@article{01KFWKWFMCMK7F1NH0B2KT4RX7,
  abstract     = {{Pain assessment in both communicative and non-communicative patients remains a major clinical challenge due to the inherently subjective nature of conventional tools such as the Numeric Rating Scale (NRS). In this study, we introduce a physiologically grounded and objective index, Delta T = T S - T D , derived from fractional-order impedance modeling of nociceptive dynamics. Here, T D represents the transduction, and T S reflects the transmission. These components are extracted non-invasively using the Anspec-Pro device, which records skin bioimpedance in real-time. A positive Delta T indicates enhanced central excitability, while a negative value suggests dominant inhibition. In a case study of postoperative patients, we show that Delta T closely follows and often precedes subjective NRS scores, with correlation coefficients reaching up to 0.86 ( p = 0.002 ). We also introduce a refined index, Delta T dyn , which incorporates the trend and local variability of Delta T for improved temporal alignment with reported pain. To address the very limited dataset (three patients, nineteen intervals each), we implemented a data augmentation strategy based on autoregressive modeling of Delta T and transfer-function mapping to NRS. This approach enabled the generation of synthetic trajectories per patient, thereby enriching the dataset while maintaining physiological plausibility. Analyses of the augmented data revealed consistent lead-lag patterns, correlations, and Granger causality relationships between Delta T , Delta T dyn , and NRS, suggesting that Delta T may serve both as an anticipatory biomarker of nociceptive activity and as a real-time index aligned with subjective pain reporting. Overall, these results provide proof-of-concept that the Anspec-Pro device can support objective, non-invasive nociceptive tracking in clinical environments.}},
  articleno    = {{1704303}},
  author       = {{Ben Othman, Ghada and Copot, Dana and Ayvaz, Bora and De Keyser, Robain and Ionescu, Clara}},
  issn         = {{1664-042X}},
  journal      = {{FRONTIERS IN PHYSIOLOGY}},
  keywords     = {{nociception,pain,fractional-order impedance modeling,nociceptive,variability,bioimpedance measurement,subjective-objective,conscious patients}},
  language     = {{eng}},
  pages        = {{20}},
  title        = {{Physiological framework for non-invasive detection and objective nociception activity in communicative patients : a pilot case study}},
  url          = {{http://doi.org/10.3389/fphys.2025.1704303}},
  volume       = {{16}},
  year         = {{2026}},
}

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