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

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.