Discriminating Cocaine Use from Other Sympathomimetics Using Wearable Electrocardiographic (ECG) Sensors

Overview

Journal Drug Alcohol Depend

Publisher Elsevier

Specialty Psychiatry

Date 2023 Jul 31

PMID 37523916

Authors

Gustavo A Angarita

Brian Pittman

Annamalai Nararajan

Talia F Mayerson

Abhinav Parate

Benjamin Marlin

Ralitza R Gueorguieva

Marc N Potenza

Deepak Ganesan

Robert T Malison

Affiliations

Soon will be listed here.

Abstract

Background: Our group has established the feasibility of using on-body electrocardiographic (ECG) sensors to detect cocaine use in the human laboratory. The purpose of the current study was to test whether ECG sensors and features are capable of discriminating cocaine use from other non-cocaine sympathomimetics.

Methods: Eleven subjects with cocaine use disorder wore the Zephyr BioHarness™ 3 chest band under six experimental (drug and non-drug) conditions, including 1) laboratory, intravenous cocaine self-administration, 2) after a single oral dose of methylphenidate, 3) during aerobic exercise, 4) during tobacco use (N=7 who smoked tobacco), and 5) during routine activities of daily inpatient living (unit activity). Three ECG-derived feature sets served as primary outcome measures, including 1) the RR interval (i.e., heart rate), 2) a group of ECG interval proxies (i.e., PR, QS, QT and QTc intervals), and 3) the full ECG waveform. Discriminatory power between cocaine and non-cocaine conditions for each of the three outcomes measures was expressed as the area under the receiver operating characteristics (AUROC) curve.

Results: All three outcomes successfully discriminated cocaine use from unit activity, exercise, tobacco, and methylphenidate conditions with a mean AUROC values ranging from 0.66 to 0.99 and with least squares means values all statistically different/higher than 0.5 among all subjects [F(3, 99) = 3.38, p =0.02] and among those with tobacco use [F(4, 84) = 5.39, p = 0.0007].

Conclusions: These preliminary results support discriminatory power of wearable ECG sensors for detecting cocaine use.

References

Magnano A, Talathoti N, Hallur R, Jurus D, Dizon J, Holleran S . Effect of acute cocaine administration on the QTc interval of habitual users. Am J Cardiol. 2006; 97(8):1244-6. DOI: 10.1016/j.amjcard.2005.11.046. View

Boyer E, Fletcher R, Fay R, Smelson D, Ziedonis D, Picard R . Preliminary efforts directed toward the detection of craving of illicit substances: the iHeal project. J Med Toxicol. 2012; 8(1):5-9. PMC: 3550228. DOI: 10.1007/s13181-011-0200-4. View

Mohr D, Burns M, Schueller S, Clarke G, Klinkman M . Behavioral intervention technologies: evidence review and recommendations for future research in mental health. Gen Hosp Psychiatry. 2013; 35(4):332-8. PMC: 3719158. DOI: 10.1016/j.genhosppsych.2013.03.008. View

Natarajan A, Gaiser E, Angarita G, Malison R, Ganesan D, Marlin B . Conditional Random Fields for Morphological Analysis of Wireless ECG Signals. ACM BCB. 2016; 2014:370-379. PMC: 4697765. DOI: 10.1145/2649387.2649414. View

Gajecki M, Berman A, Sinadinovic K, Rosendahl I, Andersson C . Mobile phone brief intervention applications for risky alcohol use among university students: a randomized controlled study. Addict Sci Clin Pract. 2014; 9:11. PMC: 4091647. DOI: 10.1186/1940-0640-9-11. View

Deckers J, Vinke R, Vos J, Simoons M . Changes in the electrocardiographic response to exercise in healthy women. Br Heart J. 1990; 64(6):376-80. PMC: 1224814. DOI: 10.1136/hrt.64.6.376. View

Hollander J, Lozano M, Fairweather P, Goldstein E, Gennis P, Brogan G . "Abnormal" electrocardiograms in patients with cocaine-associated chest pain are due to "normal" variants. J Emerg Med. 1994; 12(2):199-205. DOI: 10.1016/0736-4679(94)90699-8. View

Metcalf D, Milliard S, Gomez M, Schwartz M . Wearables and the Internet of Things for Health: Wearable, Interconnected Devices Promise More Efficient and Comprehensive Health Care. IEEE Pulse. 2017; 7(5):35-39. DOI: 10.1109/MPUL.2016.2592260. View

Irisawa H, Seyama I . The configuration of the P wave during mild exercise. Am Heart J. 1966; 71(4):467-72. DOI: 10.1016/0002-8703(66)90211-0. View

10.

Hart C, Haney M, Vosburg S, Rubin E, Foltin R . Smoked cocaine self-administration is decreased by modafinil. Neuropsychopharmacology. 2007; 33(4):761-8. DOI: 10.1038/sj.npp.1301472. View

11.

Dakwar E, Hart C, Levin F, Nunes E, Foltin R . Cocaine self-administration disrupted by the N-methyl-D-aspartate receptor antagonist ketamine: a randomized, crossover trial. Mol Psychiatry. 2016; 22(1):76-81. PMC: 5435123. DOI: 10.1038/mp.2016.39. View

12.

Fletcher R, Tam S, Omojola O, Redemske R, Kwan J . Wearable sensor platform and mobile application for use in cognitive behavioral therapy for drug addiction and PTSD. Annu Int Conf IEEE Eng Med Biol Soc. 2012; 2011:1802-5. DOI: 10.1109/IEMBS.2011.6090513. View

13.

SJOSTRAND T . The relationship between the heart frequency and the S-T level of the electrocardiogram. Acta Med Scand. 1950; 138(3):201-10. View

14.

Devi M, Arvind T, Kumar P . ECG Changes in Smokers and Non Smokers-A Comparative Study. J Clin Diagn Res. 2013; 7(5):824-6. PMC: 3681047. DOI: 10.7860/JCDR/2013/5180.2950. View

15.

Kalimullah E, Bryant S . Case files of the medical toxicology fellowship at the toxikon consortium in Chicago: cocaine-associated wide-complex dysrhythmias and cardiac arrest - treatment nuances and controversies. J Med Toxicol. 2008; 4(4):277-83. PMC: 3550110. DOI: 10.1007/BF03161213. View

16.

Stiefel G, Besag F . Cardiovascular effects of methylphenidate, amphetamines and atomoxetine in the treatment of attention-deficit hyperactivity disorder. Drug Saf. 2010; 33(10):821-42. DOI: 10.2165/11536380-000000000-00000. View

17.

Li C, Morgan P, Matuskey D, Abdelghany O, Luo X, Chang J . Biological markers of the effects of intravenous methylphenidate on improving inhibitory control in cocaine-dependent patients. Proc Natl Acad Sci U S A. 2010; 107(32):14455-9. PMC: 2922598. DOI: 10.1073/pnas.1002467107. View

18.

Hossain S, Ali A, Rahman M, Ertin E, Epstein D, Kennedy A . Identifying Drug (Cocaine) Intake Events from Acute Physiological Response in the Presence of Free-living Physical Activity. IPSN. 2014; 2014:71-82. PMC: 4269159. View

19.

Hill S, El-Khayat R, Sandilands E, Thomas S . Electrocardiographic effects of methylphenidate overdose. Clin Toxicol (Phila). 2010; 48(4):342-6. DOI: 10.3109/15563651003720234. View

20.

DANIEL W, Pirwitz M, Horton R, Landau C, Glamann D, Snyder 2nd R . Electrophysiologic effects of intranasal cocaine. Am J Cardiol. 1995; 76(5):398-400. DOI: 10.1016/s0002-9149(99)80109-x. View