Quantitative Evaluation of Pain during Electrocutaneous Stimulation using a Log-Linearized Peripheral Arterial Viscoelastic Model

Abstract

In clinical practice, subjective pain evaluations, e.g., the visual analogue scale and the numeric rating scale, are generally employed, but these are limited in terms of their ability to detect inaccurate reports, and are unsuitable for use in anesthetized patients or those with dementia. We focused on the peripheral sympathetic nerve activity that responds to pain, and propose a method for evaluating pain sensation, including intensity, sharpness, and dullness, using the arterial stiffness index. In the experiment, electrocardiogram, blood pressure, and photoplethysmograms were obtained, and an arterial viscoelastic model was applied to estimate arterial stiffness. The relationships among the stiffness index, self-reported pain sensation, and electrocutaneous stimuli were examined and modelled. The relationship between the stiffness index and pain sensation could be modelled using a sigmoid function with high determination coefficients, where R2 ≥ 0.88, p < 0.01 for intensity, R2 ≥ 0.89, p < 0.01 for sharpness, and R2 ≥ 0.84, p < 0.01 for dullness when the stimuli could appropriately evoke dull pain.

Peripheral arterial stiffness during electrocutaneous stimulation is positively correlated with pain-related brain activity and subjective pain intensity: an fMRI study

“…Therefore, stimulus duration may have affected the presented results. In this paper, we chose stimulus durations of 24 and 8 s according to our previous study 12 and preliminary experiment, respectively. Although we confirmed that peripheral arterial stiffness responds to painful stimuli at a determined stimulation duration, it will be necessary to examine the optimal duration to make use of peripheral arterial stiffness as a predictor of pain.…”

“…In recent work, we proposed a mathematical model to estimate peripheral arterial stiffness that reflects the peripheral sympathetic nerve activity from electrocardiography, continuous sphygmomanometry, and photo-plethysmography 11 . We then derived a peripheral arterial stiffness-based metric to evaluate pain intensity and qualities 12 , and found that peripheral arterial stiffness could predict pain perception 13 . Although it is plausible to assume that peripheral arterial stiffness is correlated with brain activity in pain-related areas, no studies have explored this.…”

“…The aim of this study was to explore the correlation between peripheral arterial stiffness and brain activity in response to pain stimuli. We first proposed an approximated mathematical model to estimate peripheral arterial stiffness in an fMRI environment, because some of the measurement instruments of the previous model 12 , 13 were not fMRI-compatible. To test the estimation accuracy of the proposed model, we first conducted a measurement experiment outside the fMRI environment (Experiment 1) and estimated the peripheral arterial stiffness simultaneously using both the proposed model and the previous model 12 , 13 .…”

“…We first proposed an approximated mathematical model to estimate peripheral arterial stiffness in an fMRI environment, because some of the measurement instruments of the previous model 12 , 13 were not fMRI-compatible. To test the estimation accuracy of the proposed model, we first conducted a measurement experiment outside the fMRI environment (Experiment 1) and estimated the peripheral arterial stiffness simultaneously using both the proposed model and the previous model 12 , 13 . We then conducted an fMRI experiment while applying electrocutaneous stimuli to participants (Experiment 2) and identified brain regions in which the blood oxygen level-dependent (BOLD) signal covaried with the response.…”

Prediction of Blood Pressure Change During Surgical Incision Under Opioid Analgesia Using a New Opioid Sensitivity Index: A Cross-Sectional Study

“…Therefore, we proposed a method to extract only the degree of vasoconstriction from sympathetic cutaneous blood ow responses to PPG and quantify it as vascular stiffness value (K) [5]. We reported that K could be used to quantify pain and re ect the activity of the sympathetic nervous system [6,7]. Moreover, we reported that K value re ects changes in pain caused by the administration of opioids during general anesthesia and that the response of K to pain was attenuated with increasing doses of opioids [8][9][10].…”