{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:55:08Z","timestamp":1782312908998,"version":"3.54.5"},"reference-count":48,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Operational Programme \u201cCompetitiveness, Entrepreneurship and Innovation\u201d","award":["NSRF 2014\u20132020"],"award-info":[{"award-number":["NSRF 2014\u20132020"]}]},{"name":"Greece and the European Union (European Regional Development Fund)","award":["NSRF 2014\u20132020"],"award-info":[{"award-number":["NSRF 2014\u20132020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Over the last decade, virtual reality (VR) has become an increasingly accessible commodity. Head-mounted display (HMD) immersive technologies allow researchers to simulate experimental scenarios that would be unfeasible or risky in real life. An example is extreme heights exposure simulations, which can be utilized in research on stress system mobilization. Until recently, electroencephalography (EEG)-related research was focused on mental stress prompted by social or mathematical challenges, with only a few studies employing HMD VR techniques to induce stress. In this study, we combine a state-of-the-art EEG wearable device and an electrocardiography (ECG) sensor with a VR headset to provoke stress in a high-altitude scenarios while monitoring EEG and ECG biomarkers in real time. A robust pipeline for signal clearing is implemented to preprocess the noise-infiltrated (due to movement) EEG data. Statistical and correlation analysis is employed to explore the relationship between these biomarkers with stress. The participant pool is divided into two groups based on their heart rate increase, where statistically important EEG biomarker differences emerged between them. Finally, the occipital-region band power changes and occipital asymmetry alterations were found to be associated with height-related stress and brain activation in beta and gamma bands, which correlates with the results of the self-reported Perceived Stress Scale questionnaire.<\/jats:p>","DOI":"10.3390\/s22155792","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T23:33:01Z","timestamp":1659569581000},"page":"5792","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Assessing Electroencephalography as a Stress Indicator: A VR High-Altitude Scenario Monitored through EEG and ECG"],"prefix":"10.3390","volume":"22","author":[{"given":"Vasileios","family":"Aspiotis","sequence":"first","affiliation":[{"name":"Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece"},{"name":"Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0675-9088","authenticated-orcid":false,"given":"Andreas","family":"Miltiadous","sequence":"additional","affiliation":[{"name":"Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Kalafatakis","sequence":"additional","affiliation":[{"name":"Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece"},{"name":"Institute of Health Science Education, Barts and the London School of Medicine & Dentistry, Queen Mary University of London (Malta Campus), VCT 2520 Victoria, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9640-7005","authenticated-orcid":false,"given":"Katerina D.","family":"Tzimourta","sequence":"additional","affiliation":[{"name":"Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece"},{"name":"Department of Electrical and Computer Engineering, Faculty of Engineering, University of Western Macedonia, 50100 Kozani, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0615-783X","authenticated-orcid":false,"given":"Nikolaos","family":"Giannakeas","sequence":"additional","affiliation":[{"name":"Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6757-1698","authenticated-orcid":false,"given":"Markos G.","family":"Tsipouras","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Faculty of Engineering, University of Western Macedonia, 50100 Kozani, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Peschos","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euripidis","family":"Glavas","sequence":"additional","affiliation":[{"name":"Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9043-1290","authenticated-orcid":false,"given":"Alexandros T.","family":"Tzallas","sequence":"additional","affiliation":[{"name":"Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1016\/j.neubiorev.2011.02.003","article-title":"Stress Revisited: A Critical Evaluation of the Stress Concept","volume":"35","author":"Koolhaas","year":"2011","journal-title":"Neurosci. 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