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Chronic pain is a major cause of disability worldwide. While acute pain may serve as a protective function, chronic pain and the associated changes in neural processing negatively impact function and quality of life. This neural plasticity may include changes to the autonomic nervous system (ANS) potentially detectable as changes in various physiological signals. Our aim is to evaluate differences in the physiological signals reflecting ANS changes, by comparing healthy subjects and patients with chronic low back pain during standardized pain stimuli. We extracted several features from photoplethysmography (PPG), electrodermal activity (EDA), and respiration, both at rest and during a repeated pinprick test. We found significant group differences in some PPG parameters at rest and in response to the repeated pinprick test. Chronic pain patients had consistently higher basal sympathetic activity, as well as a blunted autonomic response when subjected to nociceptive stimuli. 

Optimization of pain assessment and treatment is an active area of research in healthcare. The purpose of this research is to create an objective pain intensity estimation system based on multimodal sensing signals through experimental studies. Twenty eight healthy subjects were recruited at Northeastern University. Nine physiological modalities were utilized in this research, namely facial expressions (FE), electroencephalography (EEG), eye movement (EM), skin conductance (SC), and blood volume pulse (BVP), electromyography (EMG), respiration rate (RR), skin temperature (ST), blood pressure (BP). Statistical analysis and machine learning algorithms were deployed to analyze the physiological data. FE, EEG, SC, BVP, and BP proved to be able to detect different pain states from healthy subjects. Multi-modalities proved to be promising in detecting different levels of painful states. A decision-level multi-modal fusion also proved to be efficient and accurate in classifying painful states. 

In an attempt to understand human physiological signals when an individual is subjected to pain, we set up a tonic pain experiment in a laboratory setting. The subjects’ physiological signals were recorded, timestamped, and compared to an initial 30 second baseline measurement. Subjects were also asked to verbally state their level of pain based on a visual analog scale in order to compare reported pain levels with physiological signals. The physiological signals measured were: Electroencephalography (EEG), Pupillary Unrest Under Ambient Light (PUAL), Skin Conductance (SC), Electromyography (EMG), Respiration Rate (RR), Blood Volume Pulse (BVP), Skin Temperature (ST), Blood Pressure (BP), and Facial Expression (FE). ANOVA and frequency domain analyses were conducted on the data in order to determine whether there was a significant difference between the ‘pain’ and ‘no pain’ (baseline) states of an individual. Based on our results, skin conductance, PUAL, facial expression, and EEG signals were theorized to be good signals for the classification of tonic pain, or any pain applied directly to an individual.