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Monitoring Autonomic Tone During Spinal Cord Neuromodulation Using Wearable AURIS Sensor.

Ryan S Bohluli^1,2, 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

This summary is machine-generated.

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.

Keywords:

In-ear sensor PEDOT:PSS Wearable sensors

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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.