Fusion of heart rate variability and salivary cortisol for stress response identification based on adverse childhood experience

Abstract

Adverse childhood experiences has been suggested to cause changes in physiological processes and can determine the magnitude of the stress response which might have a significant impact on health later in life. To detect the stress response, biomarkers that represent both Autonomic Nervous System (ANS) and Hypothalamic-Pituitary-Adrenal (HPA) axis is proposed. Among the available biomarkers, Heart Rate Variability (HRV) has been proven as a powerful biomarker that represents ANS. Meanwhile, salivary cortisol has been suggested as a biomarker that reflects the HPA axis. Even though many studies used multiple biomarkers to measure the stress response, the results for each biomarker were analysed separately. Therefore, the objective of this study is to propose a fusion of ANS and HPA axis biomarkers in order to classify the stress response based on adverse childhood experience. Electrocardiograph, blood pressure (BP), pulse rate (PR) and salivary cortisol (SCort) measures were collected from 23 healthy participants, 12 participants had adverse childhood experience while the remaining 11 acted as the no adversity control group. HRV was then computed from the ECG and the HRV features were extracted. Next, the selected HRV features were combined with the other biomarkers using Euclidean distance (e d) and serial fusion, and the performance of the fused features were compared using Support Vector Machine. From the result, HRV-SCort using Euclidean distance achieved the most satisfactory performance with 80.0% accuracy, 83.3% sensitivity and 78.3% specificity. Furthermore, the performance of the stress response classification of the fused biomarker, HRV-SCort, outperformed that of the single biomarkers: HRV (61% Accuracy), Cort (59.4% Accuracy), BP (78.3% accuracy) and PR (53.3% accuracy). From this study, it was proven that the fused biomarkers that represent both ANS and HPA (HRV-SCort) able to demonstrate a better classification performance in discriminating the stress response. Furthermore, a new approach for classification of stress response using Euclidean distance and SVM named as e d-SVM was proven to be an effective method for the HRV-SCort in classifying the stress response from PASAT. The robustness of this method is crucial in contributing to the effectiveness of the stress response measures and could further be used as an indicator for future health.

Sexual Dimorphism of Heart Rate Variability in Adolescence: A Case-Control Study on Depression, Anxiety, Stress Levels, Body Composition, and Heart Rate Variability in Adolescents with Impaired Fasting Glucose

“…One recent study demonstrated the effectiveness of HRV in conjunction with salivary cortisol in assessing stress levels. They claimed that the robustness of this method renders it a potential indication of future health [30]. Another study indicated that reduced HRV with higher psychological distress and increased salivary cortisol levels were observed in patients with temporomandibular disorders [31,32].…”

Effects of Interactions with Cats in Domestic Environment on the Psychological and Physiological State of Their Owners: Associations among Cortisol, Oxytocin, Heart Rate Variability, and Emotions

“…In several previous studies, it has been reported that salivary oxytocin and cortisol levels both increased after tasks that induce stress [ 42 , 43 ] and cortisol-induced oxytocin secretion is also believed to be a part of the mechanism of stress processing [ 44 ]. Cortisol concentration in saliva and the variability of heart rate are meaningful biomarkers for assessing physiological and psychological stress as well as arousal states in humans [ 45 , 46 ]. Thus, the results of the present study suggest the existence of a physiological mechanism by which the stimuli of interactions with cats arouse the physiological state of their owners, thereby increasing oxytocin levels.…”

Emotional Self-Regulation in Primary Education: A Heart Rate-Variability Biofeedback Intervention Programme

“…Different studies have shown that greater HRV reflects better psychosocial adjustment in the childhood population [11,12]. Children with behaviour problems display lower HRV [13,14], however, we do not have enough evidence about the differential effectiveness that, regarding age, a biofeedback training programme based in breath pacing, may have on children from 7 to 11 years old in Primary Education. In order to offer a comprehensive theory on children's capacity for self-regulation through biofeedback programmes, the Polyvagal Theory should be mentioned.…”