{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:22:20Z","timestamp":1785432140448,"version":"3.56.0"},"posted":{"date-parts":[[2026,3,10]]},"group-title":"Bioengineering","reference-count":14,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"award":["DGE-2139757"],"award-info":[{"award-number":["DGE-2139757"]}],"id":[{"id":"https:\/\/ror.org\/021nxhr62","id-type":"ROR","asserted-by":"publisher"}]},{"award":["HL139158"],"award-info":[{"award-number":["HL139158"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["HL071568."],"award-info":[{"award-number":["HL071568."]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  The transition of bioelectronic medicine to clinical use is currently limited by a lack of non-invasive sensors capable of measuring autonomic tone during active neuromodulation. Conventional monitoring modalities, such as mean arterial pressure (MAP) and Ag\/AgCl chest electrodes, are often invasive, cumbersome, or susceptible to motion artifacts. Here, we present a novel framework employing an in-ear sensor (AURIS) to continuously monitor heart rate variability (HRV) during therapeutic neuromodulation. These sensors utilize a polydimethylsiloxane (PDMS) substrate to ensure biocompatibility and superior conformability. Experiments in a rodent model (\n                  <jats:italic>n = 3<\/jats:italic>\n                  ) demonstrate that the AURIS platform achieves gold-standard fidelity, with mean heart rate differences of 6.03 BPM and mean RR interval deltas of 3.18 ms compared to chest electrodes. Sensor agreement was statistically validated using independent t-tests, showing no significant difference between modalities (all\n                  <jats:italic>p &gt; 0.46<\/jats:italic>\n                  ). While time-domain shifts trended toward significance, complexity metrics showed robust sequential responses with large effect sizes, including the SD1\/SD2 ratio (\n                  <jats:italic>d = 1.474<\/jats:italic>\n                  ) and the DFA \u03b1 ratio (\n                  <jats:italic>d = 1.091<\/jats:italic>\n                  ). These findings validate a sensor architecture that is durable, accessible, and provides the necessary technical foundation for closed-loop feedback and non-invasive clinical trials.\n                <\/jats:p>","DOI":"10.64898\/2026.03.07.709943","type":"posted-content","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T20:45:18Z","timestamp":1773175518000},"source":"Crossref","is-referenced-by-count":0,"title":["Monitoring Autonomic Tone During Spinal Cord Neuromodulation Using Wearable AURIS Sensor"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4182-5773","authenticated-orcid":false,"given":"Ryan S.","family":"Bohluli","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA"},{"name":"Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4163-2915","authenticated-orcid":false,"given":"Angelica F.","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1564-4258","authenticated-orcid":false,"given":"Pierce L.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4468-1255","authenticated-orcid":false,"given":"Kenzi M.","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2904-8091","authenticated-orcid":false,"given":"Avaneesh","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5132-0958","authenticated-orcid":false,"given":"Sung-Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9981-9395","authenticated-orcid":false,"given":"Nitish V.","family":"Thakor","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA"},{"name":"Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland 21205, USA"},{"name":"Department of Electrical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026031204250660000_2026.03.07.709943v1.1","doi-asserted-by":"publisher","DOI":"10.1186\/s42234-024-00163-4"},{"key":"2026031204250660000_2026.03.07.709943v1.2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2020.2975279"},{"key":"2026031204250660000_2026.03.07.709943v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2023.04.476"},{"key":"2026031204250660000_2026.03.07.709943v1.4","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-25330-8"},{"key":"2026031204250660000_2026.03.07.709943v1.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12938-018-0469-5"},{"key":"2026031204250660000_2026.03.07.709943v1.6","doi-asserted-by":"publisher","DOI":"10.1109\/TIM.2025.3617403"},{"key":"2026031204250660000_2026.03.07.709943v1.7","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-018-00691-3"},{"key":"2026031204250660000_2026.03.07.709943v1.8","doi-asserted-by":"publisher","DOI":"10.3389\/FPAIN.2025.1606672\/FULL"},{"key":"2026031204250660000_2026.03.07.709943v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/J.BAS.2025.104298"},{"key":"2026031204250660000_2026.03.07.709943v1.10","unstructured":"K. M. Griffith et al., \u201cFROM INVASIVE TO NON-INVASIVE: FOCUSED ULTRASOUND NEUROMODULATION OF THE SPINAL CORD,\u201d Proceedings of the 2026 Design of Medical Devices Conference, DMD 2026 (In Press), 2026."},{"key":"2026031204250660000_2026.03.07.709943v1.11","doi-asserted-by":"publisher","DOI":"10.3791\/65113"},{"key":"2026031204250660000_2026.03.07.709943v1.12","unstructured":"R. S. Bohluli et al., \u201cADVANCES IN FOCUSED ULTRASOUND FOR VAGUS NERVE STIMULATION: ASSESSING AUTONOMIC TONE FOR NON-INVASIVE NEUROMODULATION,\u201d Proceedings of the 2026 Design of Medical Devices Conference, DMD 2026 (In Press), 2026."},{"key":"2026031204250660000_2026.03.07.709943v1.13","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2025.3613293"},{"key":"2026031204250660000_2026.03.07.709943v1.14","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2017.00258"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.03.07.709943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T11:25:23Z","timestamp":1773314723000},"score":1,"resource":{"primary":{"URL":"http:\/\/biorxiv.org\/lookup\/doi\/10.64898\/2026.03.07.709943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":14,"URL":"https:\/\/doi.org\/10.64898\/2026.03.07.709943","relation":{},"subject":[],"published":{"date-parts":[[2026,3,10]]},"subtype":"preprint"}}