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If improperly managed, AD can have severe clinical consequences, even possibly leading to death. Existing techniques for AD detection are time-consuming, obtrusive, lack automated detection capabilities, and have low temporal resolution. Therefore, a non-invasive, multi-modal wearable diagnostic tool was developed to quantitatively characterize and distinguish unique signatures of AD. Electrocardiography and novel skin nerve activity (skNA) sensors with neural networks were used to detect temporal changes in the sympathetic and vagal systems in rats with SCI. Clinically established metrics of AD were used to verify the onset of AD. Five physiological features reflecting different metrics of sympathetic and vagal activity were used to characterize signatures of AD. An increase in sympathetic activity, followed by a lagged increase in vagal activity during the onset of AD, was observed after inducing AD. This unique signature response was used to train a neural network to detect the onset of AD with an accuracy of 93.4%. The model also had a 79% accuracy in distinguishing between sympathetic hyperactivity reactions attributable to different sympathetic stressors above and below the level of injury. These neural networks have not been used in previous work to detect the onset of AD. The system could serve as a complementary non-invasive tool to the clinically accepted gold standard, allowing an improved management of AD in persons with SCI.<\/jats:p>","DOI":"10.1089\/neur.2022.0041","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T14:19:01Z","timestamp":1668089941000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Automatic Detection and Characterization of Autonomic Dysreflexia Using Multi-Modal Non-Invasive Sensing and Neural Networks"],"prefix":"10.1177","volume":"3","author":[{"given":"Shruthi","family":"Suresh","sequence":"first","affiliation":[{"name":"Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"IV","given":"Thomas H.","family":"Everett","sequence":"additional","affiliation":[{"name":"Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riyi","family":"Shi","sequence":"additional","affiliation":[{"name":"Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA."},{"name":"Center for Paralysis Research, West Lafayette, Indiana, USA."},{"name":"Department of Basic Medical Sciences, West Lafayette, Indiana, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley S.","family":"Duerstock","sequence":"additional","affiliation":[{"name":"Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA."},{"name":"Center for Paralysis Research, West Lafayette, Indiana, USA."},{"name":"School of Industrial Engineering, West Lafayette, Indiana, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,11,10]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100684"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.10.017"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11884-018-0488-x"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.110859"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2014.08.011"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-015-0303-0"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1179\/2045772313Y.0000000098"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2018.04.029"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-011-0025-5"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2009.11760753"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2006.11753876"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2012.155"},{"key":"e_1_3_5_14_2","doi-asserted-by":"crossref","unstructured":"Ko HY. 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