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Katagiri M, Nakabayashi M, Matsuda Y, Ono Y, Ichinose M. Differential changes in blood flow and oxygen utilization in active muscles between voluntary exercise and electrical muscle stimulation in young adults. J Appl Physiol (1985) 2024; 136:1053-1064. [PMID: 38482573 DOI: 10.1152/japplphysiol.00863.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/22/2024] [Accepted: 03/05/2024] [Indexed: 04/24/2024] Open
Abstract
The physiological effects on blood flow and oxygen utilization in active muscles during and after involuntary contraction triggered by electrical muscle stimulation (EMS) remain unclear, particularly compared with those elicited by voluntary (VOL) contractions. Therefore, we used diffuse correlation and near-infrared spectroscopy (DCS-NIRS) to compare changes in local muscle blood flow and oxygen consumption during and after these two types of muscle contractions in humans. Overall, 24 healthy young adults participated in the study, and data were successfully obtained from 17 of them. Intermittent (2-s contraction, 2-s relaxation) isometric ankle dorsiflexion with a target tension of 20% of maximal VOL contraction was performed by EMS or VOL for 2 min, followed by a 6-min recovery period. DCS-NIRS probes were placed on the tibialis anterior muscle, and relative changes in local tissue blood flow index (rBFI), oxygen extraction fraction (rOEF), and metabolic rate of oxygen (rMRO2) were continuously derived. EMS induced more significant increases in rOEF and rMRO2 than VOL exercise but a comparable increase in rBFI. After EMS, rBFI and rMRO2 decreased more slowly than after VOL and remained significantly higher until the end of the recovery period. We concluded that EMS augments oxygen consumption in contracting muscles by enhancing oxygen extraction while increasing oxygen delivery at a rate similar to the VOL exercise. Under the conditions examined in this study, EMS demonstrated a more pronounced and/or prolonged enhancement in local muscle perfusion and aerobic metabolism compared with VOL exercise in healthy participants.NEW & NOTEWORTHY This is the first study to visualize continuous changes in blood flow and oxygen utilization within contracted muscles during and after electrical muscle stimulation (EMS) using combined diffuse correlation and near-infrared spectroscopy. We found that initiating EMS increases blood flow at a rate comparable to that during voluntary (VOL) exercise but enhances oxygen extraction, resulting in higher oxygen consumption. Furthermore, EMS increased postexercise muscle perfusion and oxygen consumption compared with that after VOL exercise.
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Affiliation(s)
- Makoto Katagiri
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Mikie Nakabayashi
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Yasuhiro Matsuda
- Faculty of Medical Science, Nippon Sport Science University, Kanagawa, Japan
| | - Yumie Ono
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Masashi Ichinose
- Human Integrative Physiology Laboratory, School of Business Administration, Meiji University, Tokyo, Japan
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Cortese L, Fernández Esteberena P, Zanoletti M, Lo Presti G, Aranda Velazquez G, Ruiz Janer S, Buttafava M, Renna M, Di Sieno L, Tosi A, Dalla Mora A, Wojtkiewicz S, Dehghani H, de Fraguier S, Nguyen-Dinh A, Rosinski B, Weigel UM, Mesquida J, Squarcia M, Hanzu FA, Contini D, Mora Porta M, Durduran T. In vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle through ultrasound-guided hybrid near-infrared spectroscopies. Physiol Meas 2023; 44:125010. [PMID: 38061053 DOI: 10.1088/1361-6579/ad133a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
Objective.In this paper, we present a detailedin vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle (SCM), obtained through ultrasound-guided near-infrared time-domain and diffuse correlation spectroscopies.Approach.A total of sixty-five subjects (forty-nine females, sixteen males) among healthy volunteers and thyroid nodule patients have been recruited for the study. Their SCM hemodynamic (oxy-, deoxy- and total hemoglobin concentrations, blood flow, blood oxygen saturation and metabolic rate of oxygen extraction) and optical properties (wavelength dependent absorption and reduced scattering coefficients) have been measured by the use of a novel hybrid device combining in a single unit time-domain near-infrared spectroscopy, diffuse correlation spectroscopy and simultaneous ultrasound imaging.Main results.We provide detailed tables of the results related to SCM baseline (i.e. muscle at rest) properties, and reveal significant differences on the measured parameters due to variables such as side of the neck, sex, age, body mass index, depth and thickness of the muscle, allowing future clinical studies to take into account such dependencies.Significance.The non-invasive monitoring of the hemodynamics and metabolism of the sternocleidomastoid muscle during respiration became a topic of increased interest partially due to the increased use of mechanical ventilation during the COVID-19 pandemic. Near-infrared diffuse optical spectroscopies were proposed as potential practical monitors of increased recruitment of SCM during respiratory distress. They can provide clinically relevant information on the degree of the patient's respiratory effort that is needed to maintain an optimal minute ventilation, with potential clinical application ranging from evaluating chronic pulmonary diseases to more acute settings, such as acute respiratory failure, or to determine the readiness to wean from invasive mechanical ventilation.
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Affiliation(s)
- Lorenzo Cortese
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Pablo Fernández Esteberena
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Marta Zanoletti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Giuseppe Lo Presti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | | | - Sabina Ruiz Janer
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
| | - Mauro Buttafava
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at PIONIRS s.r.l., I-20124 Milano, Italy
| | - Marco Renna
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at Athinoula A. Martinos Center for Biomedical Imaging, MGH, Harvard Medical School, Charlestown, MA 02129, United States of America
| | - Laura Di Sieno
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Alberto Tosi
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
| | | | - Stanislaw Wojtkiewicz
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
- Now at Nalecz Institute of Biocybernetics and Biomedical Engineering, 02-109 Warsaw, Poland
| | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | | | | | | | - Udo M Weigel
- HemoPhotonics S.L., E-08860 Castelldefels (Barcelona), Spain
| | - Jaume Mesquida
- Área de Crítics, Parc Taulí Hospital Universitari, E-08208 Sabadell, Spain
| | - Mattia Squarcia
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Neuroradiology Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
| | - Felicia A Hanzu
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Mireia Mora Porta
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), E-08010 Barcelona, Spain
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Fernandez C, Blaney G, Frias J, Tavakoli F, Sassaroli A, Fantini S. Single-distance and dual-slope frequency-domain near-infrared spectroscopy to assess skeletal muscle hemodynamics. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:125004. [PMID: 38098980 PMCID: PMC10720738 DOI: 10.1117/1.jbo.28.12.125004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/19/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
Significance Non-invasive optical measurements of deep tissue (e.g., muscle) need to take into account confounding contributions from baseline and dynamic optical properties of superficial tissue (adipose tissue). Aim Discriminate superficial and deep tissue hemodynamics using data collected with frequency-domain (FD) near-infrared spectroscopy (NIRS) in a dual-slope (DS) configuration. Approach Experimental data were collected in vivo on the forearm of three human subjects during a 3-min arterial occlusion or 1-min venous occlusion. Theoretical data were generated using diffusion theory for two-layered media with varying values of the reduced scattering coefficient (μ s ' ) (range: 0.5 to 1.1 mm - 1 ) and absorption coefficient (μ a ) (range: 0.005 - 0.015 mm - 1 ) of the two layers, and top layer thickness (range: 2 to 8 mm). Data were analyzed using diffusion theory for a homogeneous semi-infinite medium. Results Experimental data in vivo were consistent with simulated data for a two-layered medium with a larger μ s ' in the top layer, comparable absorption changes in the top and bottom layers during venous occlusion, and smaller absorption changes in the top vs. bottom layers during arterial occlusion. Conclusions The dataset generated by DS FD-NIRS may allow for discrimination of superficial and deep absorption changes in two-layered media, thus lending itself to individual measurements of hemodynamics in adipose and muscle tissue.
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Affiliation(s)
- Cristianne Fernandez
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Giles Blaney
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Jodee Frias
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Fatemeh Tavakoli
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Angelo Sassaroli
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Sergio Fantini
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
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Bartlett MF, Palmero-Canton A, Oneglia AP, Mireles J, Brothers RM, Trowbridge CA, Wilkes D, Nelson MD. Epinephrine iontophoresis attenuates changes in skin blood flow and abolishes cutaneous contamination of near-infrared diffuse correlation spectroscopy estimations of muscle perfusion. Am J Physiol Regul Integr Comp Physiol 2023; 324:R368-R380. [PMID: 36693173 PMCID: PMC9970657 DOI: 10.1152/ajpregu.00242.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Abstract
Near-infrared diffuse correlation spectroscopy (NIR-DCS) is an optical imaging technique for measuring relative changes in skeletal muscle microvascular perfusion (i.e., fold change above baseline) during reactive hyperemia testing and exercise and is reported as a blood flow index (BFI). Although it is generally accepted that changes in BFI are primarily driven by changes in muscle perfusion, it is well known that large, hyperthermia-induced changes in cutaneous blood flow can uncouple this relationship. What remains unknown, is how much of an impact that changes in cutaneous perfusion have on NIR-DCS BFI and estimates of skeletal muscle perfusion under thermoneutral conditions, where changes in cutaneous blood flow are assumed to be relatively low. We therefore used epinephrine iontophoresis to pharmacologically block changes in cutaneous perfusion throughout a battery of experimental procedures. The data show that 1) epinephrine iontophoresis attenuates changes in cutaneous perfusion for up to 4-h posttreatment, even in the face of significant neural and local stimuli, 2) under thermoneutral conditions, cutaneous perfusion does not significantly impact NIR-DCS BFI during reactive hyperemia testing or moderate-intensity exercise, and 3) during passive whole body heat stress, when cutaneous vasodilation is pronounced, epinephrine iontophoresis preserves NIR-DCS measures of skeletal muscle BFI during moderate-intensity exercise. Collectively, these data suggest that cutaneous perfusion is unlikely to have a major impact on NIR-DCS estimates of skeletal muscle BFI under thermoneutral conditions, but that epinephrine iontophoresis can be used to abolish cutaneous contamination of the NIR-DCS BFI signal during studies where skin blood flow may be elevated but skeletal muscle perfusion is of specific interest.
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Affiliation(s)
- Miles F Bartlett
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Alberto Palmero-Canton
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Andrew P Oneglia
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Julissa Mireles
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Cynthia A Trowbridge
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Dustin Wilkes
- US Dermatology Partners, Weatherford, Texas, United States
| | - Michael D Nelson
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
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Yeh TS, Lei TH, Barnes MJ, Zhang L. Astragalosides Supplementation Enhances Intrinsic Muscle Repair Capacity Following Eccentric Exercise-Induced Injury. Nutrients 2022; 14:4339. [PMID: 36297022 PMCID: PMC9608496 DOI: 10.3390/nu14204339] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 10/26/2023] Open
Abstract
Astragalosides have been shown to enhance endurance exercise capacity in vivo and promote muscular hypertrophy in vitro. However, it remains unknown whether astragalosides supplementation can alter inflammatory response and enhance muscle recovery after damage in humans. We therefore aimed to evaluate the effect of astragalosides supplementation on muscle's intrinsic capacity to regenerate and repair itself after exercise-induced damage. Using a randomized double-blind placebo-controlled cross-over design, eleven male participants underwent 7 days of astragalosides supplementation (in total containing 4 mg of astragalosides per day) or a placebo control, following an eccentric exercise protocol. Serum blood samples and variables related to muscle function were collected prior to and immediately following the muscle damage protocol and also at 2 h, and 1, 2, 3, 5, and 7 days of the recovery period, to assess the pro-inflammatory cytokine response, the secretion of muscle regenerative factors, and muscular strength. Astragalosides supplementation reduced biomarkers of skeletal muscle damage (serum CK, LDH, and Mb), when compared to the placebo, at 1, 2, and 3 days following the muscle damage protocol. Astragalosides supplementation suppressed the secretion of IL-6 and TNF-α, whilst increasing the release of IGF-1 during the initial stages of muscle recovery. Furthermore, following astragaloside supplementation, muscular strength returned to baseline 2 days earlier than the placebo. Astragalosides supplementation shortens the duration of inflammation, enhances the regeneration process and restores muscle strength following eccentric exercise-induced injury.
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Affiliation(s)
- Tzu-Shao Yeh
- School of Public Health, Nantong University, Nantong 226019, China
- Institute of Interdisciplinary Integrative Medicine Research, School of Medicine, Nantong University, Nantong 226001, China
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi 435002, China
| | - Matthew J. Barnes
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North 4410, New Zealand
| | - Lei Zhang
- Institute of Interdisciplinary Integrative Medicine Research, School of Medicine, Nantong University, Nantong 226001, China
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Pillai S, Upadhyay A, Sayson D, Nguyen BH, Tran SD. Advances in Medical Wearable Biosensors: Design, Fabrication and Materials Strategies in Healthcare Monitoring. Molecules 2021; 27:165. [PMID: 35011400 PMCID: PMC8746599 DOI: 10.3390/molecules27010165] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/19/2021] [Accepted: 12/23/2021] [Indexed: 12/15/2022] Open
Abstract
In the past decade, wearable biosensors have radically changed our outlook on contemporary medical healthcare monitoring systems. These smart, multiplexed devices allow us to quantify dynamic biological signals in real time through highly sensitive, miniaturized sensing platforms, thereby decentralizing the concept of regular clinical check-ups and diagnosis towards more versatile, remote, and personalized healthcare monitoring. This paradigm shift in healthcare delivery can be attributed to the development of nanomaterials and improvements made to non-invasive biosignal detection systems alongside integrated approaches for multifaceted data acquisition and interpretation. The discovery of new biomarkers and the use of bioaffinity recognition elements like aptamers and peptide arrays combined with the use of newly developed, flexible, and conductive materials that interact with skin surfaces has led to the widespread application of biosensors in the biomedical field. This review focuses on the recent advances made in wearable technology for remote healthcare monitoring. It classifies their development and application in terms of electrochemical, mechanical, and optical modes of transduction and type of material used and discusses the shortcomings accompanying their large-scale fabrication and commercialization. A brief note on the most widely used materials and their improvements in wearable sensor development is outlined along with instructions for the future of medical wearables.
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Affiliation(s)
- Sangeeth Pillai
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (D.S.)
| | - Akshaya Upadhyay
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (D.S.)
| | - Darren Sayson
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (D.S.)
| | - Bich Hong Nguyen
- Department of Pediatrics, CHU Sainte Justine Hospital, Montreal, QC H3T 1C5, Canada;
| | - Simon D. Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (D.S.)
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Zhao M, Huang C, Mazdeyasna S, Yu G. Extraction of tissue optical property and blood flow from speckle contrast diffuse correlation tomography (scDCT) measurements. BIOMEDICAL OPTICS EXPRESS 2021; 12:5894-5908. [PMID: 34692223 PMCID: PMC8515985 DOI: 10.1364/boe.429890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/15/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Measurement of blood flow in tissue provides vital information for the diagnosis and therapeutic monitoring of various vascular diseases. A noncontact, camera-based, near-infrared speckle contrast diffuse correlation tomography (scDCT) technique has been recently developed for 3D imaging of blood flow index (αDB) distributions in deep tissues up to a centimeter. A limitation with the continuous-wave scDCT measurement of blood flow is the assumption of constant and homogenous tissue absorption coefficient (μ a ). The present study took the advantage of rapid, high-density, noncontact scDCT measurements of both light intensities and diffuse speckle contrast at multiple source-detector distances and developed two-step fitting algorithms for extracting both μ a and αDB. The new algorithms were tested in tissue-simulating phantoms with known optical properties and human forearms. Measurement results were compared against established near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS) techniques. The accuracies of our new fitting algorithms with scDCT measurements in phantoms (up to 16% errors) and forearms (up to 23% errors) are comparable to relevant study results (up to 25% errors). Knowledge of μ a not only improved the accuracy in calculating αDB but also provided the potential for quantifying tissue blood oxygenation via spectral measurements. A multiple-wavelength scDCT system with new algorithms is currently developing to fit multi-wavelength and multi-distance data for 3D imaging of both blood flow and oxygenation distributions in deep tissues.
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Boebinger SE, Brothers RO, Bong S, Sanders B, McCracken C, Ting LH, Buckley EM. Diffuse Optical Spectroscopy Assessment of Resting Oxygen Metabolism in the Leg Musculature. Metabolites 2021; 11:496. [PMID: 34436437 PMCID: PMC8400025 DOI: 10.3390/metabo11080496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 07/27/2021] [Indexed: 11/20/2022] Open
Abstract
We lack reliable methods to continuously assess localized, resting-state muscle activity that are comparable across individuals. Near-infrared spectroscopy (NIRS) provides a low-cost, non-invasive means to assess localized, resting-state muscle oxygen metabolism during venous or arterial occlusions (VO2VO and VO2AO, respectively). However, this technique is not suitable for continuous monitoring, and its utility is limited to those who can tolerate occlusions. Combining NIRS with diffuse correlated spectroscopy (DCS) enables continuous measurement of an index of muscle oxygen metabolism (VO2i). Despite the lack of previous validation, VO2i is employed as a measure of oxygen metabolism in the muscle. Here we characterized measurement repeatability and compared VO2i with VO2VO and VO2AO in the medial gastrocnemius (MG) in 9 healthy adults. Intra-participant repeatability of VO2i, VO2VO, and VO2AO were excellent. VO2i was not significantly correlated with VO2AO (p = 0.15) nor VO2VO (p = 0.55). This lack of correlation suggests that the variability in the calibration coefficient between VO2i and VO2AO/VO2VO in the MG is substantial across participants. Thus, it is preferable to calibrate VO2i prior to every monitoring session. Important future work is needed to compare VO2i against gold standard modalities such as positron emission tomography or magnetic resonance imaging.
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Affiliation(s)
- Scott E. Boebinger
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Rowan O. Brothers
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Sistania Bong
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Bharat Sanders
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Courtney McCracken
- Center for Research and Evaluation, Kaiser Permanente of Georgia, Atlanta, GA 30309, USA;
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA 30322, USA
| | - Erin M. Buckley
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA 30322, USA
- Children’s Healthcare of Atlanta, Children’s Research Scholar, Atlanta, GA 30322, USA
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Bartlett MF, Akins JD, Oneglia A, Brothers RM, Wilkes D, Nelson MD. Impact of Cutaneous Blood Flow on NIR-DCS Measures of Skeletal Muscle Blood Flow Index. J Appl Physiol (1985) 2021; 131:914-926. [PMID: 34264131 DOI: 10.1152/japplphysiol.00337.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Near-infrared diffuse correlation spectroscopy (NIR-DCS) is an optical technique for estimating relative changes in skeletal muscle perfusion during exercise, but may be affected by changes in cutaneous blood flow, as photons emitted by the laser must first pass through the skin. Accordingly, the purpose of this investigation was to examine how increased cutaneous blood flow affects NIR-DCS blood flow index (BFI) at rest and during exercise using a passive whole-body heating protocol that increases cutaneous, but not skeletal muscle, perfusion in the uncovered limb. BFI and cutaneous perfusion (laser Doppler flowmetry) were assessed in 15 healthy young subjects before (e.g., rest) and during 5-minutes of moderate-intensity hand-grip exercise in normothermic conditions and after cutaneous blood flow was elevated via whole-body heating. Hyperthermia significantly increased both cutaneous perfusion (~7.3-fold; p≤0.001) and NIR-DCS BFI (~4.5-fold; p≤0.001). Although relative BFI (i.e., fold-change above baseline) exhibited a typical exponential increase in muscle perfusion during normothermic exercise (2.81±0.95), there was almost no change in BFI during hyperthermic exercise (1.43±0.44). A subset of 8 subjects were subsequently treated with intradermal injection of botulinum toxin-A (Botox) to block heating-induced elevations in cutaneous blood flow, which 1) nearly abolished the hyperthermia-induced increase in BFI, and 2) restored BFI kinetics during hyperthermic exercise to values that were not different from normothermic exercise (p=0.091). Collectively, our results demonstrate that cutaneous blood flow can have a substantial, detrimental impact on NIR-DCS estimates of skeletal muscle perfusion and highlight the need for technical and/or pharmacological advancements to overcome this issue moving forward.
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Affiliation(s)
- Miles F Bartlett
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States
| | - John D Akins
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States
| | - Andrew Oneglia
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States
| | - Dustin Wilkes
- Medical City Weatherford Dermatology Residency Program, Weatherford, TX, United States
| | - Michael D Nelson
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States
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Giovannella M, Urtane E, Zanoletti M, Karadeniz U, Rubins U, Weigel UM, Marcinkevics Z, Durduran T. Microvascular blood flow changes of the abductor pollicis brevis muscle during sustained static exercise. BIOMEDICAL OPTICS EXPRESS 2021; 12:4235-4248. [PMID: 34457411 PMCID: PMC8367267 DOI: 10.1364/boe.427885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
A practical assessment of the general health and microvascular function of the palm muscle, abductor pollicis brevis (APB), is important for the diagnosis of different conditions. In this study, we have developed a protocol and a probe to study microvascular blood flow using near-infrared diffuse correlation spectroscopy (DCS) in APB during and after thumb abduction at 55% of maximum voluntary contraction (MVC). Near-infrared time resolved spectroscopy (TRS) was also used to characterize the baseline optical and hemodynamic properties. Thirteen (n=13) subjects were enrolled and subdivided in low MVC (N=6, MVC<2.3 kg) and high MVC (N=7, MVC≥2.3 kg) groups. After ruling out significant changes in the systemic physiology that influence the muscle hemodynamics, we have observed that the high MVC group showed a 56% and 36% decrease in the blood flow during exercise, with respect to baseline, in the long and short source-detector (SD) separations (p=0.031 for both). No statistical differences were shown for the low MVC group (p=1 for short and p=0.15 for long SD). These results suggest that the mechanical occlusion, due to increased intramuscular pressure, exceeded the vasodilation elicited by the higher metabolic demand. Also, blood flow changes during thumb contraction negatively correlated (R=-0.7, p<0.01) with the absolute force applied by each subject. Furthermore, after the exercise, muscular blood flow increased significantly immediately after thumb contractions in both high and low MVC groups, with respect to the recorded values during the exercise (p=0.031). An increase of 251% (200%) was found for the long (short) SD in the low MVC group. The high MVC groups showed a significant 90% increase in blood flow only after 80 s from the start of the protocol. For both low and high MVC groups, blood flow recovered to baseline values within 160 s from starting the exercise. In conclusion, DCS allows the study of the response of a small muscle to static exercise and can be potentially used in multiple clinical conditions scenarios for assessing microvascular health.
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Affiliation(s)
- Martina Giovannella
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - Evelina Urtane
- Faculty of Biology, Department of Human and Animal Physiology, University of Latvia, Kronvalda Blvd. 4, LV 1586, Riga, Latvia
| | - Marta Zanoletti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - Umut Karadeniz
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - Uldis Rubins
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 19 Rainis Blvd., Riga LV- 1586, Latvia
| | - Udo M. Weigel
- HemoPhotonics S.L., Av. Carl Friedrich Gauss Num. 3, 08860 Castelldefels (Barcelona), Spain
| | - Zbignevs Marcinkevics
- Faculty of Biology, Department of Human and Animal Physiology, University of Latvia, Kronvalda Blvd. 4, LV 1586, Riga, Latvia
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
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11
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Cortese L, Lo Presti G, Pagliazzi M, Contini D, Dalla Mora A, Dehghani H, Ferri F, Fischer JB, Giovannella M, Martelli F, Weigel UM, Wojtkiewicz S, Zanoletti M, Durduran T. Recipes for diffuse correlation spectroscopy instrument design using commonly utilized hardware based on targets for signal-to-noise ratio and precision. BIOMEDICAL OPTICS EXPRESS 2021; 12:3265-3281. [PMID: 34221659 PMCID: PMC8221932 DOI: 10.1364/boe.423071] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/18/2021] [Accepted: 05/04/2021] [Indexed: 05/09/2023]
Abstract
Over the recent years, a typical implementation of diffuse correlation spectroscopy (DCS) instrumentation has been adapted widely. However, there are no detailed and accepted recipes for designing such instrumentation to meet pre-defined signal-to-noise ratio (SNR) and precision targets. These require specific attention due to the subtleties of the DCS signals. Here, DCS experiments have been performed using liquid tissue simulating phantoms to study the effect of the detected photon count-rate, the number of parallel detection channels and the measurement duration on the precision and SNR to suggest scaling relations to be utilized for device design.
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Affiliation(s)
- Lorenzo Cortese
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- These authors equally contributed to this work. Authors are listed in alphabetical order except for the first three and the last
| | - Giuseppe Lo Presti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- These authors equally contributed to this work. Authors are listed in alphabetical order except for the first three and the last
| | - Marco Pagliazzi
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, 20133 Milano, Italy
| | | | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, UK
| | - Fabio Ferri
- Università degli Studi dell’Insubria, Dipartimento di Scienza e Alta Tecnologia and To. Sca. Lab., 22100 Como, Italy
| | - Jonas B. Fischer
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- HemoPhotonics S.L., 08860 Castelldefels (Barcelona), Spain
| | - Martina Giovannella
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - Fabrizio Martelli
- Università degli Studi di Firenze, Dipartimento di Fisica, 50100 Firenze, Italy
| | - Udo M. Weigel
- HemoPhotonics S.L., 08860 Castelldefels (Barcelona), Spain
| | - Stanislaw Wojtkiewicz
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, UK
| | - Marta Zanoletti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- Politecnico di Milano, Dipartimento di Fisica, 20133 Milano, Italy
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08015 Barcelona, Spain
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12
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Bartlett MF, Jordan SM, Hueber DM, Nelson MD. Impact of changes in tissue optical properties on near-infrared diffuse correlation spectroscopy measures of skeletal muscle blood flow. J Appl Physiol (1985) 2021; 130:1183-1195. [PMID: 33571054 DOI: 10.1152/japplphysiol.00857.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Near-infrared diffuse correlation spectroscopy (DCS) is increasingly used to study relative changes in skeletal muscle blood flow. However, most diffuse correlation spectrometers assume that tissue optical properties-such as absorption (μa) and reduced scattering (μ's) coefficients-remain constant during physiological provocations, which is untrue for skeletal muscle. Here, we interrogate how changes in tissue μa and μ's affect DCS calculations of blood flow index (BFI). We recalculated BFI using raw autocorrelation curves and μa/μ's values recorded during a reactive hyperemia protocol in 16 healthy young individuals. First, we show that incorrectly assuming baseline μa and μ's substantially affects peak BFI and BFI slope when expressed in absolute terms (cm2/s, P < 0.01), but these differences are abolished when expressed in relative terms (% baseline). Next, to evaluate the impact of physiologic changes in μa and μ's, we compared peak BFI and BFI slope when μa and μ's were held constant throughout the reactive hyperemia protocol versus integrated from a 3-s rolling average. Regardless of approach, group means for peak BFI and BFI slope did not differ. Group means for peak BFI and BFI slope were also similar following ad absurdum analyses, where we simulated supraphysiologic changes in μa/μ's. In both cases, however, we identified individual cases where peak BFI and BFI slope were indeed affected, with this result being driven by relative changes in μa over μ's. Overall, these results provide support for past reports in which μa/μ's were held constant but also advocate for real-time incorporation of μa and μ's moving forward.NEW & NOTEWORTHY We investigated how changes in tissue optical properties affect near-infrared diffuse correlation spectroscopy (NIR-DCS)-derived indices of skeletal muscle blood flow (BFI) during physiological provocation. Although accounting for changes in tissue optical properties has little impact on BFI on a group level, individual BFI calculations are indeed impacted by changes in tissue optical properties. NIR-DCS calculations of BFI should therefore account for real-time, physiologically induced changes in tissue optical properties whenever possible.
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Affiliation(s)
- Miles F Bartlett
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | - Scott M Jordan
- College of Information and Computer Sciences, The University of Massachusetts Amherst, Amherst, Massachusetts
| | | | - Michael D Nelson
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
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13
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Dennis JJ, Wiggins CC, Smith JR, Isautier JMJ, Johnson BD, Joyner MJ, Cross TJ. Measurement of muscle blood flow and O 2 uptake via near-infrared spectroscopy using a novel occlusion protocol. Sci Rep 2021; 11:918. [PMID: 33441688 PMCID: PMC7806775 DOI: 10.1038/s41598-020-79741-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/09/2020] [Indexed: 11/09/2022] Open
Abstract
We describe here a novel protocol that sequentially combines venous followed by arterial occlusions to determine muscle blood flow and O2 uptake from a single measurement point using near-infrared spectroscopy (NIRS) during handgrip exercise. NIRS data were obtained from the flexor digitorum superficialis (FDS) muscle on the dominant arm of 15 young, healthy adults (3 women; 26 ± 7 years; 78.6 ± 9.1 kg). Participants completed a series of 15-s static handgrip contractions at 20, 40 and 60% of maximal voluntary contraction (MVC) immediately followed by either a: (i) venous occlusion (VO); (ii); arterial occlusion (AO); or venous then arterial occlusion (COMBO). Each condition was repeated 3 times for each exercise-intensity. The concordance correlation coefficient (CCC) and robust linear mixed effects modeling were used to determine measurement agreement between vascular occlusion conditions. FDS muscle blood flow ([Formula: see text]) and conductance ([Formula: see text]) demonstrated strong absolute agreement between VO and COMBO trials from rest up to 60%MVC, as evidenced by high values for CCC (> 0.82) and a linear relationship between conditions that closely approximated the line-of-identity (perfect agreement). Conversely, although FDS muscle O2 uptake ([Formula: see text]) displayed "substantial" to "near perfect" agreement between methods across exercise intensities (i.e., CCC > 0.80), there was a tendency for COMBO trials to underestimate [Formula: see text] by up to 7%. These findings indicate that the COMBO method provides valid estimates of [Formula: see text] and, to a slightly lesser extent, [Formula: see text] at rest and during static handgrip exercise up to 60%MVC. Practical implications and suggested improvements of the method are discussed.
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Affiliation(s)
- Joshua J Dennis
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joshua R Smith
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Jennifer M J Isautier
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Bruce D Johnson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Troy J Cross
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. .,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
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14
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Liu X, Gu Y, Huang C, Zhao M, Cheng Y, Jawdeh EGA, Bada HS, Chen L, Yu G. Simultaneous measurements of tissue blood flow and oxygenation using a wearable fiber-free optical sensor. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-200314RR. [PMID: 33515216 PMCID: PMC7846117 DOI: 10.1117/1.jbo.26.1.012705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/12/2021] [Indexed: 05/08/2023]
Abstract
SIGNIFICANCE There is an essential need to develop wearable multimodality technologies that can continuously measure both blood flow and oxygenation in deep tissues to investigate and manage various vascular/cellular diseases. AIM To develop a wearable dual-wavelength diffuse speckle contrast flow oximetry (DSCFO) for simultaneous measurements of blood flow and oxygenation variations in deep tissues. APPROACH A wearable fiber-free DSCFO probe was fabricated using 3D printing to confine two small near-infrared laser diodes and a tiny CMOS camera in positions for DSCFO measurements. The spatial diffuse speckle contrast and light intensity measurements at the two different wavelengths enable quantification of tissue blood flow and oxygenation, respectively. The DSCFO was first calibrated using tissue phantoms and then tested in adult forearms during artery cuff occlusion. RESULTS Phantom tests determined the largest effective source-detector distance (15 mm) and optimal camera exposure time (10 ms) and verified the accuracy of DSCFO in measuring absorption coefficient variations. The DSCFO detected substantial changes in forearm blood flow and oxygenation resulting from the artery occlusion, which meet physiological expectations and are consistent with previous study results. CONCLUSIONS The wearable DSCFO may be used for continuous and simultaneous monitoring of blood flow and oxygenation variations in freely behaving subjects.
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Affiliation(s)
- Xuhui Liu
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Yutong Gu
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Chong Huang
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Mingjun Zhao
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Yanda Cheng
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
| | - Elie G. Abu Jawdeh
- University of Kentucky, Department of Pediatrics, College of Medicine, Lexington, Kentucky, United States
| | - Henrietta S. Bada
- University of Kentucky, Department of Pediatrics, College of Medicine, Lexington, Kentucky, United States
| | - Lei Chen
- University of Kentucky, Department of Physiology, Spinal Cord and Brain Injury Research Center, Lexington, Kentucky, United States
| | - Guoqiang Yu
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky, United States
- Address all correspondence to Guoqiang Yu,
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15
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Abu Jawdeh EG, Huang C, Mazdeyasna S, Chen L, Chen L, Bada HS, Yu G. Noncontact optical imaging of brain hemodynamics in preterm infants: a preliminary study. Phys Med Biol 2020; 65:245009. [PMID: 33113516 DOI: 10.1088/1361-6560/abc5a7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Extremely preterm infants' hemodynamic instability places them at high risk of brain injury. Currently there is no reliable bedside method to continuously monitor cerebral hemodynamics in the neonatal intensive care unit (NICU). This paper reports a feasibility study to adapt and test an innovative speckle contrast diffuse correlation tomography (scDCT) device for noncontact, high-density, 3D imaging of cerebral blood flow (CBF) in preterm infants. The scDCT scans a focused point near-infrared illumination to multiple source positions for deep tissue penetration, and controls an electron multiplying charge-coupled-device camera with thousands of pixels to achieve a high-density sampling. The optimized scDCT for use in preterm infants was first evaluated against an established diffuse correlation spectroscopy in an infant-head-simulating phantom with known properties. The observed significant correlation between the two measurements verified the capability of scDCT for transcranial brain imaging. The insignificant influence of transparent incubator wall on scDCT measurements was then confirmed by comparing adult forearm blood flow responses to artery cuff occlusions measured inside and outside the incubator. Finally, the scDCT device was moved to the NICU to image CBF variations in two preterm infants. Infant #1 with no major organ deficits showed little CBF fluctuation over the first 3 weeks of life. Infant #2 showed a significant CBF increase after the 2 h pharmacotherapy for patent ductus arteriosus closure. While these CBF variations meet physiological expectations, the fact that no significant changes are noted with peripheral monitoring of blood oxygen saturation suggests necessity of direct cerebral monitoring. This feasibility study with timely technology development is an important and necessary step towards larger clinical studies with more subjects to further validate it for continuous monitoring and instant management of cerebral pathologies and interventions in the NICU.
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Affiliation(s)
- Elie G Abu Jawdeh
- Deparment of Pediatrics/Neonatology, College of Medicine, University of Kentucky, Lexington, KY, United States of America. Contributed equally as co-first authors
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16
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McManus R, Ioussoufovitch S, Froats E, St Lawrence K, Van Uum S, Diop M. Dynamic response of cerebral blood flow to insulin-induced hypoglycemia. Sci Rep 2020; 10:21300. [PMID: 33277531 PMCID: PMC7718270 DOI: 10.1038/s41598-020-77626-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022] Open
Abstract
The dynamics of cerebral blood flow (CBF) at the onset of hypoglycemia may play a key role in hypoglycemia unawareness; however, there is currently a paucity of techniques that can monitor adult CBF with high temporal resolution. Herein, we investigated the use of diffuse correlation spectroscopy (DCS) to monitor the dynamics of CBF during insulin-induced hypoglycemia in adults. Plasma glucose concentrations, cortisol levels, and changes in CBF were measured before and during hypoglycemia in 8 healthy subjects. Cerebral blood flow increased by 42% following insulin injection with a delay of 17 ± 10 min, while the onset of hypoglycemia symptoms was delayed by 24 ± 11 min. The findings suggest that the onset of CBF increments precedes the appearance of hypoglycemia symptoms in nondiabetic subjects with normal awareness to hypoglycemia, and DCS could be a valuable tool for investigating the role of CBF in hypoglycemia unawareness.
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Affiliation(s)
- Ruth McManus
- St. Joseph's Health Care, London, ON, N6A 4V2, Canada
| | - Seva Ioussoufovitch
- Department of Biomedical Engineering, Western University, London, ON, N6A 5C1, Canada
| | | | - Keith St Lawrence
- St. Joseph's Health Care, London, ON, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, ON, N6A 5C1, Canada
| | - Stan Van Uum
- St. Joseph's Health Care, London, ON, N6A 4V2, Canada
| | - Mamadou Diop
- St. Joseph's Health Care, London, ON, N6A 4V2, Canada.
- Department of Biomedical Engineering, Western University, London, ON, N6A 5C1, Canada.
- Department of Medical Biophysics, Western University, London, ON, N6A 5C1, Canada.
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17
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Yang J, Zhang G, Chang W, Chi Z, Shang Q, Wu M, Pan T, Huang L, Jiang H. Photoacoustic imaging of hemodynamic changes in forearm skeletal muscle during cuff occlusion. BIOMEDICAL OPTICS EXPRESS 2020; 11:4560-4570. [PMID: 32923064 PMCID: PMC7449729 DOI: 10.1364/boe.392221] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 05/20/2023]
Abstract
Characterizations of circulatory and metabolic function in skeletal muscle are of great importance in clinical settings. Here in this study, we investigate the utility of photoacoustic tomography (PAT) to monitor the hemodynamic changes in forearm skeletal muscle during cuff occlusion. We show high quality photoacoustic (PA) images of human forearm in comparison with ultrasound images. Besides, we track the hemodynamic changes in the forearm during cuff occlusion cross-validated with near-infrared spectroscopy. Our study suggests that PAT, as a new tool, could be applied to common diseases affecting skeletal muscle in the future.
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Affiliation(s)
- Jinge Yang
- School of Optoelectric Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
| | - Guang Zhang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Wu Chang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Zihui Chi
- School of Optoelectric Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
| | - Qiquan Shang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Man Wu
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Teng Pan
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Lin Huang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Huabei Jiang
- Department of Medical Engineering, University of South Florida, Tampa 33620, USA
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18
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Rosenberry R, Nelson MD. Reactive hyperemia: a review of methods, mechanisms, and considerations. Am J Physiol Regul Integr Comp Physiol 2020; 318:R605-R618. [PMID: 32022580 DOI: 10.1152/ajpregu.00339.2019] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Reactive hyperemia is a well-established technique for noninvasive assessment of peripheral microvascular function and a predictor of all-cause and cardiovascular morbidity and mortality. In its simplest form, reactive hyperemia represents the magnitude of limb reperfusion following a brief period of ischemia induced by arterial occlusion. Over the past two decades, investigators have employed a variety of methods, including brachial artery velocity by Doppler ultrasound, tissue reperfusion by near-infrared spectroscopy, limb distension by venous occlusion plethysmography, and peripheral artery tonometry, to measure reactive hyperemia. Regardless of the technique used to measure reactive hyperemia, blunted reactive hyperemia is believed to reflect impaired microvascular function. With the advent of several technological advancements, together with an increased interest in the microcirculation, reactive hyperemia is becoming more common as a research tool and is widely used across multiple disciplines. With this in mind, we sought to review the various methodologies commonly used to assess reactive hyperemia and current mechanistic pathways believed to contribute to reactive hyperemia and reflect on several methodological considerations.
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Affiliation(s)
- Ryan Rosenberry
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas.,Department of Bioengineering, University of Texas at Arlington, Arlington, Texas
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19
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Zhao M, Mazdeyasna S, Huang C, Agochukwu-Nwubah N, Bonaroti A, Wong L, Yu G. Noncontact Speckle Contrast Diffuse Correlation Tomography of Blood Flow Distributions in Burn Wounds: A Preliminary Study. Mil Med 2020; 185:82-87. [PMID: 31498406 PMCID: PMC7353839 DOI: 10.1093/milmed/usz233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Tissue injuries are often associated with abnormal blood flow (BF). The ability to assess BF distributions in injured tissues enables objective evaluation of interventions and holds the potential to improve the acute management of these injuries on battlefield. MATERIALS AND METHODS We have developed a novel speckle contrast diffuse correlation tomography (scDCT) system for noncontact 3D imaging of tissue BF distributions. In scDCT, a galvo mirror was used to remotely project near-infrared point light to different source positions and an electron multiplying charge-coupled-device was used to detect boundary diffuse speckle contrasts. The normalized boundary data were then inserted into a modified Near-Infrared Fluorescence and Spectral Tomography program for 3D reconstructions of BF distributions. This article reports the first application of scDCT for noncontact 3D imaging of BF distributions in burn wounds. RESULTS Significant lower BF values were observed in the burned areas/volumes compared to surrounding normal tissues. CONCLUSIONS The unique noncontact 3D imaging capability makes the scDCT applicable for intraoperative assessment of burns/wounds, without risk of infection and without interfering with sterility of the surgical field. The portable scDCT device holds the potential to be used by surgeons in combat surgical hospitals to improve the acute management of battlefield burn injuries.
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Affiliation(s)
- Mingjun Zhao
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, 143 Graham Ave, Lexington, KY 40508
| | - Siavash Mazdeyasna
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, 143 Graham Ave, Lexington, KY 40508
| | - Chong Huang
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, 143 Graham Ave, Lexington, KY 40508
| | - Nneamaka Agochukwu-Nwubah
- Division of Plastic Surgery, University of Kentucky, 1000 S. Limestone, Lexington, KY 40536 Guarantor: Guoqaing Yu Presented as a poster at the 2018 Military Health System Research Symposium, August 2018, Kissimmee, FL; abstract # MHSRS-18-1688. The views expressed in this article are those of the authors and do not necessarily represent National Institutes of Health, American Heart Association, National Endowment for Plastic Surgery, National Science Foundation or University of the Kentucky
| | - Alisha Bonaroti
- Division of Plastic Surgery, University of Kentucky, 1000 S. Limestone, Lexington, KY 40536 Guarantor: Guoqaing Yu Presented as a poster at the 2018 Military Health System Research Symposium, August 2018, Kissimmee, FL; abstract # MHSRS-18-1688. The views expressed in this article are those of the authors and do not necessarily represent National Institutes of Health, American Heart Association, National Endowment for Plastic Surgery, National Science Foundation or University of the Kentucky
| | - Lesley Wong
- Division of Plastic Surgery, University of Kentucky, 1000 S. Limestone, Lexington, KY 40536 Guarantor: Guoqaing Yu Presented as a poster at the 2018 Military Health System Research Symposium, August 2018, Kissimmee, FL; abstract # MHSRS-18-1688. The views expressed in this article are those of the authors and do not necessarily represent National Institutes of Health, American Heart Association, National Endowment for Plastic Surgery, National Science Foundation or University of the Kentucky
| | - Guoqiang Yu
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, 143 Graham Ave, Lexington, KY 40508
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20
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Ioussoufovitch S, Morrison LB, Desjardins L, Hadway JA, Lawrence KS, Lee TY, Beier F, Diop M. Quantification of joint blood flow by dynamic contrast-enhanced near-infrared spectroscopy: application to monitoring disease activity in a rat model of rheumatoid arthritis. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-10. [PMID: 31939225 PMCID: PMC6983648 DOI: 10.1117/1.jbo.25.1.015003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 12/06/2019] [Indexed: 05/11/2023]
Abstract
Significance Current guidelines for rheumatoid arthritis (RA) management recommend early treatment with disease modifying antirheumatic drugs (DMARDs). However, DMARD treatment fails in 30% of patients and current monitoring methods can only detect failure after 3 to 6 months of therapy. Aim We investigated whether joint blood flow (BF), quantified using dynamic contrast-enhanced time-resolved near-infrared spectroscopy, can monitor disease activity and treatment response in a rat model of RA. Approach Ankle joint BF was measured every 5 days in eight rats with adjuvant-induced arthritis (AIA) and four healthy controls. Arthritis was allowed to progress for 20 days before rats with AIA were treated with a DMARD once every 5 days until day 40. Results Time and group had separate significant main effects on joint BF; however, there was no significant interaction between time and group despite a notable difference in average joint BF on day 5. Comparison of individual blood flow measures between rats with AIA and control group animals did not reveal a clear response to treatment. Conclusions Joint BF time courses could not distinguish between rats with AIA and study controls. Heterogeneous disease response and low temporal frequency of BF measurements may have been important study limitations.
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Affiliation(s)
- Seva Ioussoufovitch
- Western University, Bone and Joint Institute, School of Biomedical Engineering, Faculty of Engineering, London, Ontario, Canada
| | - Laura B. Morrison
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
| | - Lise Desjardins
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
| | - Jennifer A. Hadway
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
| | - Keith St. Lawrence
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Schulich School of Medicine and Dentistry, Department of Medical Biophysics, London, Ontario, Canada
| | - Ting-Yim Lee
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Schulich School of Medicine and Dentistry, Department of Medical Biophysics, London, Ontario, Canada
- Robarts Research Institute, Imaging Program, London, Ontario, Canada
| | - Frank Beier
- Western University, Schulich School of Medicine and Dentistry, Department of Physiology and Pharmacology, London, Ontario, Canada
| | - Mamadou Diop
- Western University, Bone and Joint Institute, School of Biomedical Engineering, Faculty of Engineering, London, Ontario, Canada
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Schulich School of Medicine and Dentistry, Department of Medical Biophysics, London, Ontario, Canada
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21
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Tucker WJ, Rosenberry R, Trojacek D, Sanchez B, Bentley RF, Haykowsky MJ, Tian F, Nelson MD. Near-infrared diffuse correlation spectroscopy tracks changes in oxygen delivery and utilization during exercise with and without isolated arterial compression. Am J Physiol Regul Integr Comp Physiol 2019; 318:R81-R88. [PMID: 31746636 DOI: 10.1152/ajpregu.00212.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Near-infrared diffuse correlation spectroscopy (NIR-DCS) is an emerging technology for simultaneous measurement of skeletal muscle microvascular oxygen delivery and utilization during exercise. The extent to which NIR-DCS can track acute changes in oxygen delivery and utilization has not yet been fully established. To address this knowledge gap, 14 healthy men performed rhythmic handgrip exercise at 30% maximal voluntary contraction, with and without isolated brachial artery compression, designed to acutely reduce convective oxygen delivery to the exercising muscle. Radial artery blood flow (Duplex Ultrasound) and NIR-DCS derived variables [blood flow index (BFI), tissue oxygen saturation (StO2), and metabolic rate of oxygen (MRO2)] were simultaneously measured. During exercise, both radial artery blood flow (+51.6 ± 20.3 mL/min) and DCS-derived BFI (+155.0 ± 82.2%) increased significantly (P < 0.001), whereas StO2 decreased -7.9 ± 6.2% (P = 0.002) from rest. Brachial artery compression during exercise caused a significant reduction in both radial artery blood flow (-32.0 ± 19.5 mL/min, P = 0.001) and DCS-derived BFI (-57.3 ± 51.1%, P = 0.01) and a further reduction of StO2 (-5.6 ± 3.8%, P = 0.001) compared with exercise without compression. MRO2 was not significantly reduced during arterial compression (P = 0.83) due to compensatory reductions in StO2, driven by increases in deoxyhemoglobin/myoglobin (+7.1 ± 6.1 μM, P = 0.01; an index of oxygen extraction). Together, these proof-of-concept data help to further validate NIR-DCS as an effective tool to assess the determinants of skeletal muscle oxygen consumption at the level of the microvasculature during exercise.
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Affiliation(s)
- Wesley J Tucker
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas.,College of Nursing, University of Texas at Arlington, Arlington, Texas.,Department of Nutrition & Food Sciences, Texas Woman's University, Houston, Texas
| | - Ryan Rosenberry
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Darian Trojacek
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Belinda Sanchez
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Robert F Bentley
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Mark J Haykowsky
- College of Nursing, University of Texas at Arlington, Arlington, Texas
| | - Fenghua Tian
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas.,Department of Bioengineering, University of Texas at Arlington, Arlington, Texas
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22
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Quaresima V, Farzam P, Anderson P, Farzam PY, Wiese D, Carp SA, Ferrari M, Franceschini MA. Diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy for measuring microvascular blood flow in dynamically exercising human muscles. J Appl Physiol (1985) 2019; 127:1328-1337. [PMID: 31513443 DOI: 10.1152/japplphysiol.00324.2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In the last 20 yr, near-infrared diffuse correlation spectroscopy (DCS) has been developed for providing a noninvasive estimate of microvascular blood flow (BF) as a BF index (BFi) in the human skin, muscle, breast, brain, and other tissue types. In this study, we proposed a new motion correction algorithm for DCS-derived BFi able to remove motion artifacts during cycling exercise. We tested this algorithm on DCS data collected during cycling exercise and demonstrated that DCS can be used to quantify muscle BFi during dynamic high-intensity exercise. In addition, we measured tissue regional oxygen metabolic rate (MRO2i) by combining frequency-domain multidistance near-infrared spectroscopy (FDNIRS) oximetry with DCS flow measures. Recreationally active subjects (n = 12; 31 ± 8 yr, 183 ± 4 cm, 79 ± 10 kg) pedaled at 80-100 revolutions/min until volitional fatigue with a work rate increase of 30 W every 4 min. Exercise intensity was normalized in each subject to the cycling power peak (Wpeak). Both rectus femoris BFi and MRO2i increased from 15% up to 75% Wpeak and then plateaued to the end of the exercise. During the recovery at 30 W cycling power, BFi remained almost constant, whereas MRO2i started to decrease. The BFi/MRO2i plateau was associated with the rising of the lactate concentration, indicating the progressive involvement of the anaerobic metabolism. These findings further highlight the utility of DCS and FDNIRS oximetry as effective, reproducible, and noninvasive techniques to assess muscle BFi and MRO2i in real time during a dynamic exercise such as cycling.NEW & NOTEWORTHY To the best of our knowledge, this study is the first to demonstrate that diffuse correlation spectroscopy in combination with frequency-domain near-infrared spectroscopy can monitor human quadriceps microvascular blood flow and oxygen metabolism with high temporal resolution during a cycling exercise. The optically measured parameters confirm the expected relationship between blood flow, muscle oxidative metabolism, and lactate production during exercise.
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Affiliation(s)
- Valentina Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Parisa Farzam
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | | | - Parya Y Farzam
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | | | - Stefan A Carp
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Marco Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Angela Franceschini
- Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
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23
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Rosenberry R, Tucker WJ, Haykowsky MJ, Trojacek D, Chamseddine HH, Arena-Marshall CA, Zhu Y, Wang J, Kellawan JM, Tian F, Nelson MD. Determinants of skeletal muscle oxygen consumption assessed by near-infrared diffuse correlation spectroscopy during incremental handgrip exercise. J Appl Physiol (1985) 2019; 127:698-706. [PMID: 31318612 DOI: 10.1152/japplphysiol.00273.2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Near-infrared diffuse correlation spectroscopy (DCS) is a rapidly evolving optical imaging technique for the assessment of skeletal muscle O2 utilization (mVO2). We compared DCS-derived determinants of mVO2 with conventional measures [blood flow by brachial artery Doppler ultrasound and venous O2 saturation (SVO2)] in eight volunteers at rest and during incremental handgrip exercise. Brachial artery blood flow and DCS-derived blood flow index (BFI) were linearly related (R2 = 0.57) and increased with each workload, whereas SVO2 decreased from 65.3 ± 2.5% (rest) to 39.9 ± 3.0% (light exercise; P < 0.01) with no change thereafter. In contrast, DCS-derived tissue O2 saturation decreased progressively with each incremental stage (P < 0.01), driven almost entirely by an initial steep rise in deoxyhemoglobin/myoglobin, followed by a linear increase thereafter. Whereas seemingly disparate at first glance, we believe these two approaches provide similar information. Indeed, by plotting the mean convective O2 delivery and diffusive O2 conductance, we show that the initial increase in mVO2 during the transition from rest to exercise was achieved by a greater increase in diffusive O2 conductance versus convective O2 delivery (10-fold vs. 4-fold increase, respectively), explaining the initial decline in SVO2. In contrast, the increase in mVO2 from light to heavy exercise was achieved by equal increases (1.8-fold) in convective O2 delivery and diffusive O2 conductance, explaining the plateau in SVO2. That DCS-derived BFI and deoxyhemoglobin/myoglobin (surrogate measure of O2 extraction) share the same general biphasic pattern suggests that both DCS and conventional approaches provide complementary information regarding the determinants of mVO2.NEW & NOTEWORTHY Near-infrared diffuse correlation spectroscopy (DCS) is an emerging optical imaging technique for quantifying skeletal muscle O2 delivery and utilization at the microvascular level. Here, we show that DCS provides complementary insight into the determinants of muscle O2 consumption across a wide range of exercise intensities, further establishing the utility of DCS.
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Affiliation(s)
- Ryan Rosenberry
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Wesley J Tucker
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas.,College of Nursing, University of Texas at Arlington, Arlington, Texas
| | - Mark J Haykowsky
- College of Nursing, University of Texas at Arlington, Arlington, Texas
| | - Darian Trojacek
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Houda H Chamseddine
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | | | - Ye Zhu
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas
| | - Jing Wang
- College of Nursing, University of Texas at Arlington, Arlington, Texas
| | - J Mikhail Kellawan
- Department of Health and Exercise Science, The University of Oklahoma, Norman, Oklahoma
| | - Fenghua Tian
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas.,Department of Bioengineering, University of Texas at Arlington, Arlington, Texas
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24
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Tucker WJ, Rosenberry R, Trojacek D, Chamseddine HH, Arena-Marshall CA, Zhu Y, Wang J, Kellawan JM, Haykowsky MJ, Tian F, Nelson MD. Studies into the determinants of skeletal muscle oxygen consumption: novel insight from near-infrared diffuse correlation spectroscopy. J Physiol 2019; 597:2887-2901. [PMID: 30982990 DOI: 10.1113/jp277580] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/10/2019] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS Diffuse correlation spectroscopy (DCS) is emerging as a powerful tool to assess skeletal muscle perfusion. Near-infrared spectroscopy (NIRS) is an established technique for characterizing the transport and utilization of oxygen through the microcirculation. Here we compared a combined NIRS-DCS system with conventional measures of oxygen delivery and utilization during handgrip exercise. The data show good concurrent validity between convective oxygen delivery and DCS-derived blood flow index, as well as between oxygen extraction at the conduit and microvascular level. We then manipulated forearm arterial perfusion pressure by adjusting the position of the exercising arm relative to the position of the heart. The data show that microvascular perfusion can be uncoupled from convective oxygen delivery, and that tissue saturation seemingly compensates to maintain skeletal muscle oxygen consumption. Taken together, these data support a novel role for NIRS-DCS in understanding the determinants of muscle oxygen consumption at the microvascular level. ABSTRACT Diffuse correlation spectroscopy (DCS) is emerging as a powerful tool to assess skeletal muscle perfusion. Combining DCS with near-infrared spectroscopy (NIRS) introduces exciting possibilities for understanding the determinants of muscle oxygen consumption; however, no investigation has directly compared NIRS-DCS to conventional measures of oxygen delivery and utilization in an exercising limb. To address this knowledge gap, nine healthy males performed rhythmic handgrip exercise with simultaneous measurements by NIRS-DCS, Doppler blood flow and venous oxygen content. The two approaches showed good concurrent validity, with directionally similar responses between: (a) Doppler-derived forearm blood flow and DCS-derived blood flow index (BFI), and (b) venous oxygen saturation and NIRS-derived tissue saturation. To explore the utility of combined NIRS-DCS across the physiological spectrum, we manipulated forearm arterial perfusion pressure by altering the arm position above or below the level of the heart. As expected, Doppler-derived skeletal muscle blood flow increased with exercise in both arm positions, but with markedly different magnitudes (below: +424.3 ± 41.4 ml/min, above: +306 ± 12.0 ml/min, P = 0.002). In contrast, DCS-derived microvascular BFI increased to a similar extent with exercise, regardless of arm position (P = 0.65). Importantly, however, the time to reach BFI steady state was markedly slower with the arm above the heart, supporting the experimental design. Notably, we observed faster tissue desaturation at the onset of exercise with the arm above the heart, resulting in similar muscle oxygen consumption profiles throughout exercise. Taken together, these data support a novel role for NIRS-DCS in understanding the determinants of skeletal muscle oxygen utilization non-invasively and throughout exercise.
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Affiliation(s)
- Wesley J Tucker
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA.,College of Nursing, University of Texas at Arlington, Arlington, TX, USA
| | - Ryan Rosenberry
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Darian Trojacek
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Houda H Chamseddine
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | | | - Ye Zhu
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Jing Wang
- College of Nursing, University of Texas at Arlington, Arlington, TX, USA
| | - J Mikhail Kellawan
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Mark J Haykowsky
- College of Nursing, University of Texas at Arlington, Arlington, TX, USA
| | - Fenghua Tian
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA.,Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
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25
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Local In Vivo Measures of Muscle Lipid and Oxygen Consumption Change in Response to Combined Vitamin D Repletion and Aerobic Training in Older Adults. Nutrients 2019; 11:nu11040930. [PMID: 31027191 PMCID: PMC6521174 DOI: 10.3390/nu11040930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 12/31/2022] Open
Abstract
Intramyocellular (IMCL), extramyocellular lipid (EMCL), and vitamin D deficiency are associated with muscle metabolic dysfunction. This study compared the change in [IMCL]:[EMCL] following the combined treatment of vitamin D and aerobic training (DAT) compared with vitamin D (D), aerobic training (AT), and control (CTL). Male and female subjects aged 60–80 years with a BMI ranging from 18.5–34.9 and vitamin D status of ≤32 ng/mL (25(OH)D) were recruited to randomized, prospective clinical trial double-blinded for supplement with a 2 × 2 factorial design. Cholecalciferol (Vitamin D3) (10,000 IU × 5 days/week) or placebo was provided for 13 weeks and treadmill aerobic training during week 13. Gastrocnemius IMCL and EMCL were measured with magnetic resonance spectroscopy (MRS) and MRI. Hybrid near-infrared diffuse correlation spectroscopy measured hemodynamics. Group differences in IMCL were observed when controlling for baseline IMCL (p = 0.049). DAT was the only group to reduce IMCL from baseline, while a mean increase was observed in all other groups combined (p = 0.008). IMCL reduction and the corresponding increase in rVO2 at study end (p = 0.011) were unique to DAT. Vitamin D, when combined with exercise, may potentiate the metabolic benefits of exercise by reducing IMCL and increasing tissue-level VO2 in healthy, older adults.
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26
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Farzam P, Starkweather Z, Franceschini MA. Validation of a novel wearable, wireless technology to estimate oxygen levels and lactate threshold power in the exercising muscle. Physiol Rep 2019; 6:e13664. [PMID: 29611324 PMCID: PMC5880957 DOI: 10.14814/phy2.13664] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 02/23/2018] [Indexed: 01/28/2023] Open
Abstract
There is a growing interest in monitoring muscle oxygen saturation (SmO2), which is a localized measure of muscle oxidative metabolism and can be acquired continuously and noninvasively using near‐infrared spectroscopy (NIRS) methods. Most NIRS systems are cumbersome, expensive, fiber coupled devices, with use limited to lab settings. A novel, low cost, wireless, wearable has been developed for use in athletic training. In this study, we evaluate the advantages and limitations of this new simple continuous‐wave (CW) NIRS device with respect to a benchtop, frequency‐domain near‐infrared spectroscopy (FDNIRS) system. Oxygen saturation and hemoglobin/myoglobin concentration in the exercising muscles of 17 athletic individuals were measured simultaneously with the two systems, while subjects performed an incremental test on a stationary cycle ergometer. In addition, blood lactate concentration was measured at the end of each increment with a lactate analyzer. During exercise, the correlation coefficients of the SmO2 and hemoglobin/myoglobin concentrations between the two systems were over 0.70. We also found both systems were insensitive to the presence of thin layers of varying absorption, mimicking different skin colors. Neither system was able to predict the athletes’ lactate threshold power accurately by simply using SmO2 thresholds. Instead, the proprietary software of the wearable device was able to predict the athletes’ lactate threshold power within half of one power increment of the cycling test. These results indicate this novel wearable device may provide a physiological indicator of athlete's exertion.
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Affiliation(s)
- Parisa Farzam
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zack Starkweather
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maria A Franceschini
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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27
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Portable Near-Infrared Technologies and Devices for Noninvasive Assessment of Tissue Hemodynamics. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:3750495. [PMID: 30891170 PMCID: PMC6390246 DOI: 10.1155/2019/3750495] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/24/2018] [Accepted: 01/14/2019] [Indexed: 12/29/2022]
Abstract
Tissue hemodynamics, including the blood flow, oxygenation, and oxygen metabolism, are closely associated with many diseases. As one of the portable optical technologies to explore human physiology and assist in healthcare, near-infrared diffuse optical spectroscopy (NIRS) for tissue oxygenation measurement has been developed for four decades. In recent years, a dynamic NIRS technology, namely, diffuse correlation spectroscopy (DCS), has been emerging as a portable tool for tissue blood flow measurement. In this article, we briefly describe the basic principle and algorithms for static NIRS and dynamic NIRS (i.e., DCS). Then, we elaborate on the NIRS instrumentation, either commercially available or custom-made, as well as their applications to physiological studies and clinic. The extension of NIRS/DCS from spectroscopy to imaging was depicted, followed by introductions of advanced algorithms that were recently proposed. The future prospective of the NIRS/DCS and their feasibilities for routine utilization in hospital is finally discussed.
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28
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Nyberg SK, Berg OK, Helgerud J, Wang E. Reliability of forearm oxygen uptake during handgrip exercise: assessment by ultrasonography and venous blood gas. Physiol Rep 2018; 6:e13696. [PMID: 29845765 PMCID: PMC5974736 DOI: 10.14814/phy2.13696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 01/18/2023] Open
Abstract
Assessment of forearm oxygen uptake (V˙O2 ) during handgrip exercise is a keenly investigated concept for observing small muscle mass metabolism. Although a combination of Doppler ultrasound measurements of brachial artery blood flow (Q˙) and blood gas drawn from a deep forearm vein has been utilized to calculate forearm V˙O2 for more than two decades, the applicability of this experimental design may benefit from a thorough evaluation of its reliability during graded exercise. Therefore, we evaluated the reliability of this technique during incremental handgrip exercise in ten healthy young (24 ± 3(SD) years.) males. V˙O2 and work rate (WR) exhibited a linear relationship (1.0 W: 43.8 ± 10.1 mL·min-1 ; 1.5 W: 53.8 ± 14.1 mL·min-1 ; 2.0 W: 63.4 ± 16.3 mL·min-1 ; 2.5 W: 72.2 ± 17.6 mL·min-1 ; 3.0 W: 79.2 ± 18.6 mL·min-1 ; r = 0.65, P < 0.01). In turn, V˙O2 was strongly associated with Q˙ (1.0 W: 359 ± 86 mL·min-1 ; 1.5 W: 431 ± 112 mL·min-1 ; 2.0 W: 490 ± 123 mL·min-1 ; 2.5 W: 556 ± 112 mL·min-1 ; 3.0 W: 622 ± 131 mL·min-1 ; r = 0.96; P < 0.01), whereas arteriovenous oxygen difference (a-vO2diff ) remained constant following all WRs (123 ± 11-130 ± 10 mL·L-1 ). Average V˙O2 test-retest difference was -0.4 mL·min-1 with ±2SD limits of agreement (LOA) of 8.4 and -9.2 mL·min-1 , respectively, whereas coefficients of variation (CVs) ranged from 4-7%. Accordingly, test-retest Q˙ difference was 11.9 mL·min-1 (LOA: 84.1 mL·min-1 ; -60.4 mL·min-1 ) with CVs between 4 and 7%. Test-retest difference for a-vO2diff was -0.28 mL·dL-1 (LOA: 1.26mL·dL-1 ; -1.82 mL·dL-1 ) with 3-5% CVs. In conclusion, our results revealed that forearm V˙O2 determination by Doppler ultrasound and direct venous sampling is linearly related to WR, and a reliable experimental design across a range of exercise intensities.
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Affiliation(s)
- Stian K. Nyberg
- Department of Circulation and Medical ImagingFaculty of MedicineNorwegian University of Science and TechnologyTrondheimNorway
| | - Ole Kristian Berg
- Faculty of Health and Social SciencesMolde University CollegeMoldeNorway
| | - Jan Helgerud
- Department of Circulation and Medical ImagingFaculty of MedicineNorwegian University of Science and TechnologyTrondheimNorway
| | - Eivind Wang
- Department of Circulation and Medical ImagingFaculty of MedicineNorwegian University of Science and TechnologyTrondheimNorway
- Faculty of Health and Social SciencesMolde University CollegeMoldeNorway
- Department of Internal MedicineUniversity of UtahSalt Lake CityUtah
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29
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Hammer SM, Alexander AM, Didier KD, Smith JR, Caldwell JT, Sutterfield SL, Ade CJ, Barstow TJ. The noninvasive simultaneous measurement of tissue oxygenation and microvascular hemodynamics during incremental handgrip exercise. J Appl Physiol (1985) 2018; 124:604-614. [DOI: 10.1152/japplphysiol.00815.2017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Limb blood flow increases linearly with exercise intensity; however, invasive measurements of muscle microvascular blood flow during incremental exercise have demonstrated submaximal plateaus. We tested the hypotheses that 1) brachial artery blood flow (Q̇BA) would increase with increasing exercise intensity until task failure, 2) blood flow index of the flexor digitorum superficialis (BFIFDS) measured noninvasively via diffuse correlation spectroscopy would plateau at a submaximal work rate, and 3) muscle oxygenation characteristics (total-[heme], deoxy-[heme], and percentage saturation) measured noninvasively with near-infrared spectroscopy would demonstrate a plateau at a similar work rate as BFIFDS. Sixteen subjects (23.3 ± 3.9 yr, 170.8 ± 1.9 cm, 72.8 ± 3.4 kg) participated in this study. Peak power (Ppeak) was determined for each subject (1.8 ± 0.4 W) via an incremental handgrip exercise test. Q̇BA, BFIFDS, total-[heme], deoxy-[heme], and percentage saturation were measured during each stage of the exercise test. On a subsequent testing day, muscle activation measurements of the FDS (RMSFDS) were collected during each stage of an identical incremental handgrip exercise test via electromyography from a subset of subjects ( n = 7). Q̇BA increased with exercise intensity until the final work rate transition ( P < 0.05). No increases in BFIFDS or muscle oxygenation characteristics were observed at exercise intensities greater than 51.5 ± 22.9% of Ppeak. No submaximal plateau in RMSFDS was observed. Whereas muscle activation of the FDS increased until task failure, noninvasively measured indices of perfusive and diffusive muscle microvascular oxygen delivery demonstrated submaximal plateaus. NEW & NOTEWORTHY Invasive measurements of muscle microvascular blood flow during incremental exercise have demonstrated submaximal plateaus. We demonstrate that indices of perfusive and diffusive microvascular oxygen transport to skeletal muscle, measured completely noninvasively, plateau at submaximal work rates during incremental exercise, even though limb blood flow and muscle recruitment continued to increase.
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Affiliation(s)
- Shane M. Hammer
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | | | - Kaylin D. Didier
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Joshua R. Smith
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Jacob T. Caldwell
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | | | - Carl J. Ade
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Thomas J. Barstow
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
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30
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Rosenberry R, Chung S, Nelson MD. Skeletal Muscle Neurovascular Coupling, Oxidative Capacity, and Microvascular Function with 'One Stop Shop' Near-infrared Spectroscopy. J Vis Exp 2018. [PMID: 29553570 DOI: 10.3791/57317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Exercise represents a major hemodynamic stress that demands a highly coordinated neurovascular response in order to match oxygen delivery to metabolic demand. Reactive hyperemia (in response to a brief period of tissue ischemia) is an independent predictor of cardiovascular events and provides important insight into vascular health and vasodilatory capacity. Skeletal muscle oxidative capacity is equally important in health and disease, as it determines the energy supply for myocellular processes. Here, we describe a simple, non-invasive approach using near-infrared spectroscopy to assess each of these major clinical endpoints (reactive hyperemia, neurovascular coupling, and muscle oxidative capacity) during a single clinic or laboratory visit. Unlike Doppler ultrasound, magnetic resonance images/spectroscopy, or invasive catheter-based flow measurements or muscle biopsies, our approach is less operator-dependent, low-cost, and completely non-invasive. Representative data from our lab taken together with summary data from previously published literature illustrate the utility of each of these end-points. Once this technique is mastered, application to clinical populations will provide important mechanistic insight into exercise intolerance and cardiovascular dysfunction.
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Affiliation(s)
- Ryan Rosenberry
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington
| | - Susie Chung
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington
| | - Michael D Nelson
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington;
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Bangalore-Yogananda CG, Rosenberry R, Soni S, Liu H, Nelson MD, Tian F. Concurrent measurement of skeletal muscle blood flow during exercise with diffuse correlation spectroscopy and Doppler ultrasound. BIOMEDICAL OPTICS EXPRESS 2018; 9:131-141. [PMID: 29359092 PMCID: PMC5772569 DOI: 10.1364/boe.9.000131] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/26/2017] [Accepted: 12/05/2017] [Indexed: 06/01/2023]
Abstract
Noninvasive, direct measurement of local muscle blood flow in humans remains limited. Diffuse correlation spectroscopy (DCS) is an emerging technique to measure regional blood flow at the microvascular level. In order to better understand the strengths and limitations of this novel technique, we performed a validation study by comparing muscle blood flow changes measured with DCS and Doppler ultrasound during exercise. Nine subjects were measured (all males, 27.4 ± 2.9 years of age) for a rhythmic handgrip exercise at 20% and 50% of individual maximum voluntary contraction (MVC), followed by a post-exercise recovery. The results from DCS and Doppler ultrasound were highly correlated (R = 0.99 ± 0.02). DCS was more reliable and less susceptible to motion artifact.
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Affiliation(s)
- Chandan-Ganesh Bangalore-Yogananda
- Department of Bioengineering, The University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA
- Two authors contributed equally
| | - Ryan Rosenberry
- Department of Kinesiology, The University of Texas at Arlington, 411 S. Nedderman Dr., Arlington, TX 76010, USA
- Two authors contributed equally
| | - Sagar Soni
- Department of Bioengineering, The University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA
| | - Hanli Liu
- Department of Bioengineering, The University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA
| | - Michael D. Nelson
- Department of Bioengineering, The University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA
- Department of Kinesiology, The University of Texas at Arlington, 411 S. Nedderman Dr., Arlington, TX 76010, USA
| | - Fenghua Tian
- Department of Bioengineering, The University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA
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Baker WB, Li Z, Schenkel SS, Chandra M, Busch DR, Englund EK, Schmitz KH, Yodh AG, Floyd TF, Mohler ER. Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease. J Appl Physiol (1985) 2017; 123:1599-1609. [PMID: 28982943 PMCID: PMC5814687 DOI: 10.1152/japplphysiol.00585.2017] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/28/2017] [Accepted: 10/03/2017] [Indexed: 12/28/2022] Open
Abstract
We employed near-infrared optical techniques, diffuse correlation spectroscopy (DCS), and frequency-domain near-infrared spectroscopy (FD-NIRS) to test the hypothesis that supervised exercise training increases skeletal muscle microvascular blood flow and oxygen extraction in patients with peripheral artery disease (PAD) who experience claudication. PAD patients ( n = 64) were randomly assigned to exercise and control groups. Patients in the exercise group received 3 mo of supervised exercise training. Calf muscle blood flow and oxygen extraction were optically monitored before, during, and after performance of a graded treadmill protocol at baseline and at 3 mo in both groups. Additionally, measurements of the ankle-brachial index (ABI) and peak walking time (PWT) to maximal claudication were made during each patient visit. Supervised exercise training was found to increase the maximal calf muscle blood flow and oxygen extraction levels during treadmill exercise by 29% (13%, 50%) and 8% (1%, 12%), respectively [ P < 0.001; median (25th percentile, 75th percentile)]. These improvements across the exercise group population were significantly higher than corresponding changes in the control group ( P < 0.004). Exercise training also increased PWT by 49% (18%, 101%) ( P = 0.01). However, within statistical error, the ABI, resting calf muscle blood flow and oxygen extraction, and the recovery half-time for hemoglobin\myoglobin desaturation following cessation of maximal exercise were not altered by exercise training. The concurrent monitoring of both blood flow and oxygen extraction with the hybrid DCS/FD-NIRS instrument revealed enhanced muscle oxidative metabolism during physical activity from exercise training, which could be an underlying mechanism for the observed improvement in PWT. NEW & NOTEWORTHY We report on noninvasive optical measurements of skeletal muscle blood flow and oxygen extraction dynamics before/during/after treadmill exercise in peripheral artery disease patients who experience claudication. The measurements tracked the effects of a 3-mo supervised exercise training protocol and revealed that supervised exercise training improved patient ability to increase microvascular calf muscle blood flow and oxygen extraction during physical activity.
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Affiliation(s)
- Wesley B Baker
- Department of Physics and Astronomy, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Zhe Li
- Department of Physics and Astronomy, University of Pennsylvania , Philadelphia, Pennsylvania
- School of Information and Communication Engineering, Beijing University of Technology , Beijing , China
| | - Steven S Schenkel
- Department of Physics and Astronomy, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Malavika Chandra
- Department of Physics and Astronomy, University of Pennsylvania , Philadelphia, Pennsylvania
| | - David R Busch
- Department of Physics and Astronomy, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Erin K Englund
- Department of Radiology, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Kathryn H Schmitz
- Department of Biostatistics and Epidemiology, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Thomas F Floyd
- Department of Anesthesiology, Stony Brook University Medical Center , Stony Brook, New York
| | - Emile R Mohler
- Department of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
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33
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Shang Y, Li T, Yu G. Clinical applications of near-infrared diffuse correlation spectroscopy and tomography for tissue blood flow monitoring and imaging. Physiol Meas 2017; 38:R1-R26. [PMID: 28199219 PMCID: PMC5726862 DOI: 10.1088/1361-6579/aa60b7] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Blood flow is one such available observable promoting a wealth of physiological insight both individually and in combination with other metrics. APPROACH Near-infrared diffuse correlation spectroscopy (DCS) and, to a lesser extent, diffuse correlation tomography (DCT), have increasingly received interest over the past decade as noninvasive methods for tissue blood flow measurements and imaging. DCS/DCT offers several attractive features for tissue blood flow measurements/imaging such as noninvasiveness, portability, high temporal resolution, and relatively large penetration depth (up to several centimeters). MAIN RESULTS This review first introduces the basic principle and instrumentation of DCS/DCT, followed by presenting clinical application examples of DCS/DCT for the diagnosis and therapeutic monitoring of diseases in a variety of organs/tissues including brain, skeletal muscle, and tumor. SIGNIFICANCE Clinical study results demonstrate technical versatility of DCS/DCT in providing important information for disease diagnosis and intervention monitoring.
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Affiliation(s)
- Yu Shang
- Key Laboratory of Instrumentation Science & Dynamic Measurement, North University of China, No.3 Xueyuan Road, Taiyuan, Shanxi 030051, China
| | - Ting Li
- State Key Lab Elect Thin Film & Integrated Device, University of Electronic Science & Technology of China, Chengdu, Sichuan 610054, China
| | - Guoqiang Yu
- Department of Biomedical Engineering, University of Kentucky, 514C RMB, 143 Graham Avenue, Lexington, KY 40506-0108, USA
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Nyberg SK, Berg OK, Helgerud J, Wang E. Blood flow regulation and oxygen uptake during high-intensity forearm exercise. J Appl Physiol (1985) 2017; 122:907-917. [PMID: 28057820 DOI: 10.1152/japplphysiol.00983.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/20/2016] [Accepted: 01/03/2017] [Indexed: 12/29/2022] Open
Abstract
The vascular strain is very high during heavy handgrip exercise, but the intensity and kinetics to reach peak blood flow, and peak oxygen uptake, are uncertain. We included 9 young (25 ± 2 yr) healthy males to evaluate blood flow and oxygen uptake responses during continuous dynamic handgrip exercise with increasing intensity. Blood flow was measured using Doppler-ultrasound, and venous blood was drawn from a deep forearm vein to determine arteriovenous oxygen difference (a-vO2diff) during 6-min bouts of 60, 80, and 100% of maximal work rate (WRmax), respectively. Blood flow and oxygen uptake increased (P < 0.05) from 60%WRmax [557 ± 177(SD) ml/min; 56.0 ± 21.6 ml/min] to 80%WRmax (679 ± 190 ml/min; 70.6 ± 24.8 ml/min), but no change was seen from 80%WRmax to 100%WRmax Blood velocity (49.5 ± 11.5 to 58.1 ± 11.6 cm/s) and brachial diameter (0.49 ± 0.05 to 0.50 ± 0.06 cm) showed concomitant increases (P < 0.05) with blood flow from 60% to 80%WRmax, whereas no differences were observed in a-vO2diff Shear rate also increased (P < 0.05) from 60% (822 ± 196 s-1) to 80% (951 ± 234 s-1) of WRmax The mean response time (MRT) was slower (P < 0.05) for blood flow (60%WRmax 50 ± 22 s; 80%WRmax 51 ± 20 s; 100%WRmax 51 ± 23 s) than a-vO2diff (60%WRmax 29 ± 9 s; 80%WRmax 29 ± 5 s; 100%WRmax 20 ± 5 s), but not different from oxygen uptake (60%WRmax 44 ± 25 s; 80%WRmax 43 ± 14 s; 100%WRmax 41 ± 32 s). No differences were observed in MRT for blood flow or oxygen uptake with increased exercise intensity. In conclusion, when approaching maximal intensity, oxygen uptake appeared to reach a critical level at ~80% of WRmax and be regulated by blood flow. This implies that high, but not maximal, exercise intensity may be an optimal stimulus for shear stress-induced small muscle mass training adaptations.NEW & NOTEWORTHY This study evaluated blood flow regulation and oxygen uptake during small muscle mass forearm exercise with high to maximal intensity. Despite utilizing only a fraction of cardiac output, blood flow reached a plateau at 80% of maximal work rate and regulated peak oxygen uptake. Furthermore, the results revealed that muscle contractions dictated bulk oxygen delivery and yielded three times higher peak blood flow in the relaxation phase compared with mean values.
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Affiliation(s)
- S K Nyberg
- Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Trondheim, Norway
| | - O K Berg
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
| | - J Helgerud
- Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Trondheim, Norway.,Hokksund Medical Rehabilitation Centre, Hokksund, Norway.,Department of Sports and Outdoor Life Studies, Telemark University College, Bø, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Trondheim, Norway; .,Department of Medicine, University of Utah, Salt Lake City, Utah; and.,Department of Research and Development, St. Olav's University Hospital, Trondheim, Norway
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35
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Rajaram A, Ioussoufovitch S, Morrison LB, St Lawrence K, Lee TY, Bureau Y, Diop M. Joint blood flow is more sensitive to inflammatory arthritis than oxyhemoglobin, deoxyhemoglobin, and oxygen saturation. BIOMEDICAL OPTICS EXPRESS 2016; 7:3843-3854. [PMID: 27867697 PMCID: PMC5102556 DOI: 10.1364/boe.7.003843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/23/2016] [Accepted: 08/28/2016] [Indexed: 05/11/2023]
Abstract
Joint hypoxia plays a central role in the progression and perpetuation of rheumatoid arthritis (RA). Thus, optical techniques that can measure surrogate markers of hypoxia such as blood flow, oxyhemoglobin, deoxyhemoglobin, and oxygen saturation are being developed to monitor RA. The purpose of the current study was to compare the sensitivity of these physiological parameters to arthritis. Experiments were conducted in a rabbit model of RA and the results revealed that joint blood flow was the most sensitive to arthritis and could detect a statistically significant difference (p<0.05, power = 0.8) between inflamed and healthy joints with a sample size of only four subjects. Considering that this a quantitative technique, the high sensitivity to arthritis suggests that joint perfusion has the potential to become a potent tool for monitoring disease progression and treatment response in RA.
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Affiliation(s)
- Ajay Rajaram
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Seva Ioussoufovitch
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Laura B. Morrison
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Keith St Lawrence
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Ting-Yim Lee
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
- Imaging Program, Robarts Research Institute, 100 Perth Drive, London, Ontario N6A 5K8, Canada
| | - Yves Bureau
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
| | - Mamadou Diop
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
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36
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Dong L, Kudrimoti M, Irwin D, Chen L, Kumar S, Shang Y, Huang C, Johnson EL, Stevens SD, Shelton BJ, Yu G. Diffuse optical measurements of head and neck tumor hemodynamics for early prediction of chemoradiation therapy outcomes. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:85004. [PMID: 27564315 PMCID: PMC4999482 DOI: 10.1117/1.jbo.21.8.085004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/08/2016] [Indexed: 05/03/2023]
Abstract
This study used a hybrid near-infrared diffuse optical instrument to monitor tumor hemodynamic responses to chemoradiation therapy for early prediction of treatment outcomes in patients with head and neck cancer. Forty-seven patients were measured once per week to evaluate the hemodynamic status of clinically involved cervical lymph nodes as surrogates for the primary tumor response. Patients were classified into two groups: complete response (CR) (n=29) and incomplete response (IR) (n=18). Tumor hemodynamic responses were found to be associated with clinical outcomes (CR/IR), wherein the associations differed depending on human papillomavirus (HPV-16) status. In HPV-16 positive patients, significantly lower levels in tumor oxygenated hemoglobin concentration ([HbO2]) at weeks 1 to 3, total hemoglobin concentration at week 3, and blood oxygen saturation (StO2) at week 3 were found in the IR group. In HPV-16 negative patients, significantly higher levels in tumor blood flow index and reduced scattering coefficient (μs′) at week 3 were observed in the IR group. These hemodynamic parameters exhibited significantly high accuracy for early prediction of clinical outcomes, within the first three weeks of therapy, with the areas under the receiver operating characteristic curves (AUCs) ranging from 0.83 to 0.96.
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Affiliation(s)
- Lixin Dong
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Mahesh Kudrimoti
- University of Kentucky College of Medicine, Department of Radiation Medicine, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Daniel Irwin
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Li Chen
- University of Kentucky, Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, Lexington, 800 Rose Street, Kentucky 40536, United States
- University of Kentucky College of Public Health, Department of Biostatistics, Lexington, 111 Washington Avenue, Kentucky 40536, United States
| | - Sameera Kumar
- University of Kentucky College of Medicine, Department of Radiation Medicine, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Yu Shang
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Chong Huang
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Ellis L. Johnson
- University of Kentucky College of Medicine, Department of Radiation Medicine, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Scott D. Stevens
- University of Kentucky College of Medicine, Department of Radiology, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Brent J. Shelton
- University of Kentucky, Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, Lexington, 800 Rose Street, Kentucky 40536, United States
- University of Kentucky College of Public Health, Department of Biostatistics, Lexington, 111 Washington Avenue, Kentucky 40536, United States
| | - Guoqiang Yu
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
- Address all correspondence to: Guoqiang Yu, E-mail:
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37
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Wang D, Parthasarathy AB, Baker WB, Gannon K, Kavuri V, Ko T, Schenkel S, Li Z, Li Z, Mullen MT, Detre JA, Yodh AG. Fast blood flow monitoring in deep tissues with real-time software correlators. BIOMEDICAL OPTICS EXPRESS 2016; 7:776-97. [PMID: 27231588 PMCID: PMC4866455 DOI: 10.1364/boe.7.000776] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 05/19/2023]
Abstract
We introduce, validate and demonstrate a new software correlator for high-speed measurement of blood flow in deep tissues based on diffuse correlation spectroscopy (DCS). The software correlator scheme employs standard PC-based data acquisition boards to measure temporal intensity autocorrelation functions continuously at 50 - 100 Hz, the fastest blood flow measurements reported with DCS to date. The data streams, obtained in vivo for typical source-detector separations of 2.5 cm, easily resolve pulsatile heart-beat fluctuations in blood flow which were previously considered to be noise. We employ the device to separate tissue blood flow from tissue absorption/scattering dynamics and thereby show that the origin of the pulsatile DCS signal is primarily flow, and we monitor cerebral autoregulation dynamics in healthy volunteers more accurately than with traditional instrumentation as a result of increased data acquisition rates. Finally, we characterize measurement signal-to-noise ratio and identify count rate and averaging parameters needed for optimal performance.
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Affiliation(s)
- Detian Wang
- Dept. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104
USA
- Interdisciplinary Laboratory of Physics and Biomedicine, Institute of Fluid Physics, China Academy of Engineering Physics, Mianyang 621900,
China
| | | | - Wesley B. Baker
- Dept. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104
USA
| | - Kimberly Gannon
- Div. of Stroke and Neurocritical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
USA
| | - Venki Kavuri
- Dept. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104
USA
| | - Tiffany Ko
- Dept. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104
USA
| | - Steven Schenkel
- Dept. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104
USA
| | - Zhe Li
- Dept. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104
USA
- State Key Laboratory of Precision Measurement Technology and Instruments, Tianjin University, Tianjin 300072,
China
| | - Zeren Li
- Interdisciplinary Laboratory of Physics and Biomedicine, Institute of Fluid Physics, China Academy of Engineering Physics, Mianyang 621900,
China
| | - Michael T. Mullen
- Div. of Stroke and Neurocritical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
USA
| | - John A. Detre
- Div. of Stroke and Neurocritical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
USA
| | - Arjun G. Yodh
- Dept. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104
USA
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38
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MasoudiMotlagh M, Sugar JJ, Azimipour M, Linz WW, Michalak G, Seo NJ, Ranji M. Monitoring hemodynamic changes in stroke-affected muscles using near-infrared spectroscopy. J Rehabil Assist Technol Eng 2015; 2:2055668315614195. [PMID: 31191919 PMCID: PMC6531806 DOI: 10.1177/2055668315614195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The oxygenation level of a tissue is an important marker of the health of the
tissue and has a direct effect on performance. It has been shown that the blood
flow to the paretic muscles of hemiparetic post-stroke patients is significantly
reduced compared to non-paretic muscles. It is hypothesized that hemodynamic
activity in paretic muscles is suppressed as compared to non-paretic muscles,
and that oximetry can be used to measure this disparity in real-time. In order
to test this hypothesis, a custom-made oximetry device was used to measure
hemodynamic activity in the forearm extensor muscles in post-stroke patients’
paretic and non-paretic sides and in a control population during three exercise
levels calibrated to the subject’s maximum effort. The change in oxygenation
(ΔOxy) and blood volume (ΔBV) were
calculated and displayed in real-time. Results show no apparent difference in
either ΔOxy or ΔBV between control subjects’
dominant and non-dominant muscles. However, the results show a significant
difference in ΔOxy between paretic and non-paretic muscles, as
well as a significant difference between normalized post-stroke and control
data. Further work will be necessary to determine if the observed difference
between the paretic and non-paretic muscles changes over the course of physical
therapy and can be correlated with functional improvements.
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Affiliation(s)
- Mohammad MasoudiMotlagh
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, USA
| | - Jeffrey J Sugar
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, USA
| | - Mehdi Azimipour
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, USA
| | - Whitney W Linz
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, USA
| | - Gregory Michalak
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, USA
| | - Na Jin Seo
- Division of Occupational Therapy, Department of Health Professions, Department of Health Sciences and Research, Medical University of South Carolina
| | - Mahsa Ranji
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, USA
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Noninvasive Multimodal Imaging to Predict Recovery of Locomotion after Extended Limb Ischemia. PLoS One 2015; 10:e0137430. [PMID: 26368024 PMCID: PMC4569513 DOI: 10.1371/journal.pone.0137430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/17/2015] [Indexed: 01/19/2023] Open
Abstract
Acute limb ischemia is a common cause of morbidity and mortality following trauma both in civilian centers and in combat related injuries. Rapid determination of tissue viability and surgical restoration of blood flow are desirable, but not always possible. We sought to characterize the response to increasing periods of hind limb ischemia in a porcine model such that we could define a period of critical ischemia (the point after which irreversible neuromuscular injury occurs), evaluate non-invasive methods for characterizing that ischemia, and establish a model by which we could predict whether or not the animal’s locomotion would return to baselines levels post-operatively. Ischemia was induced by either application of a pneumatic tourniquet or vessel occlusion (performed by clamping the proximal iliac artery and vein at the level of the inguinal ligament). The limb was monitored for the duration of the procedure with both 3-charge coupled device (3CCD) and infrared (IR) imaging for tissue oxygenation and perfusion, respectively. The experimental arms of this model are effective at inducing histologically evident muscle injury with some evidence of expected secondary organ damage, particularly in animals with longer ischemia times. Noninvasive imaging data shows excellent correlation with post-operative functional outcomes, validating its use as a non-invasive means of viability assessment, and directly monitors post-occlusive reactive hyperemia. A classification model, based on partial-least squares discriminant analysis (PLSDA) of imaging variables only, successfully classified animals as “returned to normal locomotion” or “did not return to normal locomotion” with 87.5% sensitivity and 66.7% specificity after cross-validation. PLSDA models generated from non-imaging data were not as accurate (AUC of 0.53) compared the PLSDA model generated from only imaging data (AUC of 0.76). With some modification, this limb ischemia model could also serve as a means on which to test therapies designed to prolong the time before critical ischemia.
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40
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Huang C, Radabaugh JP, Aouad RK, Lin Y, Gal TJ, Patel AB, Valentino J, Shang Y, Yu G. Noncontact diffuse optical assessment of blood flow changes in head and neck free tissue transfer flaps. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:075008. [PMID: 26187444 PMCID: PMC4696658 DOI: 10.1117/1.jbo.20.7.075008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 06/23/2015] [Indexed: 05/18/2023]
Abstract
Knowledge of tissue blood flow (BF) changes after free tissue transfer may enable surgeons to predict the failure of flap thrombosis at an early stage. This study used our recently developed noncontact diffuse correlation spectroscopy to monitor dynamic BF changes in free flaps without getting in contact with the targeted tissue. Eight free flaps were elevated in patients with head and neck cancer; one of the flaps failed. Multiple BF measurements probing the transferred tissue were performed during and post the surgical operation. Postoperative BF values were normalized to the intraoperative baselines (assigning "1") for the calculation of relative BF change (rBF). The rBF changes over the seven successful flaps were 1.89 ± 0.15, 2.26 ± 0.13, and 2.43 ± 0.13 (mean ± standard error), respectively, on postoperative days 2, 4, and 7. These postoperative values were significantly higher than the intraoperative baseline values (p<0.001), indicating a gradual recovery of flap vascularity after the tissue transfer. By contrast, rBF changes observed from the unsuccessful flaps were 1.14 and 1.34, respectively, on postoperative days 2 and 4, indicating less flow recovery. Measurement of BF recovery after flap anastomosis holds the potential to act early to salvage ischemic flaps.
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Affiliation(s)
- Chong Huang
- University of Kentucky, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Jeffrey P. Radabaugh
- University of Kentucky College of Medicine, Department of Otolaryngology–Head and Neck Surgery, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Rony K. Aouad
- University of Kentucky College of Medicine, Department of Otolaryngology–Head and Neck Surgery, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Yu Lin
- University of Kentucky, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Thomas J. Gal
- University of Kentucky College of Medicine, Department of Otolaryngology–Head and Neck Surgery, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Amit B. Patel
- University of Kentucky College of Medicine, Department of Otolaryngology–Head and Neck Surgery, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Joseph Valentino
- University of Kentucky College of Medicine, Department of Otolaryngology–Head and Neck Surgery, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Yu Shang
- University of Kentucky, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Guoqiang Yu
- University of Kentucky, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
- Address all correspondence to: Guoqiang Yu,
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41
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Henry B, Zhao M, Shang Y, Uhl T, Thomas DT, Xenos ES, Saha SP, Yu G. Hybrid diffuse optical techniques for continuous hemodynamic measurement in gastrocnemius during plantar flexion exercise. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:125006. [PMID: 26720871 PMCID: PMC4688865 DOI: 10.1117/1.jbo.20.12.125006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/20/2015] [Indexed: 05/26/2023]
Abstract
Occlusion calibrations and gating techniques have been recently applied by our laboratory for continuous and absolute diffuse optical measurements of forearm muscle hemodynamics during handgrip exercises. The translation of these techniques from the forearm to the lower limb is the goal of this study as various diseases preferentially affect muscles in the lower extremity. This study adapted a hybrid near-infrared spectroscopy and diffuse correlation spectroscopy system with a gating algorithm to continuously quantify hemodynamic responses of medial gastrocnemius during plantar flexion exercises in 10 healthy subjects. The outcomes from optical measurement include oxy-, deoxy-, and total hemoglobin concentrations, blood oxygen saturation, and relative changes in blood flow (rBF) and oxygen consumption rate (rV̇O2). We calibrated rBF and rV̇O2 profiles with absolute baseline values of BF and V̇O2 obtained by venous and arterial occlusions, respectively. Results from this investigation were comparable to values from similar studies. Additionally, significant correlation was observed between resting local muscle BF measured by the optical technique and whole limb BF measured concurrently by a strain gauge venous plethysmography. The extensive hemodynamic and metabolic profiles during exercise will allow for future comparison studies to investigate the diagnostic value of hybrid technologies in muscles affected by disease.
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Affiliation(s)
- Brad Henry
- University of Kentucky, College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506-0108, United States
| | - Mingjun Zhao
- University of Kentucky, College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506-0108, United States
| | - Yu Shang
- University of Kentucky, College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506-0108, United States
| | - Timothy Uhl
- University of Kentucky, College of Health Sciences, Department of Rehabilitation Science, 900 S Limestone Street, Lexington, Kentucky 40536-0200, United States
| | - D. Travis Thomas
- University of Kentucky, College of Health Sciences, Department of Clinical Sciences, 900 S Limestone Street, Lexington, Kentucky 40536-0200, United States
| | - Eleftherios S. Xenos
- University of Kentucky, College of Medicine, Department of Surgery, 900 S Limestone Street, Lexington, Kentucky 40536-0200, United States
| | - Sibu P. Saha
- University of Kentucky, College of Medicine, Department of Surgery, 900 S Limestone Street, Lexington, Kentucky 40536-0200, United States
| | - Guoqiang Yu
- University of Kentucky, College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506-0108, United States
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Li Z, Baker WB, Parthasarathy AB, Ko TS, Wang D, Schenkel S, Durduran T, Li G, Yodh AG. Calibration of diffuse correlation spectroscopy blood flow index with venous-occlusion diffuse optical spectroscopy in skeletal muscle. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:125005. [PMID: 26720870 PMCID: PMC4688416 DOI: 10.1117/1.jbo.20.12.125005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/17/2015] [Indexed: 05/09/2023]
Abstract
We investigate and assess the utility of a simple scheme for continuous absolute blood flow monitoring based on diffuse correlation spectroscopy (DCS). The scheme calibrates DCS using venous-occlusion diffuse optical spectroscopy (VO-DOS) measurements of arm muscle tissue at a single time-point. A calibration coefficient (γ) for the arm is determined, permitting conversion of DCS blood flow indices to absolute blood flow units, and a study of healthy adults (N=10) is carried out to ascertain the variability of γ. The average DCS calibration coefficient for the right (i.e., dominant) arm was γ=(1.24±0.15)×10(8) (mL·100 mL(−1)·min(−1))/(cm(2)/s). However, variability can be significant and is apparent in our site-to-site and day-to-day repeated measurements. The peak hyperemic blood flow overshoot relative to baseline resting flow was also studied following arm-cuff ischemia; excellent agreement between VO-DOS and DCS was found (R(2)=0.95, slope=0.94±0.07, mean difference=−0.10±0.45). Finally, we show that incorporation of subject-specific absolute optical properties significantly improves blood flow calibration accuracy.
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Affiliation(s)
- Zhe Li
- University of Pennsylvania, Department of Physics & Astronomy, 209 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
- Tianjin University, School of Precision Instrument and Opto-Electronics Engineering, Tianjin 300072, China
- Tianjin University, State Key Laboratory of Precision Measurement Technology and Instruments, Tianjin 300072, China
- Address all correspondence to: Zhe Li, E-mail:
| | - Wesley B. Baker
- University of Pennsylvania, Department of Physics & Astronomy, 209 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
| | - Ashwin B. Parthasarathy
- University of Pennsylvania, Department of Physics & Astronomy, 209 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
| | - Tiffany S. Ko
- University of Pennsylvania, Department of Bioengineering, 210 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
| | - Detian Wang
- University of Pennsylvania, Department of Physics & Astronomy, 209 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
- Institute of Fluid Physics, Mianyang 621000, China
| | - Steven Schenkel
- University of Pennsylvania, Department of Physics & Astronomy, 209 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
| | - Turgut Durduran
- ICFO-Institut de Ciéncies Fotóniques, Mediterranean Technology Park, 08860 Castelldefels (Barcelona), Spain
| | - Gang Li
- Tianjin University, School of Precision Instrument and Opto-Electronics Engineering, Tianjin 300072, China
- Tianjin University, State Key Laboratory of Precision Measurement Technology and Instruments, Tianjin 300072, China
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics & Astronomy, 209 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
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Buckley EM, Parthasarathy AB, Grant PE, Yodh AG, Franceschini MA. Diffuse correlation spectroscopy for measurement of cerebral blood flow: future prospects. NEUROPHOTONICS 2014; 1:011009. [PMID: 25593978 PMCID: PMC4292799 DOI: 10.1117/1.nph.1.1.011009] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Diffuse correlation spectroscopy (DCS) is an emerging optical modality used to measure cortical cerebral blood flow. This outlook presents a brief overview of the technology, summarizing the advantages and limitations of the method, and describing its recent applications to animal, adult, and infant cohorts. At last, the paper highlights future applications where DCS may play a pivotal role individualizing patient management and enhancing our understanding of neurovascular coupling, activation, and brain development.
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Affiliation(s)
- Erin M. Buckley
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts 02129
- Address all correspondence to: Erin M. Buckley,
| | - Ashwin B. Parthasarathy
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania 19104
| | - P. Ellen Grant
- Boston Children’s Hospital, Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston, Massachusetts 02115
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania 19104
| | - Maria Angela Franceschini
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts 02129
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Cheng CS, Davis BNJ, Madden L, Bursac N, Truskey GA. Physiology and metabolism of tissue-engineered skeletal muscle. Exp Biol Med (Maywood) 2014; 239:1203-14. [PMID: 24912506 DOI: 10.1177/1535370214538589] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Skeletal muscle is a major target for tissue engineering, given its relative size in the body, fraction of cardiac output that passes through muscle beds, as well as its key role in energy metabolism and diabetes, and the need for therapies for muscle diseases such as muscular dystrophy and sarcopenia. To date, most studies with tissue-engineered skeletal muscle have utilized murine and rat cell sources. On the other hand, successful engineering of functional human muscle would enable different applications including improved methods for preclinical testing of drugs and therapies. Some of the requirements for engineering functional skeletal muscle include expression of adult forms of muscle proteins, comparable contractile forces to those produced by native muscle, and physiological force-length and force-frequency relations. This review discusses the various strategies and challenges associated with these requirements, specific applications with cultured human myoblasts, and future directions.
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Affiliation(s)
- Cindy S Cheng
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Brittany N J Davis
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Lauran Madden
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Nenad Bursac
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - George A Truskey
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
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Shang Y, Lin Y, Henry BA, Cheng R, Huang C, Chen L, Shelton BJ, Swartz KR, Salles SS, Yu G. Noninvasive evaluation of electrical stimulation impacts on muscle hemodynamics via integrating diffuse optical spectroscopies with muscle stimulator. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:105002. [PMID: 24096298 PMCID: PMC3790391 DOI: 10.1117/1.jbo.18.10.105002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 09/04/2013] [Indexed: 05/03/2023]
Abstract
Technologies currently available for the monitoring of electrical stimulation (ES) in promoting blood circulation and tissue oxygenation are limited. This study integrated a muscle stimulator with a diffuse correlation spectroscopy (DCS) flow-oximeter to noninvasively quantify muscle blood flow and oxygenation responses during ES. Ten healthy subjects were tested using the integrated system. The muscle stimulator delivered biphasic electrical current to right leg quadriceps muscle, and a custom-made DCS flow-oximeter was used for simultaneous measurements of muscle blood flow and oxygenation in both legs. To minimize motion artifact of muscle fibers during ES, a novel gating algorithm was developed for data acquisition at the time when the muscle was relaxed. ES at 2, 10, and 50 Hz were applied for 20 min on each subject in three days sequentially. Results demonstrate that the 20-min ES at all frequencies promoted muscle blood flow significantly. However, only the ES at 10 Hz resulted in significant and persistent increases in oxy-hemoglobin concentration during and post ES. This pilot study supports the application of the integrated system to quantify tissue hemodynamic improvements for the optimization of ES treatment in patients suffering from diseases caused by poor blood circulation and low tissue oxygenation (e.g., pressure ulcer).
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Affiliation(s)
- Yu Shang
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506
| | - Yu Lin
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506
| | - Brad A. Henry
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506
| | - Ran Cheng
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506
| | - Chong Huang
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506
| | - Li Chen
- University of Kentucky, Department of Biostatistics, Lexington, Kentucky 40536
| | - Brent J. Shelton
- University of Kentucky, Department of Biostatistics, Lexington, Kentucky 40536
| | - Karin R. Swartz
- University of Kentucky, Department of Neurosurgery, Lexington, Kentucky 40536
| | - Sara S. Salles
- University of Kentucky, Department of Physical Medicine and Rehabilitation, Lexington, Kentucky 40536
| | - Guoqiang Yu
- University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506
- Address all correspondence to: Guoqiang Yu, University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506. Tel: 859-257-9110; Fax: 859-257-1856; E-mail:
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46
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Simultaneous measurement of deep tissue blood flow and oxygenation using noncontact diffuse correlation spectroscopy flow-oximeter. Sci Rep 2013; 3:1358. [PMID: 23446991 PMCID: PMC3584314 DOI: 10.1038/srep01358] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 02/14/2013] [Indexed: 01/10/2023] Open
Abstract
We report a novel noncontact diffuse correlation spectroscopy flow-oximeter for simultaneous quantification of relative changes in tissue blood flow (rBF) and oxygenation (Δ[oxygenation]). The noncontact probe was compared against a contact probe in tissue-like phantoms and forearm muscles (n = 10), and the dynamic trends in both rBF and Δ[oxygenation] were found to be highly correlated. However, the magnitudes of Δ[oxygenation] measured by the two probes were significantly different. Monte Carlo simulations and phantom experiments revealed that the arm curvature resulted in a significant underestimation (~−20%) for the noncontact measurements in Δ[oxygenation], but not in rBF. Other factors that may cause the residual discrepancies between the contact and noncontact measurements were discussed, and further comparisons with other established technologies are needed to identify/quantify these factors. Our research paves the way for noncontact and simultaneous monitoring of blood flow and oxygenation in soft and vulnerable tissues without distorting tissue hemodynamics.
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Mesquita RC, Putt M, Chandra M, Yu G, Xing X, Han SW, Lech G, Shang Y, Durduran T, Zhou C, Yodh AG, Mohler ER. Diffuse optical characterization of an exercising patient group with peripheral artery disease. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:57007. [PMID: 23708193 PMCID: PMC3662991 DOI: 10.1117/1.jbo.18.5.057007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 04/07/2013] [Accepted: 04/19/2013] [Indexed: 05/19/2023]
Abstract
Peripheral artery disease (PAD) is a common condition with high morbidity. While measurement of tissue oxygen saturation (S(t)O(2)) has been demonstrated, this is the first study to assess both S(t)O(2) and relative blood flow (rBF) in the extremities of PAD patients. Diffuse optics is employed to measure hemodynamic response to treadmill and pedal exercises in 31 healthy controls and 26 patients. For S(t)O(2), mild and moderate/severe PAD groups show pronounced differences compared with controls. Pre-exercise mean S(t)O(2) is lower in PAD groups by 9.3% to 10.6% compared with means of 63.5% to 66.2% in controls. For pedal, relative rate of return of S(t)O(2) to baseline is more rapid in controls (p < 0.05). Patterns of rBF also differ among groups. After both exercises, rBF tend to occur at depressed levels among severe PAD patients compared with healthy (p < 0.05); post-treadmill, rBF tend to occur at elevated levels among healthy compared with severe PAD patients (p < 0.05). Additionally, relative rate of return to baseline S(t)O(2) is more rapid among subjects with reduced levels of depression in rBF (p = 0.041), even after adjustment for ankle brachial index. This suggests a physiologic connection between rBF and oxygenation that can be measured using diffuse optics, and potentially employed as an evaluative tool in further studies.
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Affiliation(s)
- Rickson C Mesquita
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, PA 19104, USA.
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He L, Lin Y, Shang Y, Shelton BJ, Yu G. Using optical fibers with different modes to improve the signal-to-noise ratio of diffuse correlation spectroscopy flow-oximeter measurements. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:037001. [PMID: 23455963 PMCID: PMC4023649 DOI: 10.1117/1.jbo.18.3.037001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The dual-wavelength diffuse correlation spectroscopy (DCS) flow-oximeter is an emerging technique enabling simultaneous measurements of blood flow and blood oxygenation changes in deep tissues. High signal-to-noise ratio (SNR) is crucial when applying DCS technologies in the study of human tissues where the detected signals are usually very weak. In this study, single-mode, few-mode, and multimode fibers are compared to explore the possibility of improving the SNR of DCS flow-oximeter measurements. Experiments on liquid phantom solutions and in vivo muscle tissues show only slight improvements in flow measurements when using the few-mode fiber compared with using the single-mode fiber. However, light intensities detected by the few-mode and multimode fibers are increased, leading to significant SNR improvements in detections of phantom optical property and tissue blood oxygenation. The outcomes from this study provide useful guidance for the selection of optical fibers to improve DCS flow-oximeter measurements.
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Affiliation(s)
- Lian He
- University of Kentucky, Center for Biomedical Engineering, Lexington, Kentucky 40506
| | - Yu Lin
- University of Kentucky, Center for Biomedical Engineering, Lexington, Kentucky 40506
| | - Yu Shang
- University of Kentucky, Center for Biomedical Engineering, Lexington, Kentucky 40506
| | - Brent J. Shelton
- University of Kentucky, Markey Cancer Center, Lexington, Kentucky 40536
| | - Guoqiang Yu
- University of Kentucky, Center for Biomedical Engineering, Lexington, Kentucky 40506
- Address all correspondence to: Guoqiang Yu, University of Kentucky, Center for Biomedical Engineering, Lexington, Kentucky 40506. Tel: 859-257-9110; Fax: 859-257-1856; E-mail:
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49
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Shang Y, Gurley K, Yu G. Diffuse Correlation Spectroscopy (DCS) for Assessment of Tissue Blood Flow in Skeletal Muscle: Recent Progress. ACTA ACUST UNITED AC 2013; 3:128. [PMID: 24724043 PMCID: PMC3979478 DOI: 10.4172/2161-0940.1000128] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Near-infrared diffuse correlation spectroscopy (DCS) is an emerging technology for monitoring blood flow in various tissues. This article reviews the recent progress of DCS for the assessment of skeletal muscle blood flow, including the developments in technology allowing use during dynamic exercise and muscular electrical stimulation, the utilization for diagnosis of muscle vascular diseases, and the applications for evaluating treatment effects. The limitations of current DCS studies and future perspective are finally discussed.
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Affiliation(s)
- Yu Shang
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Katelyn Gurley
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA ; Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA
| | - Guoqiang Yu
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
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50
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Shang Y, Gurley K, Symons B, Long D, Srikuea R, Crofford LJ, Peterson CA, Yu G. Noninvasive optical characterization of muscle blood flow, oxygenation, and metabolism in women with fibromyalgia. Arthritis Res Ther 2012; 14:R236. [PMID: 23116302 PMCID: PMC3674608 DOI: 10.1186/ar4079] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 10/25/2012] [Indexed: 12/11/2022] Open
Abstract
Introduction Women with fibromyalgia (FM) have symptoms of increased muscular fatigue and reduced exercise tolerance, which may be associated with alterations in muscle microcirculation and oxygen metabolism. This study used near-infrared diffuse optical spectroscopies to noninvasively evaluate muscle blood flow, blood oxygenation and oxygen metabolism during leg fatiguing exercise and during arm arterial cuff occlusion in post-menopausal women with and without FM. Methods Fourteen women with FM and twenty-three well-matched healthy controls participated in this study. For the fatiguing exercise protocol, the subject was instructed to perform 6 sets of 12 isometric contractions of knee extensor muscles with intensity steadily increasing from 20 to 70% maximal voluntary isometric contraction (MVIC). For the cuff occlusion protocol, forearm arterial blood flow was occluded via a tourniquet on the upper arm for 3 minutes. Leg or arm muscle hemodynamics, including relative blood flow (rBF), oxy- and deoxy-hemoglobin concentration ([HbO2] and [Hb]), total hemoglobin concentration (THC) and blood oxygen saturation (StO2), were continuously monitored throughout protocols using a custom-built hybrid diffuse optical instrument that combined a commercial near-infrared oximeter for tissue oxygenation measurements and a custom-designed diffuse correlation spectroscopy (DCS) flowmeter for tissue blood flow measurements. Relative oxygen extraction fraction (rOEF) and oxygen consumption rate (rVO2) were calculated from the measured blood flow and oxygenation data. Post-manipulation (fatiguing exercise or cuff occlusion) recovery in muscle hemodynamics was characterized by the recovery half-time, a time interval from the end of manipulation to the time that tissue hemodynamics reached a half-maximal value. Results Subjects with FM had similar hemodynamic and metabolic response/recovery patterns as healthy controls during exercise and during arterial occlusion. However, tissue rOEF during exercise in subjects with FM was significantly lower than in healthy controls, and the half-times of oxygenation recovery (Δ[HbO2] and Δ[Hb]) were significantly longer following fatiguing exercise and cuff occlusion. Conclusions Our results suggest an alteration of muscle oxygen utilization in the FM population. This study demonstrates the potential of using combined diffuse optical spectroscopies (i.e., NIRS/DCS) to comprehensively evaluate tissue oxygen and flow kinetics in skeletal muscle.
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