| 1. |
- Ajan, Aida, et al.
(författare)
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Reproducibility of Laser Doppler Flowmetry in gingival microcirculation. A study on six different protocols
- 2024
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Ingår i: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 153
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Laser Doppler Flowmetry (LDF) is a non-invasive technique for the assessment of tissue blood flow, but increased reproducibility would facilitate longitudinal studies. The aim of the study was to assess the interday reproducibility of Laser Doppler Flowmetry (LDF) at rest, at elevated local temperatures, and with the use of the vasodilator Methyl Nicotinate (MN) in six interconnected protocols for the measurement of the blood supply to the microvascular bed of the gingiva. Methods: Ten healthy volunteers were included. Interweek LDF measurements with custom-made acrylic splints were performed. Six protocols were applied in separate regions of interest (ROI): 1; basal LDF, 2; LDF with thermoprobe 42 degrees C, 3; LDF with thermoprobe 45 degrees C, 4; LDF with thermoprobe 42 degrees C and MN, 5; LDF with thermoprobe 45 C and MN and 6; LDF with MN. Results: Intra-individual reproducibility was assessed by the within -subject coefficient of variation (wCV) and the intraclass correlation coefficient (ICC). Basal LDF measurements demonstrated high reproducibility with wCV 11.1 in 2 min and 10.3 in 5 min. ICC was 0.9 and 0.92. wCV after heat and MN was 4.9-10.3 and ICC 0.82-0.93. The topically applied MN yielded increased blood flow. Conclusion: This is the first study evaluating the reproducibility of basal LDF compared to single or multiple vasodilatory stimuli in gingiva. Multiple collector fibers probe and stabilizing acrylic splints are recommended. Vasodilatory stimulation showed a tendency toward higher reproducibility. Furthermore, MN yields vasodilation in gingiva.
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| 2. |
- Bergstrand, Sara, et al.
(författare)
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Association between cardiovascular risk profile and impaired microvascular function in a Swedish middle-aged cohort (the SCAPIS study)
- 2024
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Ingår i: European Journal of Preventive Cardiology. - : OXFORD UNIV PRESS. - 2047-4873 .- 2047-4881.
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Tidskriftsartikel (refereegranskat)abstract
- Aims The aim was to investigate the relationship between microvascular function, cardiovascular risk profile, and subclinical atherosclerotic burden. Methods and results The study enrolled 3809 individuals, 50-65 years old, participating in the population-based observational cross-sectional Swedish CArdioPulmonary bioImage Study. Microvascular function was assessed in forearm skin using an arterial occlusion and release protocol determining peak blood oxygen saturation (OxyP). Cardiovascular risk was calculated using the updated Systematic Coronary Risk Evaluation [SCORE2; 10-year risk of fatal and non-fatal cardiovascular disease (CVD) events]. The OxyP was compared with coronary artery calcification score (CACS) and to plaques in the carotid arteries. Individuals with OxyP values in the lowest quartile (Q1; impaired microvascular function) had a mean SCORE2 of 5.8% compared with 3.8% in those with the highest values of OxyP (Q4), a relative risk increase of 53%. The risk of having a SCORE2 > 10% was five times higher for those in Q1 (odds ratio: 4.96, 95% confidence interval: 2.76-8.93) vs. Q4 when adjusting for body mass index and high-sensitivity C-reactive protein. The OxyP was lower in individuals with CACS > 0 and in those with both carotid plaques and CACS > 0, compared with individuals without subclinical atherosclerotic burdens (87.5 +/- 5.6% and 86.9 +/- 6.0%, vs. 88.6 +/- 5.8%, P < 0.01). Conclusion In a population without CVD or diabetes mellitus, impaired microvascular function is associated with cardiovascular risk profiles such as higher SCORE2 risk and CACS. We suggest that OxyP may serve as a microcirculatory functional marker of subclinical atherosclerosis and CVD risk that is not detected by structural assessments.
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| 3. |
- Elawa, Sherif, et al.
(författare)
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Skin perfusion and oxygen saturation after mastectomy and radiation therapy in breast cancer patients
- 2024
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Ingår i: Breast. - : Elsevier. - 0960-9776 .- 1532-3080. ; 75
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Tidskriftsartikel (refereegranskat)abstract
- The pathophysiological mechanism behind complications associated with postmastectomy radiotherapy (PMRT) and subsequent implant-based breast reconstruction are not completely understood. The aim of this study was to examine if there is a relationship between PMRT and microvascular perfusion and saturation in the skin after mastectomy and assess if there is impaired responsiveness to a topically applied vasodilator (Methyl nicotinate - MN). Skin microvascular perfusion and oxygenation >2 years after PMRT were measured using white light diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LDF) in the irradiated chest wall of 31 women with the contralateral breast as a control. In the non-irradiated breast, the perfusion after application of MN (median 0.84, 25th-75th centile 0.59-1.02 % RBC × mm/s) was higher compared to the irradiated chest wall (median 0.51, 25th-75th centile 0.21-0.68 % RBC × mm/s, p < 0.001). The same phenomenon was noted for saturation (median 91 %, 25th-75th centile 89-94 % compared to 89 % 25th-75th centile 77-93 %, p = 0.001). Eight of the women (26%) had a ≥10 % difference in skin oxygenation between the non-irradiated breast and the irradiated chest wall. These results indicate that late microvascular changes caused by radiotherapy of the chest wall significantly affect skin perfusion and oxygenation.
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| 4. |
- Hultman, Martin, et al.
(författare)
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Robust analysis of microcirculatory flowmotion during post-occlusive reactive hyperemia
- 2024
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Ingår i: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 155
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Tidskriftsartikel (refereegranskat)abstract
- Background: Flowmotion analysis of the microcirculatory blood flow is a method to extract information about the vessel regulatory function. It has previously shown promise when applied to measurements during a postocclusive reactive hyperemia. However, the reperfusion peak and the following monotonic decline introduces false low frequencies that should not be interpreted as rhythmic vasomotion effect. Aim: To develop and validate a robust method for flowmotion analysis of post-occlusive reactive hyperemia signals. Method: The occlusion-induced reperfusion response contains a typical rapid increase followed by a monotonic decline to baseline. A mathematical model is proposed to detrend this transient part of the signal to enable further flowmotion analysis. The model is validated in 96 measurements on healthy volunteers. Results: Applying the proposed model corrects the flowmotion signal without adding any substantial new false flowmotion components. Conclusion: Future studies should use the proposed method or equivalent when analyzing flowmotion during post-occlusive reactive hyperemia to ensure valid results.
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| 5. |
- Meyerson, Amanda, et al.
(författare)
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Effects of daylight and darkness at daytime versus nighttime on driver sleepiness : A driving simulator study
- 2024
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Ingår i: Transportation Research Interdisciplinary Perspectives. - : Elsevier. - 2590-1982. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- The study explores the impact of light conditions on driver sleepiness. In a driving simulator experiment, 20 drivers drove both during daytime in an alert condition and then later at night after being awake since early morning. Light conditions were manipulated by driving in a simulated nighttime scenario in a dark room (1 lx) versus driving in simulated daylight in a room lit with light emitting diodes combining blue light with a yellow phosphor giving a two peaked spectrum (212 lx). Both the daylight and the darkness scenarios were driven daytime and nighttime in a 2 × 2 design. Sleepiness was measured during the four 1-hour drives in terms of subjective sleepiness ratings, divided attention ability, driving performance, heart rate variability and blink behaviour. Significant differences were found in all measured sleepiness indicators between the daytime and nighttime drives, and in most indicators for time-on- task. No significant main effects were found between simulated daylight and darkness. A psychomotor vigilance test conducted before and after each drive also showed no significant effects for lighting condition. Further research, preferably using longitudinal studies in more realistic settings on real roads, is needed to determine which behaviours and which cognitive processes that are affected when driving in daylight versus darkness.
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| 6. |
- Hultman, Martin, et al.
(författare)
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Flowmotion imaging analysis of spatiotemporal variations in skin microcirculatory perfusion
- 2023
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Ingår i: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 146
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Tidskriftsartikel (refereegranskat)abstract
- Background: Flowmotion is the rhythmical variations in measured skin blood flow that arise due to global and local regulation of the vessels and can be studied using frequency analysis of time-resolved blood flow signals. It has the potential to reveal clinically useful information about microvascular diseases, but the spatial heteroge-neous nature of the microvasculature makes interpretation difficult. However, recent technological advances in multi-exposure laser speckle contrast imaging (MELSCI) enable new possibilities for simultaneously studying spatial and temporal variations in flowmotion.Aim: To develop a method for flowmotion analysis of MELSCI perfusion images. Furthermore, to investigate the spatial and temporal variations in flowmotion in forearm baseline skin perfusion.Method: In four healthy subjects, forearm skin perfusion was imaged at 15.6 fps for 10 min in baseline. The time -trace signal in each pixel was analyzed using the wavelet transform and summarized in five physiologically relevant frequency intervals, resulting in images of flowmotion. Furthermore, a method for reducing the effect of motion artifacts in the flowmotion analysis was developed.Results: The flowmotion images displayed patterns of high spatial heterogeneity that differed between the fre-quency intervals. The spatial variations in flowmotion, quantified as the coefficient of variation, was between 11 % and 31 % in four subjects. Furthermore, significant temporal variations in flowmotion were also observed, indicating the importance of a spatiotemporal analysis.Conclusion: The new imaging technique reveals significant spatial differences in flowmotion that cannot be ob-tained with single-point measurements. The results indicate that global statistics of flowmotion, such as the mean value in a large region of interest, is more representative of the microcirculation than data measured only in a single point. Therefore, imaging techniques have potential to increase the clinical usefulness of flowmotion analysis.
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| 7. |
- Hultman, Martin, et al.
(författare)
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Speed-resolved perfusion imaging using multi-exposure laser speckle contrast imaging and machine learning
- 2023
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Ingår i: Journal of Biomedical Optics. - : SPIE-SOC PHOTO-OPTICAL INSTRUMENTATION ENGINEERS. - 1083-3668 .- 1560-2281. ; 28:3
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Tidskriftsartikel (refereegranskat)abstract
- Significance: Laser speckle contrast imaging (LSCI) gives a relative measure of microcirculatory perfusion. However, due to the limited information in single-exposure LSCI, models are inaccurate for skin tissue due to complex effects from e.g. static and dynamic scatterers, multiple Doppler shifts, and the speed-distribution of blood. It has been demonstrated how to account for these effects in laser Doppler flowmetry (LDF) using inverseMonte Carlo (MC) algorithms. This allows for a speed-resolved perfusion measure in absolute units %RBC x mm/s, improving the physiological interpretation of the data. Until now, this has been limited to a single-point LDF technique but recent advances inmulti-exposure LSCI (MELSCI) enable the analysis in an imaging modality. Aim: To present a method for speed-resolved perfusion imaging in absolute units %RBC x mm/s, computed from multi-exposure speckle contrast images. Approach: An artificial neural network (ANN) was trained on a large simulated dataset of multi- exposure contrast values and corresponding speed-resolved perfusion. The dataset was generated using MC simulations of photon transport in randomized skin models covering a wide range of physiologically relevant geometrical and optical tissue properties. The ANN was evaluated on in vivo data sets captured during an occlusion provocation. Results: Speed-resolved perfusion was estimated in the three speed intervals 0 to 1 mm/s, 1 to 10 mm/s, and > 10 mm/s, with relative errors 9.8%, 12%, and 19%, respectively. The perfusion had a linear response to changes in both blood tissue fraction and blood flow speed and was less affected by tissue properties compared with single-exposure LSCI. The image quality was subjectively higher compared with LSCI, revealing previously unseen macro- and microvascular structures. Conclusions: The ANN, trained on modeled data, calculates speed-resolved perfusion in absolute units from multi-exposure speckle contrast. This method facilitates the physiological interpretation of measurements using MELSCI and may increase the clinical impact of the technique. (c) The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.
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| 8. |
- Jonasson, Hanna, et al.
(författare)
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Absorption and reduced scattering coefficients in epidermis and dermis from a Swedish cohort study
- 2023
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Ingår i: Journal of Biomedical Optics. - : SPIE-SOC PHOTO-OPTICAL INSTRUMENTATION ENGINEERS. - 1083-3668 .- 1560-2281. ; 28:11
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Tidskriftsartikel (refereegranskat)abstract
- Significance Knowledge of optical properties is important to accurately model light propagation in tissue, but in vivo reference data are sparse.Aim The aim of our study was to present in vivo skin optical properties from a large Swedish cohort including 3809 subjects using a three-layered skin model and spatially resolved diffuse reflectance spectroscopy (Periflux PF6000 EPOS).Approach Diffuse reflectance spectra (475 to 850 nm) at 0.4 and 1.2 mm source-detector separations were analyzed using an inverse Monte Carlo method. The model had one epidermis layer with variable thicknesses and melanin-related absorptions and two dermis layers with varying hemoglobin concentrations and equal oxygen saturations. The reduced scattering coefficient was equal across all layers.Results Median absorption coefficients (mm (- 1)) in the upper dermis ranged from 0.094 at 475 nm to 0.0048 at 850 nm and similarly in the lower dermis from 0.059 to 0.0035. The reduced scattering coefficient (mm( - 1)) ranged from 3.22 to 1.20, and the sampling depth (mm) ranged from 0.23 to 0.38 (0.4 mm separation) and from 0.49 to 0.68 (1.2 mm separation). There were differences in optical properties across sex, age groups, and BMI categories.Conclusions Reference material for skin optical properties is presented.
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| 9. |
- Jonsson, Hanna, et al.
(författare)
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Absorption and reduced scattering coefficients in epidermis and dermis from a Swedish cohort study
- 2023
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Ingår i: PHOTONICS IN DERMATOLOGY AND PLASTIC SURGERY 2023. - : SPIE-INT SOC OPTICAL ENGINEERING. - 9781510658097 - 9781510658103
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Konferensbidrag (refereegranskat)abstract
- We present in vivo optical properties of skin tissue assessed using spatially resolved diffuse reflectance spectroscopy. Data was collected in a sub-study of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Measurements were performed on 3,809 subjects, 50-65 years, on the volar side of the forearm with the PeriFlux 6000 EPOS system. The analysis consisted of an inverse Monte Carlo method where modeled spectra were non-linearly fitted to measured diffuse reflectance spectra at 0.4 and 1.2-mm source-detector fiber separations, respectively, between 475 and 850 nm. The model consisted of one epidermis layer with adaptable thickness and absorption caused by melanin, and two dermis layers. The upper dermis had a fixed thickness of 0.2 mm and the lower an infinite thickness. The absorption in the dermis layers depended on varying amounts of hemoglobin and its oxygen saturation. The reduced scattering coefficient, with three adaptable parameters, was equal in all layers in the model. Absorption coefficient in epidermis times epidermis thickness, reflecting the total amount of melanin, was 0.19 +/- 0.16 [-] at 570 nm with a significant difference between winter (0.12 +/- 0.10) and summer (0.26 +/- 0.19). Melanin absorption implies an average of 3.9% tissue fraction of melanosomes in epidermis. Absorption coefficient at the 570 nm isosbestic point was 0.19 +/- 0.11 mm(-1) in the upper dermis layer and 0.10 +/- 0.05 mm(-1) in the lower. The reduced scattering coefficient was 2.3 +/- 0.5 mm(-1) at 570 nm. Average sampling depth for all wavelengths and both separations was 0.43 +/- 0.03 mm.
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| 10. |
- Samils, Linda, et al.
(författare)
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Workload and sex effects in comprehensive assessment of cutaneous microcirculation
- 2023
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Ingår i: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 148
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Workload and sex-related differences have been proposed as factors of importance when evaluating the microcirculation. Simultaneous assessments with diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LDF) enable a comprehensive evaluation of the microcirculation. The aim of the study was to compare the response between sexes in the microcirculatory parameters red blood cell (RBC) tissue fraction, RBC oxygen saturation, average vessel diameter, and speed-resolved perfusion during baseline, cycling, and recovery, respectively.Methods: In 24 healthy participants (aged 20 to 30 years, 12 females), cutaneous microcirculation was assessed by LDF and DRS at baseline, during a workload generated by cycling at 75 to 80 % of maximal age-predicted heart rate, and recovery, respectively.Results: Females had significantly lower RBC tissue fraction and total perfusion in forearm skin microcirculation at all phases (baseline, workload, and recovery). All microvascular parameters increased significantly during cycling, most evident in RBC oxygen saturation (34 % increase on average) and perfusion (9-fold increase in total perfusion). For perfusion, the highest speeds (>10 mm/s) increased by a factor of 31, whereas the lowest speeds (<1 mm/s) increased by a factor of 2.Conclusion: Compared to a resting state, all studied microcirculation measures increased during cycling. For perfusion, this was mainly due to increased speed, and only to a minor extent due to increased RBC tissue fraction. Skin microcirculatory differences between sexes were seen in RBC concentration and total perfusion.
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