Identifying Pain, Sleep, Anxiety Biomarkers Related to Post-traumatic Stress with Technology

Laura Straus, MD

Laura Straus, MD, San Francisco VA Medical Center, San Francisco, California, and investigators just published a study evaluating wrist-wearable devices and their ability to provide useful biomarkers for patients after being exposed to traumatic stress. Posttraumatic stress after traumatic exposure is common, especially in socioeconomically disadvantaged populations.

According to the study, after experiencing trauma patients have reported pain, depression, avoidance of trauma reminders, reexperiencing trauma,anxiety, hyperarousal, sleep disruption, and nightmares. Investigators believed that wrist-wearable devices could have the ability in measuring outcomes in this population because of the accelerometers with the capability of 24-hour assessments of rest activity.

To determine if the devices can effectively show biomarkers that would be useful for recovery following traumatic stress exposure, investigators looked at emergency department (ED) data gathered from the Advancing Understanding of Recovery After Trauma (AURORA) study.

Investigating Neuropsychiatric Symptoms

In the diverse cohort study that recruited patients who wore wrist devices for at least 8 weeks, from 27 different emergency departments, the serial assessments of their neuropsychiatric symptoms were evaluated. Of the study population of 19,019 patients that were screened, 3040 met the inclusion criteria.

Within that population, 2021 patients were able to provide data from their wrist devices and complete the 8-week assessment for the final analysis. Biomarker identification and validation were divided into 2 equal parts of 1010 patients.

The exposures of this study mainly consisted of traumatic stress related to motor vehicle collisons. The data were collected from September 2017-January 2020 and investigators performed analyses from May 2020-November 2022.

Identifying the Biomarkers

The majority of the 2021 patients were women (62.2%) with an average age of 35.8 years. Investigators isolated 8 wrist-wearable device biomarkers for symptoms of adverse posttraumatic neuropsychiatric sequelae that proved statistical significance.

The biomarker for variance in reduced 24-hour activity with greater pain severity, and the changes in 6 rest-activity meaures were associated with changes in pain, number of sleep transitions between sleep and wake, as well as changes in pain, sleep, and anxiety.

Based on the identified biomarkers, it was possible to distinguish patients with a good predictive value for pain, sleep, and anxiety.

"These findings suggest that wrist-wearable device biomarkersmay have utility as screening tools for pain, sleep, and anxiety symptom outcomes after trauma exposure in high-risk populations," investigators wrote.

The study "Utility of Wrist-Wearable Data for Assessing Pain, Sleep,and Anxiety Outcomes After Traumatic Stress Exposure" was published in JAMA Psychiatry.