The variability of the photoplethysmographic signal - a potential method for the evaluation of the autonomic nervous system
Abstract
The heart rate variability is composed of low- and high-frequency fluctuations, which are mediated by the sympathetic and the parasympathetic nervous systems. The baseline and the amplitude of the photoplethysmographic (PPG) signal also show fluctuations in the same frequencies. In the current study, PPG examinations were performed on the fingers of normal subjects and diabetic patients, and three parameters were derived from each PPG pulse: the baseline of the pulse, its amplitude and its period (which is equal to the heart period). The level of the variability of each PPG pulse parameter was measured by the ratio of the standard deviation of the parameter to its mean value. The level of the low-frequency fluctuations for the PPG amplitude and for the heart cycle period did not differ between males and females, but was lower for diabetic patients, indicating lower activity of the autonomic nervous system. The curves of the baseline and the amplitude of the PPG signal for the non-diabetic subjects showed high correlation between the left and the right hands. For most of the diabetic patients the right-left correlation coefficients were significantly lower than those for the non-diabetic subjects. Our initial results have shown that the variability of the PPG parameters shows promise for the assessment of the function of the autonomic nervous system.
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Prior works developed approaches from at most 100 individuals and in most cases recorded less than a day of data.
“These works developed approaches from at most 100 individuals and in most cases, recorded less than a day of data.”
From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [12]
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Kimmel, M., Fransson, E., Cunningham, J. L., Bränn, E., Grewen, K., Boschiero, D., Chrousos, G. P., Meltzer-Brody, S. E., & Skalkidou, A. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01401-y · Cited by 27 · see citing works
Magneto-Plethysmographic Sensor for Peripheral Blood Flow Velocity
Lee, Y., Lee, C.-K., Kang, M., Kang, S.-J., Kim, K., Kim, K.-H., Kim, K.-S., & Lee, J. (2014) · IEEE Sensors Journal · doi:10.1109/jsen.2014.2304752 · Cited by 26 · see citing works
Prediction of Intradialytic Hypotension Using Photoplethysmography
Solem, K., Olde, B., & Sörnmo, L. (2010) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2010.2042170 · Cited by 26 · see citing works
Respiratory modulation of peripheral vasoconstriction: a modeling perspective
Khoo, M. C. K., & Chalacheva, P. (2019) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00111.2019 · Cited by 25 · see citing works
Finger and forehead PPG signal comparison for respiratory rate estimation
Hernando, A., Peláez‐Coca, M. D., Lozano, M. T., Lázaro, J. M., & Gil, E. (2019) · Physiological Measurement · doi:10.1088/1361-6579/ab3be0 · Cited by 25 · see citing works
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A new method to estimate arterial blood pressure using photoplethysmographic signal
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Comparison of Stress Detection through ECG and PPG signals using a Random Forest-based Algorithm
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Analysis of the photoplethysmographic signal by means of the decomposition in principal components
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Self-citationEstimation of blood pressure using Photoplethysmography on the wrist
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Camera-Based Cardiorespiratory Monitoring of Preterm Infants in NICU
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The use of overnight pulse wave analysis for recognition of cardiovascular risk factors and risk
Sommermeyer, D., Zou, D., Eder, D. N., Hedner, J. A., Ficker, J. H., Randerath, W. J., Priegnitz, C., Penzel, T., Fietze, I., Sanner, B. M., et al. (2013) · Journal of Hypertension · doi:10.1097/hjh.0000000000000039 · Cited by 20 · see citing works
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- Authors
- Nitzan, M., Babchenko, A., Khanokh, B., & Landau, D.
- Affiliations
- Jerusalem College of Technology (IL)
- Shaare Zedek Medical Center (IL)
- ORCID
- Nitzan, Meir
- Venue
- Physiological Measurement
- Publisher
- IOP Publishing
- Published
- 1998-02-01
- Volume
- 19
- Issue
- 1
- Pages
- 93-102
- ISSN
- 0967-3334 (ISSN-L)
- 1361-6579
- OpenAlex
- W2069780950
- Cited by
- 217
- References
- 18
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 10 · 2023: 6 · 2022: 7 · 2021: 13 · 2020: 7 · 2019: 14 · 2018: 10 · 2017: 11 · 2016: 6 · 2015: 8 · 2014: 17 · 2013: 11 · 2012: 7
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Physiological Measurement (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- photoplethysmography, autonomic nervous system, heart rate variability, diabetes mellitus, sympathetic and parasympathetic activity, low-frequency fluctuations
- MeSH terms
- Adult, Aged, Autonomic Nervous System, Female, Humans, Male, Middle Aged, Reproducibility of Results, Photoplethysmography
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