Automatic pain quantification using autonomic parameters

ABSTRACT

The objective measurement of subjective, multi-dimensionally experienced pain is a problem for which there has not been an adequate solution. Although verbal methods (e.g., pain scales and questionnaires) are commonly used to measure clinical pain, they tend to lack objectivity, reliability, or validity when applied to mentally impaired individuals. Biopotential and behavioral parameters may represent a solution. Such coding systems already exist, but they are either very costly or time-consuming or have not been sufficiently evaluated. In this context, we collected a database of biopotentials to advance an automated pain recognition system, determine its theoretical testing quality, and optimize its performance. For this purpose, participants were subjected to painful heat stimuli under controlled conditions. One hundred thirty-five features were extracted from the mathematical groupings of amplitude, frequency, stationarity, entropy, linearity, and variability. The following features were chosen as the most selective (1) electromyography corrugator peak to peak, (2) corrugator shannon entropy, and (3) heart rate variability slope RR. Individual-specific calibration allows the adjustment of feature patterns, resulting in significantly more accurate pain detection rates. The objective measurement of pain in patients will provide valuable information for the clinical team, which may aid the objective assessment of treatment (e.g., effectiveness of drugs for pain reduction, information on surgical indication, and quality of care provided to patients).