{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:02:39Z","timestamp":1782846159525,"version":"3.54.5"},"reference-count":19,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Entrapment of sickled red blood cells in the microvasculature leads to sudden painful vaso-occlusive crises (VOCs) in sickle cell disease (SCD). This is potentially triggered by autonomic nervous system\u2013mediated vasoconstriction in the microvasculature. Indeed, vasoconstriction biomarkers derived from a single night of laboratory-based fingertip photoplethysmography (PPG) recording were predictive of a higher frequency of future VOC in SCD. Noninvasive, remote, and longitudinal monitoring of autonomic vasoreactivity will facilitate the development of predictive biomarkers of imminent VOC.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to assess the feasibility and performance of a wearable wristband device to longitudinally monitor nocturnal peripheral autonomic vasoreactivity and to cross-validate the vasoconstriction parameters across the \u201cgold-standard\u201d finger sensor.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 12 patients with SCD and 6 healthy controls were recruited to wear a wristband device (Biostrap) with a PPG sensor on a nightly basis. For cross-validation studies, 50% (3\/6) controls wore both the wristband and a sleep monitoring device (AliceNightOne) with a finger PPG sensor. We quantified autonomic vasoreactivity by processing PPG signals and deriving vasoconstriction parameters\u2014magnitude of vasoconstriction (Mvasoc) and photoplethysmography amplitude coefficient of variation (PPGampCV). We performed a correlation analysis of the vasoconstriction parameters within each device to investigate whether Mvasoc and PPGampCV can be used as surrogate markers of vasoconstriction, and then cross-validated the PPGampCV across the wristband and finger PPG devices.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 131 nocturnal PPG recordings were made with a wristband device (1\u201019 nights per participant; patients with SCD: n=79, 60%; controls: n=52, 40%). A total of 9 nocturnal recordings (3 nights per participant) were made with both wristband and finger sensor devices. Longitudinal continuous PPG recordings were feasible with the wearable device, with significant within-night and night-to-night variability in vasoconstriction parameters, suggesting dynamic changes in autonomic vasoreactivity. Mvasoc and PPGampCV significantly correlated within devices\u2014the maximum overnight correlation was 0.82 (\n P<\/jats:italic>\n <.001) for the finger sensor and 0.69 (\n P<\/jats:italic>\n <.001) for the wristband sensor, suggesting that PPGampCV can serve as a surrogate for Mvasoc. Cross-validation analysis of PPGampCV across wristband and fingertip sensors showed statistically significant correlations on all 9 nights (overnight correlation coefficient ranging from 0.24\u20100.7), with some nightly segments of PPGampCV showing very strong correlation across devices.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Wearable wristband devices are feasible tools for the collection of continuous PPG measurements and vasoconstriction parameters, which serve as objective markers of autonomic vasoreactivity in users with and without SCD. We have optimized the methods of quantifying vasoconstriction from wearable device PPG signals, and cross-validated them with standardized sensors. These findings enable large-scale, real-time monitoring of autonomic vasoreactivity along with pain outcomes for the development of vasoconstriction parameters as biomarkers imminent VOC in patients with SCD. This biomarker also has the potential to impact other diseases involving autonomic vascular dysregulation.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/75465","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T19:05:06Z","timestamp":1764615906000},"page":"e75465-e75465","source":"Crossref","is-referenced-by-count":1,"title":["Wearable Device Photoplethysmography As a Viable Tool to Longitudinally Monitor Vasoconstriction Biomarkers for Predicting Vaso-Occlusive Crisis in Sickle Cell Disease: Feasibility and Validation Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5211-6169","authenticated-orcid":false,"given":"Payal","family":"Shah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7817-417X","authenticated-orcid":false,"given":"Sabrina","family":"Sy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5987-8772","authenticated-orcid":false,"given":"Mingjing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7680-5989","authenticated-orcid":false,"given":"Michael CK","family":"Khoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9878-6029","authenticated-orcid":false,"given":"Thomas D","family":"Coates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7965-2994","authenticated-orcid":false,"given":"Saranya","family":"Veluswamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.10","article-title":"Sickle cell disease","volume":"4","author":"Kato","journal-title":"Nat Rev Dis Primers"},{"issue":"2-3","key":"R2","doi-asserted-by":"publisher","first-page":"251","DOI":"10.3233\/CH-189011","article-title":"Autonomic nervous system involvement in sickle cell disease","volume":"68","author":"Coates","journal-title":"Clin Hemorheol Microcirc"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3324\/haematol.2018.211391","article-title":"Mental stress causes vasoconstriction in subjects with sickle cell disease and in normal controls","volume":"105","author":"Shah","journal-title":"Haematologica"},{"issue":"10","key":"R4","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1182\/blood.2020005045","article-title":"Progressive vasoconstriction with sequential thermal stimulation indicates vascular dysautonomia in sickle cell disease","volume":"136","author":"Veluswamy","journal-title":"Blood"},{"issue":"11","key":"R5","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1002\/ajh.24858","article-title":"Individuals with sickle cell disease have a significantly greater vasoconstriction response to thermal pain than controls and have significant vasoconstriction in response to anticipation of pain","volume":"92","author":"Khaleel","journal-title":"Am J Hematol"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1164\/rccm.201103-0537OC","article-title":"Peripheral vasoconstriction and abnormal parasympathetic response to sighs and transient hypoxia in sickle cell disease","volume":"184","author":"Sangkatumvong","journal-title":"Am J Respir Crit Care Med"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1109\/IEMBS.2008.4649581","article-title":"Abnormal cardiac autonomic control in sickle cell disease following transient hypoxia","volume":"2008","author":"Sangkatumvong","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1002\/ajh.26014","article-title":"Nocturnal peripheral vasoconstriction predicts the frequency of severe acute pain episodes in children with sickle cell disease","volume":"96","author":"Chalacheva","journal-title":"Am J Hematol"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2021.04.003","article-title":"Rationale and design of a large population study to validate software for the assessment of atrial fibrillation from data acquired by a consumer tracker or smartwatch: the Fitbit heart study","volume":"238","author":"Lubitz","journal-title":"Am Heart J"},{"issue":"4","key":"R10","doi-asserted-by":"publisher","first-page":"04NT01","DOI":"10.1088\/1361-6579\/ab840a","article-title":"Feasible assessment of recovery and cardiovascular health: accuracy of nocturnal HR and HRV assessed via ring PPG in comparison to medical grade ECG","volume":"41","author":"Kinnunen","journal-title":"Physiol Meas"},{"issue":"2","key":"R11","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1080\/15402002.2017.1300587","article-title":"The sleep of the ring: comparison of the \u014cURA sleep tracker against polysomnography","volume":"17","author":"de Zambotti","journal-title":"Behav Sleep Med"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.2196\/43134","article-title":"Compliance challenges in a longitudinal COVID-19 cohort using wearables for continuous monitoring: observational study","volume":"25","author":"Mekhael","journal-title":"J Med Internet Res"},{"key":"R13","unstructured":"Biostrap. URL: https:\/\/biostrap.com\/ [Accessed 21-03-2024]"},{"key":"R14","unstructured":"Alice NightOne. Philips. URL: https:\/\/www.documents.philips.com\/doclib\/enc\/17329407\/Alice_NightOne_Data_Sheet.pdf [Accessed 21-03-2024]"},{"issue":"5","key":"R15","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/0013-4694(92)90009-7","article-title":"A simple format for exchange of digitized polygraphic recordings","volume":"82","author":"Kemp","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"R16","unstructured":"Derrick TR Thomas JM . Time-series analysis: the cross-correlation function. In: Stergiou N , editor. Innovative Analyses of Human Movement. Human Kinetics Publishers; 2004:189-205."},{"key":"R17","unstructured":"Characteristics of inpatient hospital stays involving sickle cell disease, 2000-2016. Agency for Healthcare Research and Quality. 2019. URL: https:\/\/hcup-us.ahrq.gov\/reports\/statbriefs\/sb251-Sickle-Cell-Disease-Stays-2016.jsp [Accessed 21-03-2024]"},{"issue":"4","key":"R18","doi-asserted-by":"publisher","first-page":"E101","DOI":"10.1002\/ajh.25736","article-title":"Aura and mental stress are associated with reports of pain in sickle cell disease-a pilot study using a mobile application","volume":"95","author":"Espinoza","journal-title":"Am J Hematol"},{"issue":"Supplement 1","key":"R19","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2023-187353","article-title":"Nocturnal autonomic and vasoconstriction parameters by wearable wrist photoplethysmography predict intensity of imminent pain in subjects with sickle cell disease","volume":"142","author":"Veluswamy","journal-title":"Blood"}],"container-title":["JMIR Human Factors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/humanfactors.jmir.org\/2026\/1\/e75465","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:06:31Z","timestamp":1782842791000},"score":1,"resource":{"primary":{"URL":"https:\/\/humanfactors.jmir.org\/2026\/1\/e75465"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":19,"URL":"https:\/\/doi.org\/10.2196\/75465","relation":{},"ISSN":["2292-9495"],"issn-type":[{"value":"2292-9495","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]},"article-number":"v13i2-3e75465"}}