Portable and wearable real-time stress monitoring: A critical review
Open accessAbstract
This review aims to summarize the rapidly emerging field of real-time stress monitoring by focusing on early breakthroughs and critical developments in portable and wearable cortisol sensors. Here, brief, albeit comprehensive, information on technological advances and current state-of-the-art concepts on real-time cortisol sensing are provided. Specific examples where materials include up-to-date information related to complex sensing conditions, and methodologies, are pieced together. Examples of electrochemical cortisol sensing are categorized by sample types, focusing on sensing from body fluids in vitro and wearable sensors, which have attracted significant interest due to their integration with everyday life activity. The overall progress made to date in building such conceptualized efforts for real-time, continuous monitoring of cortisol and the future of the field is discussed.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Effects of stress throughout the lifespan on the brain, behaviour and cognition
Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2639 · Cited by 6,256 · see citing works
A Syndrome produced by Diverse Nocuous Agents
Selye, H. (1936) · Nature · doi:10.1038/138032a0 · Cited by 3,967 · see citing works
Wearable biosensors for healthcare monitoring
Kim, J., Campbell, A. S., de Ávila, B. E.-F., & Wang, J. (2019) · Nature Biotechnology · doi:10.1038/s41587-019-0045-y · Cited by 3,373 · see citing works
Stress and disorders of the stress system
Chrousos, G. P. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.106 · Cited by 3,215 · see citing works
Allostatic load biomarkers of chronic stress and impact on health and cognition
Juster, R.-P., McEwen, B. S., & Lupien, S. J. (2010) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2009.10.002 · Cited by 2,565 · see citing works
The neuroendocrinology of stress and aging: The glucocorticoid cascade hypothesis
SAPOLSKY, R. M., KREY, L. C., & McEWEN, B. S. (1986) · Endocrine Reviews · doi:10.1210/edrv-7-3-284 · Cited by 2,298
The Neuroendocrinology of Stress and Aging: The Glucocorticoid Cascade Hypothesis
Sapolsky, R. M., Krey, L. C., & McEwen, B. S. (1986) · Science of Aging Knowledge Environment · doi:10.1126/sageke.2002.38.cp21 · Cited by 2,287 · see citing works
Salivary cortisol as a biomarker in stress research
Hellhammer, D. H., Wüst, S., & Kudielka, B. M. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.10.026 · Cited by 1,925 · see citing works
Mechanisms of stress in the brain
McEwen, B. S., Bowles, N. P., Gray, J. D., Hill, M. N., Hunter, R. G., Karatsoreos, I. N., & Nasca, C. (2015) · Nature Neuroscience · doi:10.1038/nn.4086 · Cited by 1,386 · see citing works
Protective and damaging effects of stress mediators: central role of the brain
McEwen, B. S. (2006) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2006.8.4/bmcewen · Cited by 1,220 · see citing works
Parlak, O., Keene, S. T., Marais, A., Curto, V. F., & Salleo, A. (2018) · Science Advances · doi:10.1126/sciadv.aar2904 · Cited by 603 · see citing works
Self-citationWearable sensors for monitoring the physiological and biochemical profile of the athlete
Seshadri, D. R., Li, R. T., Voos, J. E., Rowbottom, J. R., Alfes, C. M., Zorman, C. A., & Drummond, C. K. (2019) · npj Digital Medicine · doi:10.1038/s41746-019-0150-9 · Cited by 537 · see citing works
Investigation of Cortisol Dynamics in Human Sweat Using a Graphene-Based Wireless mHealth System
Torrente-Rodríguez, R. M., Tu, J., Yang, Y., Min, J., Wang, M., Song, Y., Yu, Y., Xu, C., Ye, C., IsHak, W. W., et al. (2020) · Matter · doi:10.1016/j.matt.2020.01.021 · Cited by 479 · see citing works
Surwit, R. S., Schneider, M. S., & Feinglos, M. N. (1992) · Diabetes Care · doi:10.2337/diacare.15.10.1413 · Cited by 400 · see citing works
Depression and immunity: A role for T cells?
Miller, A. H. (2009) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2009.09.009 · Cited by 340 · see citing works
Mass spectrometry and immunoassay: how to measure steroid hormones today and tomorrow
Taylor, A. E., Keevil, B., & Huhtaniemi, I. T. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0338 · Cited by 320 · see citing works
Stress Biomarkers in Biological Fluids and Their Point-of-Use Detection
Steckl, A. J., & Ray, P. (2018) · ACS Sensors · doi:10.1021/acssensors.8b00726 · Cited by 319 · see citing works
Recent advances in cortisol sensing technologies for point-of-care application
Kaushik, A., Vasudev, A., Arya, S. K., Pasha, S. K., & Bhansali, S. (2014) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2013.09.060 · Cited by 316 · see citing works
Szabó, S., Taché, Y., & Somogyi, A. (2012) · Stress · doi:10.3109/10253890.2012.710919 · Cited by 301 · see citing works
Goldstein, D. S. (2010) · Cellular and Molecular Neurobiology · doi:10.1007/s10571-010-9606-9 · Cited by 288 · see citing works
Smart, soft contact lens for wireless immunosensing of cortisol
Ku, M., Kim, J., Won, J., Kang, W., Park, Y., Park, J., Lee, J., Cheon, J., Lee, H. H., & Park, J. (2020) · Science Advances · doi:10.1126/sciadv.abb2891 · Cited by 274 · see citing works
Interaction between circadian rhythms and stress
Koch, C. E., Leinweber, B., Drengberg, B. C., Blaum, C. M., & Oster, H. (2016) · Neurobiology of Stress · doi:10.1016/j.ynstr.2016.09.001 · Cited by 256 · see citing works
Combinations of biomarkers predictive of later life mortality
Gruenewald, T. L., Seeman, T. E., Ryff, C. D., Karlamangla, A. S., & Singer, B. H. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0606215103 · Cited by 242 · see citing works
Recent advances and perspectives in sweat based wearable electrochemical sensors
Mohan, A. M. V., Rajendran, V., Mishra, R. K., & Mathiyarasu, J. (2020) · TrAC Trends in Analytical Chemistry · doi:10.1016/j.trac.2020.116024 · Cited by 234 · see citing works
Portable biosensor for monitoring cortisol in low-volume perspired human sweat
Kinnamon, D., Ghanta, R., Lin, K.-C., Muthukumar, S., & Prasad, S. (2017) · Scientific Reports · doi:10.1038/s41598-017-13684-7 · Cited by 231 · see citing works
Cortisol in hair, body mass index and stress-related measures
Tobias Stalder, A., Steudte‐Schmiedgen, S., Alexander, N., Miller, R. E., Gao, W., Dettenborn, L., & Kirschbaum, C. (2012) · Biological Psychology · doi:10.1016/j.biopsycho.2012.03.010 · Cited by 182 · see citing works
A low-cost miniaturized potentiostat for point-of-care diagnosis
Cruz, A. F. D., Norena, N., Kaushik, A. K., & Bhansali, S. (2014) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2014.06.053 · Cited by 164 · see citing works
Lee, H.-B., Meeseepong, M., Trung, T. Q., Kim, B.-Y., & Lee, N.-E. (2020) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2020.112133 · Cited by 153 · see citing works
A Flexible and Wearable Human Stress Monitoring Patch
Yoon, S., Sim, J. K., & Cho, Y.-H. (2016) · Scientific Reports · doi:10.1038/srep23468 · Cited by 151 · see citing works
Wearable Biomedical Measurement Systems for Assessment of Mental Stress of Combatants in Real Time
Seoane, F., Mohíno-Herranz, I., Ferreira, J., Álvarez, L., Buendía, R., Ayllón, D., Llerena, C., & Gil‐Pita, R. (2014) · Sensors · doi:10.3390/s140407120 · Cited by 144 · see citing works
Flexible molecularly imprinted electrochemical sensor for cortisol monitoring in sweat
Mugo, S. M., & Alberkant, J. (2020) · Analytical and Bioanalytical Chemistry · doi:10.1007/s00216-020-02430-0 · Cited by 139 · see citing works
Electrochemical sensors for cortisol detections: Almost there
Zea, M., Bellagambi, F. G., Halima, H. B., Zine, N., Jaffrezic-Renault, N. J., Villa, R., Gabriel, G., & Errachid, A. (2020) · TrAC Trends in Analytical Chemistry · doi:10.1016/j.trac.2020.116058 · Cited by 118 · see citing works
Khan, M. S., Misra, S. K., Wang, Z., Daza, E., Schwartz‐Duval, A. S., Kus, J., Pan, D., & Pan, D. (2017) · Analytical Chemistry · doi:10.1021/acs.analchem.6b04769 · Cited by 117 · see citing works
A decade of digital medicine innovation
Topol, E. J. (2019) · Science Translational Medicine · doi:10.1126/scitranslmed.aaw7610 · Cited by 117 · see citing works
ZnO Nanorod Integrated Flexible Carbon Fibers for Sweat Cortisol Detection
Madhu, S., Anthuuvan, A. J., Ramasamy, S., Manickam, P., Bhansali, S., Nagamony, P., & Chinnuswamy, V. (2020) · ACS Applied Electronic Materials · doi:10.1021/acsaelm.9b00730 · Cited by 102 · see citing works
A realtime and continuous assessment of cortisol in ISF using electrochemical impedance spectroscopy
Venugopal, M., Arya, S. K., Chornokur, G., & Bhansali, S. (2011) · Sensors and Actuators A: Physical · doi:10.1016/j.sna.2011.04.028 · Cited by 100 · see citing works
Portable System for Real-Time Detection of Stress Level
Minguillón, J., Perez, E., López-Gordo, M. A., Pelayo, F. J., & Sanchez-Carrion, M. J. (2018) · Sensors · doi:10.3390/s18082504 · Cited by 99 · see citing works
Current methods for stress marker detection in saliva
Giacomello, G., Scholten, A., & Parr, M. K. (2020) · Journal of Pharmaceutical and Biomedical Analysis · doi:10.1016/j.jpba.2020.113604 · Cited by 91 · see citing works
Comparison of Colorimetric Analyses to Determine Cortisol in Human Sweat
Tu, E., Pearlmutter, P., Tiangco, M., Derose, G., Begdache, L., & Koh, A. (2020) · ACS Omega · doi:10.1021/acsomega.0c00498 · Cited by 90 · see citing works
Uygun, H. D. E., Uygun, Z. O., Canbay, E., Sağın, F. G., & Sezer, E. (2019) · Talanta · doi:10.1016/j.talanta.2019.120225 · Cited by 81 · see citing works
Electrochemical Sensing of Cortisol: A Recent Update
Singh, A., Kaushik, A. K., Kumar, R., Nair, M. G., & Bhansali, S. (2014) · Applied Biochemistry and Biotechnology · doi:10.1007/s12010-014-0894-2 · Cited by 80 · see citing works
Manickam, P., Pasha, S. K., Snipes, S. A., & Bhansali, S. (2016) · Journal of The Electrochemical Society · doi:10.1149/2.0781702jes · Cited by 78 · see citing works
Direct immune-detection of cortisol by chemiresistor graphene oxide sensor
Kim, Y., Lee, K., Jung, H., Kang, H. K., Jo, J., Park, I., & Lee, H. H. (2017) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2017.07.017 · Cited by 75 · see citing works
Fernandez, R. E., Umasankar, Y., Manickam, P., Nickel, J. C., Iwasaki, L. R., Kawamoto, B., Todoki, K. C., Scott, J. M., & Bhansali, S. (2017) · Scientific Reports · doi:10.1038/s41598-017-17835-8 · Cited by 74 · see citing works
Reconfigurable Carbon Nanotube Multiplexed Sensing Devices
Xu, X., Clément, P., Eklӧf, J., Kelley‐Loughnane, N., Moth‐Poulsen, K., Chávez, J. L., & Palma, M. (2018) · Nano Letters · doi:10.1021/acs.nanolett.8b00856 · Cited by 73 · see citing works
An immunoelectrochemical sensor for salivary cortisol measurement
Sun, K., Ramgir, N. S., & Bhansali, S. (2008) · Sensors and Actuators B Chemical · doi:10.1016/j.snb.2008.03.018 · Cited by 66 · see citing works
CortiWatch: Watch-Based Cortisol Tracker
Rice, P., Upasham, S., Jagannath, B., Manuel, R., Pali, M., & Prasad, S. (2019) · Future Science OA · doi:10.2144/fsoa-2019-0061 · Cited by 63 · see citing works
Real-time measurements of corticosteroids in conscious animals using an antibody-based electrode
Cook, C. J. (1997) · Nature Biotechnology · doi:10.1038/nbt0597-467 · Cited by 54 · see citing works
(2020) · Elsevier eBooks · doi:10.1016/c2017-0-00863-7 · Cited by 40 · see citing works
Pharmacological Classification of Steroid Hormones
Selye, H. (1941) · Nature · doi:10.1038/148084c0 · Cited by 38 · see citing works
Highly sensitive and rapid sequential cortisol detection using twin sensor QCM
Ito, T., Aoki, N., Kaneko, S., & Suzuki, K. A. O. (2014) · Analytical Methods · doi:10.1039/c4ay01387e · Cited by 32 · see citing works
Rhythmic Release of Corticosterone Induces Circadian Clock Gene Expression in the Cerebellum
Bering, T., HERTZ, H., & Rath, M. F. (2019) · Neuroendocrinology · doi:10.1159/000503720 · Cited by 28 · see citing works
Programmable bioelectronics in a stimuli-encoded 3D graphene interface
Parlak, O., Beyazıt, S., Bui, B. T. S., et al. (2016) · Nanoscale · doi:10.1039/c6nr02355j · Cited by 27 · see citing works
Self-citationWearable biosensors and sample handling strategies
Parlak, O., Curto, V. F., Ojeda, E., Basabe‐Desmonts, L., Benito‐Lopez, F., & Salleo, A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-08-102407-2.00004-7 · Cited by 20 · see citing works
Self-citationLight‐Triggered Switchable Graphene–Polymer Hybrid Bioelectronics
Parlak, O., Beyazıt, S., Jafari, M. J., et al. (2015) · Advanced Materials Interfaces · doi:10.1002/admi.201500353 · Cited by 19 · see citing works
Self-citationReusable Amperometric Immunosensor for the Determination of Cortisol
Xu, Y., & Suleiman, A. A. (1997) · Analytical Letters · doi:10.1080/00032719708001813 · Cited by 19 · see citing works
Cortisol extraction through human skin by reverse iontophoresis
Ventura, S. A., Heikenfeld, J. C., Brooks, T., Esfandiari, L., Boyce, S. T., Park, Y. C., & Kasting, G. B. (2016) · Bioelectrochemistry · doi:10.1016/j.bioelechem.2016.12.004 · Cited by 18 · see citing works
AN ATTEMPT AT A NATURAL CLASSIFICATION OF THE STEROIDS
Selye, H. (1943) · Nature · doi:10.1038/151662a0 · Cited by 14 · see citing works
Yawning As a New Potential Diagnostic Marker for Neurological Diseases
Thompson, S. B. N., & Simonsen, M. (2015) · Journal of Neurology and Neuroscience · doi:10.21767/2171-6625.100022 · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Shajari, S., Salahandish, R., Zare, A., Hassani, M., Moossavi, S., Munro, E., Rashid, R., Rosenegger, D., Bains, J. S., & Sanati Nezhad, A. (2023) · Advanced Science · doi:10.1002/advs.202204171 · Cited by 55 · see citing works
- Authors
- Parlak, O.
- Affiliations
- Karolinska Institutet (SE)
- Corresponding author
- Parlak, Onur
- ORCID
- Parlak, Onur
- Venue
- Sensors and Actuators Reports
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 3
- Pages
- 100036
- ISSN
- 2666-0539 (ISSN-L)
- OpenAlex
- W3159299085
- Cited by
- 60
- References
- 59
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 14 · 2023: 21 · 2022: 13 · 2021: 2
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Sensors and Actuators Reports (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Familjen Erling-Perssons Stiftelse
- Karolinska Institutet (1-249/2019)
- Knut och Alice Wallenbergs Stiftelse (KAW2014.0387)
- Kungliga Tekniska Högskolan (VF-2019-0110)
- Topics
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Electrochemical sensors and biosensors
- Physical Sciences › Engineering › Biomedical Engineering › Advanced Sensor and Energy Harvesting Materials
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Advanced biosensing and bioanalysis techniques
- Keywords
- wearable sensors, portable sensors, real-time stress monitoring, electrochemical sensor, biological fluids, stress biomarkers, sensor materials
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review