Digital biomarkers for non-motor symptoms in Parkinson’s disease: the state of the art

Continuous and beat-to-beat monitoring of blood pressure (BP), compared to office-based BP measurement, provides significant advantages in predicting future cardiovascular disease. Traditional BP measurement methods are based on a cuff, which is bulky, obtrusive and not applicable to continuous monitoring. Measurement of pulse transit time (PTT) is one of the prominent cuffless methods for continuous BP monitoring. PTT is the time taken by the pressure pulse to travel between two points in an arterial vessel, which is correlated with the BP. In this paper, we present a new cuffless BP method using an array of wrist-worn bio-impedance sensors placed on the radial and the ulnar arteries of the wrist to monitor the arterial pressure pulse from the blood volume changes at each sensor site. BP is accurately estimated by using AdaBoost regression model based on selected arterial pressure pulse features such as transit time, amplitude and slope of the pressure pulse, which are dependent on the cardiac activity and the vascular properties of the wrist arteries. A separate model is developed for each subject based on calibration data to capture the individual variations of BP parameters. In this pilot study, data was collected from 10 healthy participants with age ranges from 18 to 30 years after exercising using our custom low-noise bio-impedance sensing hardware. Post-exercise BP was accurately estimated with an average correlation coefficient and root mean square error (RMSE) of 0.77 and 2.6 mmHg for the diastolic BP and 0.86 and 3.4 mmHg for the systolic BP.

[1]  Yuan-Ting Zhang,et al.  Long-term blood pressure prediction with deep recurrent neural networks , 2017, 2018 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI).

[2]  Survi Kyal,et al.  Toward Ubiquitous Blood Pressure Monitoring via Pulse Transit Time: Theory and Practice , 2015, IEEE Transactions on Biomedical Engineering.

[3]  Roozbeh Jafari,et al.  An Accurate Bioimpedance Measurement System for Blood Pressure Monitoring , 2018, Sensors.

[4]  Roozbeh Jafari,et al.  Continuous Blood Pressure Monitoring using Wrist-worn Bio-impedance Sensors with Wet Electrodes , 2018, 2018 IEEE Biomedical Circuits and Systems Conference (BioCAS).

[5]  Omer T. Inan,et al.  SeismoWatch , 2017, Proc. ACM Interact. Mob. Wearable Ubiquitous Technol..

[6]  T. Dawber,et al.  Characteristics of the Dicrotic Notch of the Arterial Pulse Wave in Coronary Heart Disease , 1973, Angiology.

[7]  Bo Wen,et al.  Multi-Sensor Fusion Approach for Cuff-Less Blood Pressure Measurement , 2020, IEEE Journal of Biomedical and Health Informatics.

[8]  L. Wurfel Mcdonald S Blood Flow In Arteries Theoretical Experimental And Clinical Principles , 2016 .

[9]  J. Neaton,et al.  Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. , 1993, Archives of internal medicine.

[10]  Roozbeh Jafari,et al.  BioWatch: A Noninvasive Wrist-Based Blood Pressure Monitor That Incorporates Training Techniques for Posture and Subject Variability , 2016, IEEE Journal of Biomedical and Health Informatics.

[11]  Qifa Zhou,et al.  Monitoring of the central blood pressure waveform via a conformal ultrasonic device , 2018, Nature Biomedical Engineering.

[12]  Roberto Ferrari,et al.  Our time: a call to save preventable death from cardiovascular disease (heart disease and stroke). , 2012, Circulation.

[13]  Alice Stanton,et al.  Superiority of Ambulatory Over Clinic Blood Pressure Measurement in Predicting Mortality: The Dublin Outcome Study , 2005, Hypertension.

[14]  X. Aubert,et al.  Cuffless Estimation of Systolic Blood Pressure for Short Effort Bicycle Tests: The Prominent Role of the Pre-Ejection Period , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[15]  T. Pickering,et al.  Principles and techniques of blood pressure measurement. , 2002, Cardiology clinics.

[16]  L. Geddes,et al.  Measurements of Young's Modulus of Elasticity of the Canine Aorta with Ultrasound , 1979 .

[17]  J. Karemaker,et al.  Baroreflex and chemoreflex function after bilateral carotid body tumor resection , 2003, Journal of hypertension.

[18]  W. Nichols,et al.  McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles , 1998 .

[19]  Zhiwen Liu,et al.  Cuff-less blood pressure measurement from dual-channel photoplethysmographic signals via peripheral pulse transit time with singular spectrum analysis , 2018, Physiological measurement.

[20]  Egidijus Kazanavičius,et al.  MATHEMATICAL METHODS FOR DETERMINING THE FOOT POINT OF THE ARTERIAL PULSE WAVE AND EVALUATION OF PROPOSED METHODS , 2015 .

[21]  Mahdi Shabany,et al.  Cuffless Blood Pressure Estimation Algorithms for Continuous Health-Care Monitoring , 2017, IEEE Transactions on Biomedical Engineering.

[22]  Yuan-Ting Zhang,et al.  Multi-Wavelength Photoplethysmography Enabling Continuous Blood Pressure Measurement With Compact Wearable Electronics , 2019, IEEE Transactions on Biomedical Engineering.

[23]  Andreas Voss,et al.  Comparison of nonlinear methods symbolic dynamics, detrended fluctuation, and Poincare plot analysis in risk stratification in patients with dilated cardiomyopathy. , 2007, Chaos.

[24]  Carmen C. Y. Poon,et al.  Flexible Piezoresistive Sensor Patch Enabling Ultralow Power Cuffless Blood Pressure Measurement , 2016 .

[25]  J. Hahn,et al.  Smartphone-based blood pressure monitoring via the oscillometric finger-pressing method , 2018, Science Translational Medicine.

[26]  Ye Li,et al.  A Novel Continuous Blood Pressure Estimation Approach Based on Data Mining Techniques , 2017, IEEE Journal of Biomedical and Health Informatics.

[27]  Carmen C. Y. Poon,et al.  Cuff-less and Noninvasive Measurements of Arterial Blood Pressure by Pulse Transit Time , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[28]  PhD Jerica Maver MD,et al.  Autonomic nervous system activity in normotensive subjects with a family history of hypertension , 2004, Clinical Autonomic Research.

[29]  SeongHwan Cho,et al.  A bio-impedance measurement system for portable monitoring of heart rate and pulse wave velocity using small body area , 2009, 2009 IEEE International Symposium on Circuits and Systems.

[30]  Roozbeh Jafari,et al.  A novel method for pulse transit time estimation using wrist bio-impedance sensing based on a regression model , 2017, 2017 IEEE Biomedical Circuits and Systems Conference (BioCAS).