Facial Micro-Movements as a Proxy of Increasingly Erratic Heart Rate Variability While Experiencing Pressure Pain

The sensation of pain varies from person to person. These patterns of individual variations are difficult to capture using coarse subjective self-reports. However, they are important when prescribing therapies and tailoring them to the persons own sensations. Pain can be experienced differently by the same person, and fluctuate differently depending on the context, yet most analyses treat the problem under a one-size-fits-all model. In this work, we introduce a series of assays to objectively assess pressure pain across tasks with different motoric and cognitive demands, in relation to resting state. In a cohort of healthy individuals, we examine pain-free vs. pain states at rest, during drawing with heavy cognitive demands, during pointing to a visual target, and during a grooved peg task like inserting a grooved key in a matching grooved keyhole. We recorded Face videos, electrocardiographic signals and adopt a standardized data type called the micro-movement spikes (MMS) to characterize the biorhythmic activities of the Face micro-expressions and of the micro-fluctuations in the hearts inter beat interval timings. Using the MMS peaks, we find that the continuous Gamma family of probability distribution functions best fit the frequency histograms of both the Face and the heart data. Further, we find that the Gamma shape and scale parameters in both signals span a scaling power law whereby as the noise- to-signal ratio (Gamma scale parameter) increases, so does the randomness of the stochastic process (the Gamma shape decreases towards the memoryless exponential range). We find that as the heart IBI turns more erratic (noisier and more random) the facial ophthalmic region increases the noise and randomness too, with higher linear correlation for tasks requiring haptic feedback (R2 0.84) than for tasks requiring higher cognitive and memory loads (R2 0.77). Increases in transfer entropy shows that recent past activity ([~]167ms back) of the heart IBI and Face combined lower the uncertainty in the prediction of the present ophthalmic-Face activity, suggesting that this Face region may serve as a proxy of an increasingly dysregulated heart. These results bear implications for the detection and monitoring of pressure pain and heart dysregulated states. Scope StatementThis work uncovers personalized thresholds of pain through the combination of the participants fluctuations in HRV and facial micro-expressions. These signals are obtained before and after experiencing the sensation of pressure pain compared to a pain-free control condition. Tasks with higher haptic demand evoke higher differentiation in the signals than tasks with higher cognitive and memory loads. As the detection and tracking of such individual thresholds is possible through these unobtrusive and highly scalable methods, the work has implications for the personalized tailoring of pain treatments beyond the realms of the lab.