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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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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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Metadata
- 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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