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Monitoring Autonomic Tone During Spinal Cord Neuromodulation Using Wearable AURIS Sensor
Ryan S Bohluli1,2, Angelica F Lopez1, Pierce L Perkins1
1Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA.
Biorxiv : the Preprint Server for Biology
|April 10, 2026
Summary
A novel in-ear sensor (AURIS) offers non-invasive monitoring of heart rate variability (HRV) for bioelectronic medicine. This biocompatible sensor provides gold-standard fidelity, paving the way for closed-loop neuromodulation therapies.
Area of Science:
- Bioelectronic Medicine
- Biomedical Engineering
- Wearable Technology
Background:
- Clinical translation of bioelectronic medicine is hindered by the lack of non-invasive autonomic tone monitoring during neuromodulation.
- Existing methods like mean arterial pressure (MAP) and Ag/AgCl electrodes are invasive, cumbersome, or prone to motion artifacts.
Purpose of the Study:
- To introduce a novel in-ear sensor framework (AURIS) for continuous, non-invasive heart rate variability (HRV) monitoring during therapeutic neuromodulation.
- To validate the fidelity and performance of the AURIS platform against gold-standard monitoring techniques.
Main Methods:
- Development of an in-ear sensor using a polydimethylsiloxane (PDMS) substrate for biocompatibility and conformability.
- Experimental validation in a rodent model comparing AURIS HRV measurements with traditional chest electrodes.
- Statistical analysis including independent t-tests and calculation of effect sizes for time-domain and complexity metrics.
Main Results:
- The AURIS platform demonstrated high fidelity, with minimal differences in mean heart rate (6.03 BPM) and RR intervals (3.18 ms) compared to chest electrodes.
- Statistically validated sensor agreement (p > 0.46), indicating no significant difference between modalities.
- Robust sequential responses in complexity metrics like SD1/SD2 ratio (d = 1.474) and DFA α ratio (d = 1.091) were observed.
Conclusions:
- The AURIS sensor architecture is validated as a durable, accessible, and high-fidelity solution for non-invasive HRV monitoring.
- This technology provides a crucial technical foundation for future closed-loop feedback systems and non-invasive clinical trials in bioelectronic medicine.
