Assessing mental stress from the photoplethysmogram: a numerical study
Open accessAbstract
OBJECTIVE: Mental stress is detrimental to cardiovascular health, being a risk factor for coronary heart disease and a trigger for cardiac events. However, it is not currently routinely assessed. The aim of this study was to identify features of the photoplethysmogram (PPG) pulse wave which are indicative of mental stress. APPROACH: A numerical model of pulse wave propagation was used to simulate blood pressure signals, from which simulated PPG pulse waves were estimated using a transfer function. Pulse waves were simulated at six levels of stress by changing the model input parameters both simultaneously and individually, in accordance with haemodynamic changes associated with stress. Thirty-two feature measurements were extracted from pulse waves at three measurement sites: the brachial, radial and temporal arteries. Features which changed significantly with stress were identified using the Mann-Kendall monotonic trend test. MAIN RESULTS: Seventeen features exhibited significant trends with stress in measurements from at least one site. Three features showed significant trends at all three sites: the time from pulse onset to peak, the time from the dicrotic notch to pulse end, and the pulse rate. More features showed significant trends at the radial artery (15) than the brachial (8) or temporal (7) arteries. Most features were influenced by multiple input parameters. SIGNIFICANCE: The features identified in this study could be used to monitor stress in healthcare and consumer devices. Measurements at the radial artery may provide superior performance than the brachial or temporal arteries. In vivo studies are required to confirm these observations.
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Reliable detection of the dicrotic notch and diastolic peak requires the use of derivatives.
“The feet and systolic peak are simply detected as the minima and maximum, whereas reliable detection of the dicrotic notch and diastolic peak requires the use of derivatives [113].”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [113]
Over 30 features have been proposed for assessing the stiffness of both large and small arteries from a single PPG.
“Over 30 features have been proposed for assessing the stiffness of both the large and small arteries from a single PPG”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [113]
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Self-citation
- Authors
- Charlton, P. H., Celka, P., Farukh, B., Chowienczyk, P., & Alastruey, J.
- Affiliations
- St Thomas' Hospital (GB)
- Polar (Finland) (FI)
- Corresponding author
- Charlton, Peter H
- Venue
- Physiological Measurement
- Publisher
- IOP Publishing
- Published
- 2018-05-15
- Volume
- 39
- Issue
- 5
- Pages
- 054001
- ISSN
- 0967-3334 (ISSN-L)
- 1361-6579
- PMC
- PMC5964362
- OpenAlex
- W2801325359
- Cited by
- 131
- References
- 63
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 28 · 2023: 20 · 2022: 16 · 2021: 22 · 2020: 8 · 2019: 8 · 2018: 6
- FWCI
- 4.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Physiological Measurement (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- British Heart Foundation (PG/15/104/31913)
- Wellcome Trust (WT 203148/Z/16/Z)
- Engineering and Physical Sciences Research Council (WT 203148/Z/16/Z)
- 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
- psychological stress, photoplethysmogram, pulse wave analysis, pulse wave propagation, hemodynamic changes, radial artery, brachial artery, temporal artery, stress biomarkers, cardiovascular risk, non-invasive stress monitoring
- MeSH terms
- Blood Pressure, Heart Rate, Humans, Signal Processing, Computer-Assisted, Stress, Psychological, Photoplethysmography
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