Correcting hypothalamic-pituitary-adrenal axis dysfunction using observer-based explicit nonlinear model predictive control

The hypothalamic-pituitary-adrenal (HPA) axis is critical in maintaining homeostasis under physical and psychological stress by modulating cortisol levels in the body. Dysregulation of cortisol levels is linked to numerous stress-related disorders. In this paper, an automated treatment methodology is proposed, employing a variant of nonlinear model predictive control (NMPC), called explicit MPC (EMPC). The controller is informed by an unknown input observer (UIO), which estimates various hormonal levels in the HPA axis system in conjunction with the magnitude of the stress applied on the body, based on measured concentrations of adreno-corticotropic hormones (ACTH). The proposed closed-loop control strategy is tested on multiple in silico patients and the effectiveness of the controller performance is demonstrated.