.o.) participated in this study after giving informed consent. While seated, subjects remained for 7 min with both arms at heart level (baseline), after which a random hand was placed 40 cm below the heart level for 5 min (dependency) before resuming the initial position for another 7 min (recovery). Skin perfusion was assessed bilaterally with photoplethysmography, and electrodermal activity (EDA) was assessed in the contralateral hand. During hand dependency, perfusion decreased significantly in both limbs, although it was more pronounced in the dependent limb, corroborating previous reports that unilateral limb dependency evokes a decrease in contralateral perfusion. Transient EDA peaks were detected in the first seconds of the dependency and recovery phases. These results support the participation of the sympathetic nervous system as a mechanism regulating contralateral perfusion during unilateral limb dependency. This sympathetic activation is probably attributed to the postural changes themselves and is likely not related to the VAR. Full article
(This article belongs to the Section Physiology)
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