Understanding near infrared spectroscopy and its application to skeletal muscle research

Near infrared spectroscopy (NIRS) is a powerful noninvasive tool with which to study the matching of oxygen delivery to oxygen utilization and the number of new publications utilizing this technique has increased exponentially in the last 20 yr. By measuring the state of oxygenation of the primary heme compounds in skeletal muscle (hemoglobin and myoglobin), greater understanding of the underlying control mechanisms that couple perfusive and diffusive oxygen delivery to oxidative metabolism can be gained from the laboratory to the athletic field to the intensive care unit or emergency room. However, the field of NIRS has been complicated by the diversity of instrumentation, the inherent limitations of some of these technologies, the associated diversity of terminology, and a general lack of standardization of protocols. This Cores of Reproducibility in Physiology (CORP) will describe in basic but important detail the most common methodologies of NIRS, their strengths and limitations, and discuss some of the potential confounding factors that can affect the quality and reproducibility of NIRS data. Recommendations are provided to reduce the variability and errors in data collection, analysis, and interpretation. The goal of this CORP is to provide readers with a greater understanding of the methodology, limitations, and best practices so as to improve the reproducibility of NIRS research in skeletal muscle.

Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest

BACKGROUND AND PURPOSE

Current guidelines suggest that cardiac arrest (CA) survivors should be ventilated with 100% O(2) after resuscitation. Breathing 100% O(2) may worsen neurological outcome after experimental CA. This study tested the hypothesis that graded reoxygenation, with oximetry guidance, can safely reduce FiO(2) after resuscitation, avoiding hypoxia while promoting neurological recovery.

METHODS

Mature dogs underwent 10 minutes of CA and restoration of spontaneous circulation with 100% O(2.) Animals were randomized to 1-hour additional ventilation on 100% FiO(2) or to rapid lowering of arterial O(2) saturation to <96% but >94% with pulse oximeter guidance. Animals were awakened at hour 23, and the neurological deficit score (0=normal; 100=brain-dead) was measured. Reanesthetized animals were perfusion-fixed and the brains removed for histopathology.

RESULTS

The neurological deficit score was significantly better in oximetry (O) dogs. O dogs appeared aware of their surroundings, whereas most hyperoxic (H) animals were stuporous (neurological deficit score=43.0+/-5.9 [O] versus 61.0+/-4.2 [H]; n=8, P<0.05). Stereological analysis revealed fewer injured CA1 neurons in O animals (cresyl violet: 35.5+/-4.3% [O] versus 60.5+/-3.3% [H]; P<0.05). There were also fewer fluoro-Jade B-stained degenerating CA1 neurons in O animals (3320+/-267 [O] versus 6633+/-356 [H] per 0.1 mm(3); P<0.001).

CONCLUSIONS

A clinically applicable protocol designed to reduce postresuscitative hyperoxia after CA results in significant neuroprotection. Clinical trials of controlled normoxia after CA/restoration of spontaneous circulation should strongly be considered.

Tissue hypoxia: implications for the respiratory clinician

Oxygen is essential for normal aerobic metabolism in mammals. Hypoxia is the presence of lower than normal oxygen content and pressure in the cell. Causes of hypoxia include hypoxemia (low blood oxygen content and pressure), impaired oxygen delivery, and impaired cellular oxygen uptake/utilization. Many compensatory mechanisms exist at the global, regional, and cellular levels to allow cells to function in a hypoxic environment. Clinical management of tissue hypoxia usually focuses on global hypoxemia and oxygen delivery. As we move into the future, the clinical focus needs to change to assessing and managing mission-critical regional hypoxia to avoid unnecessary and potential toxic global strategies. We also need to focus on understanding and better harnessing the body's own adaptive mechanisms to hypoxia.

Validation of a high-power, time-resolved, near-infrared spectroscopy system for measurement of superficial and deep muscle deoxygenation during exercise

Near-infrared assessment of skeletal muscle is restricted to superficial tissues due to power limitations of spectroscopic systems. We reasoned that understanding of muscle deoxygenation may be improved by simultaneously interrogating deeper tissues. To achieve this, we modified a high-power (∼8 mW), time-resolved, near-infrared spectroscopy system to increase depth penetration. Precision was first validated using a homogenous optical phantom over a range of inter-optode spacings (OS). Coefficients of variation from 10 measurements were minimal (0.5-1.9%) for absorption (μa), reduced scattering, simulated total hemoglobin, and simulated O2 saturation. Second, a dual-layer phantom was constructed to assess depth sensitivity, and the thickness of the superficial layer was varied. With a superficial layer thickness of 1, 2, 3, and 4 cm (μa = 0.149 cm(-1)), the proportional contribution of the deep layer (μa = 0.250 cm(-1)) to total μa was 80.1, 26.9, 3.7, and 0.0%, respectively (at 6-cm OS), validating penetration to ∼3 cm. Implementation of an additional superficial phantom to simulate adipose tissue further reduced depth sensitivity. Finally, superficial and deep muscle spectroscopy was performed in six participants during heavy-intensity cycle exercise. Compared with the superficial rectus femoris, peak deoxygenation of the deep rectus femoris (including the superficial intermedius in some) was not significantly different (deoxyhemoglobin and deoxymyoglobin concentration: 81.3 ± 20.8 vs. 78.3 ± 13.6 μM, P > 0.05), but deoxygenation kinetics were significantly slower (mean response time: 37 ± 10 vs. 65 ± 9 s, P ≤ 0.05). These data validate a high-power, time-resolved, near-infrared spectroscopy system with large OS for measuring the deoxygenation of deep tissues and reveal temporal and spatial disparities in muscle deoxygenation responses to exercise.

Modeling O₂ transport as an integrated system limiting (.)V(O₂MAX)

Maximal endurance exercise capacity is determined by a variety of factors, including maximal ability to transport O₂ to the muscle mitochondria and to use this O₂ for ATP generation ((.)V(O₂MAX)). This analysis combines the individually well-known O₂ mass conservation equations for the four critical steps in the O₂ transport pathway (ventilation, alveolar/capillary diffusion, circulation and muscle diffusion) into an analytical, closed form, model showing how (.)V(O₂MAX) depends on all four steps. It further shows how changes in any one step affect the function of the others. This analytical approach however requires approximating the O₂Hb dissociation curve as linear. Removing this condition to allow for the real O₂Hb curve requires numerical analysis best explained graphically. Incorporating maximal mitochondrial metabolic capacity to use O₂ allows prediction of when (.)V(O₂MAX) is limited by transport or by metabolic capacity. This simple approach recapitulates in vivo behavior and clarifies the determinants of maximal exercise.

Disabled cell density sensing leads to dysregulated cholesterol synthesis in glioblastoma

A hallmark of cellular transformation is the evasion of contact-dependent inhibition of growth. To find new therapeutic targets for glioblastoma, we looked for pathways that are inhibited by high cell density in astrocytes but not in glioma cells. Here we report that glioma cells have disabled the normal controls on cholesterol synthesis. At high cell density, astrocytes turn off cholesterol synthesis genes and have low cholesterol levels, but glioma cells keep this pathway on and maintain high cholesterol. Correspondingly, cholesterol pathway upregulation is associated with poor prognosis in glioblastoma patients. Densely-plated glioma cells increase oxygen consumption, aerobic glycolysis, and the pentose phosphate pathway to synthesize cholesterol, resulting in a decrease in reactive oxygen species, TCA cycle intermediates, and ATP. This constitutive cholesterol synthesis is controlled by the cell cycle, as it can be turned off by cyclin-dependent kinase inhibitors and it correlates with disabled cell cycle control though loss of p53 and RB. Finally, glioma cells, but not astrocytes, are sensitive to cholesterol synthesis inhibition downstream of the mevalonate pathway, suggesting that specifically targeting cholesterol synthesis might be an effective treatment for glioblastoma.

Skeletal muscle microvascular oxygenation dynamics in heart failure: exercise training and nitric oxide-mediated function

Chronic heart failure (CHF) impairs nitric oxide (NO)-mediated regulation of skeletal muscle O2 delivery-utilization matching such that microvascular oxygenation falls faster (i.e., speeds PO2mv kinetics) during increases in metabolic demand. Conversely, exercise training improves (slows) muscle PO2mv kinetics following contractions onset in healthy young individuals via NO-dependent mechanisms. We tested the hypothesis that exercise training would improve contracting muscle microvascular oxygenation in CHF rats partly via improved NO-mediated function. CHF rats (left ventricular end-diastolic pressure = 17 ± 2 mmHg) were assigned to sedentary (n = 11) or progressive treadmill exercise training (n = 11; 5 days/wk, 6-8 wk, final workload of 60 min/day at 35 m/min; -14% grade downhill running) groups. PO2mv was measured via phosphorescence quenching in the spinotrapezius muscle at rest and during 1-Hz twitch contractions under control (Krebs-Henseleit solution), sodium nitroprusside (SNP; NO donor; 300 μM), and N(G)-nitro-l-arginine methyl ester (L-NAME, nonspecific NO synthase blockade; 1.5 mM) superfusion conditions. Exercise-trained CHF rats had greater peak oxygen uptake and spinotrapezius muscle citrate synthase activity than their sedentary counterparts (p < 0.05 for both). The overall speed of the PO2mv fall during contractions (mean response time; MRT) was slowed markedly in trained compared with sedentary CHF rats (sedentary: 20.8 ± 1.4, trained: 32.3 ± 3.0 s; p < 0.05), and the effect was not abolished by L-NAME (sedentary: 16.8 ± 1.5, trained: 31.0 ± 3.4 s; p > 0.05). Relative to control, SNP increased MRT in both groups such that trained CHF rats had slower kinetics (sedentary: 43.0 ± 6.8, trained: 55.5 ± 7.8 s; p < 0.05). Improved NO-mediated function is not obligatory for training-induced improvements in skeletal muscle microvascular oxygenation (slowed PO2mv kinetics) following contractions onset in rats with CHF.

Skeletal muscle mitochondrial oxidative phosphorylation function in idiopathic pulmonary arterial hypertension: in vivo and in vitro study

Mitochondrial dysfunction within the pulmonary vessels has been shown to contribute to the pathology of idiopathic pulmonary arterial hypertension (IPAH). We investigated the hypothesis of whether impaired exercise capacity observed in IPAH patients is in part due to primary mitochondrial oxidative phosphorylation (OXPHOS) dysfunction in skeletal muscle. This could lead to potentially new avenues of treatment beyond targeting the pulmonary vessels. Nine clinically stable participants with IPAH underwent cardiopulmonary exercise testing, in vivo and in vitro assessment of mitochondrial function by ³¹P-magnetic resonance spectroscopy (³¹P-MRS) and laboratory muscle biopsy analysis. ³¹P-MRS showed abnormal skeletal muscle bioenergetics with prolonged recovery times of phosphocreatine and abnormal muscle pH handling. Histochemistry and quadruple immunofluorescence performed on muscle biopsies showed normal function and subunit protein abundance of the complexes within the OXPHOS system. Our findings suggest that there is no primary mitochondrial OXPHOS dysfunction but raises the possibility of impaired oxygen delivery to the mitochondria affecting skeletal muscle bioenergetics during exercise.

The effect of dietary nitrate supplementation on the spatial heterogeneity of quadriceps deoxygenation during heavy-intensity cycling

This study investigated the influence of dietary inorganic nitrate (NO₃⁻) supplementation on pulmonary O₂ uptake (V˙O₂) and muscle deoxyhemoglobin/myoglobin (i.e. deoxy [Hb + Mb]) kinetics during submaximal cycling exercise. In a randomized, placebo‐controlled, cross‐over study, eight healthy and physically active male subjects completed two step cycle tests at a work rate equivalent to 50% of the difference between the gas exchange threshold and peak V˙O₂ over separate 4‐day supplementation periods with NO₃⁻‐rich (BR; providing 8.4 mmol NO₃⁻∙day⁻¹) and NO₃⁻‐depleted (placebo; PLA) beetroot juice. Pulmonary V˙O₂ was measured breath‐by‐breath and time‐resolved near‐infrared spectroscopy was utilized to quantify absolute deoxy [Hb + Mb] and total [Hb + Mb] within the rectus femoris, vastus lateralis, and vastus medialis. There were no significant differences (P > 0.05) in the primary deoxy [Hb + Mb] mean response time or amplitude between the PLA and BR trials at each muscle site. BR significantly increased the mean (three‐site) end‐exercise deoxy [Hb + Mb] (PLA: 91 ± 9 vs. BR: 95 ± 12 μmol/L, P < 0.05), with a tendency to increase the mean (three‐site) area under the curve for total [Hb + Mb] responses (PLA: 3650 ± 1188 vs. BR: 4467 ± 1315 μmol/L sec⁻¹, P = 0.08). The V˙O₂ slow component reduction after BR supplementation (PLA: 0.27 ± 0.07 vs. BR: 0.23 ± 0.08 L min⁻¹, P = 0.07) correlated inversely with the mean increases in deoxy [Hb + Mb] and total [Hb + Mb] across the three muscle regions (r² = 0.62 and 0.66, P < 0.05). Dietary NO₃⁻ supplementation increased O₂ diffusive conductance across locomotor muscles in association with improved V˙O₂ dynamics during heavy‐intensity cycling transitions.

Local metabolic rate during whole body vibration

Whole body vibration (WBV) platforms are currently used for muscle training and rehabilitation. However, the effectiveness of WBV training remains elusive, since scientific studies vary largely in the vibration parameters used. The origin of this issue may be related to a lack in understanding of the training intensity that is imposed on individual muscles by WBV. Therefore, this study evaluates the training intensity in terms of metabolic rate of two lower-extremity muscles during WBV under different vibration parameters. Fourteen healthy male subjects were randomly exposed to 0 (control)-, 10-, 17-, and 28-Hz vibrations while standing upright on a vibration platform. A near-infrared spectrometer was used to determine the gastrocnemius medialis (GM) and vastus lateralis (VL) muscles' metabolic rates during arterial occlusion. The metabolic rates during each vibration condition were significantly higher compared with control for both muscles (P < 0.05). Each increase in vibration frequency translated into a significantly higher metabolic rate than the previous lower frequency (P < 0.05) for both muscles. The current study showed that the local metabolic rate during WBV at 28 Hz was on average 5.4 times (GM) and 3.7 times (VL) of the control metabolic rate. The substantial changes in local metabolic rate indicate that WBV may represent a significant local training stimulus for particular leg muscles.

Relationship between (non)linear phase II pulmonary oxygen uptake kinetics with skeletal muscle oxygenation and age in 11-15 year olds

NEW FINDINGS

What is the central question of this study? Do the phase II parameters of pulmonary oxygen uptake ( V ̇ O 2 ) kinetics display linear, first-order behaviour in association with alterations in skeletal muscle oxygenation during step cycling of different intensities or when exercise is initiated from an elevated work rate in youths. What is the main finding and its importance? Both linear and non-linear features of phase II V ̇ O 2 kinetics may be determined by alterations in the dynamic balance between microvascular O₂ delivery and utilization in 11-15 year olds. The recruitment of higher-order (i.e. type II) muscle fibres during 'work-to-work' cycling might be responsible for modulating V ̇ O 2 kinetics with chronological age.

ABSTRACT

This study investigated in 19 male youths (mean age: 13.6 ± 1.1 years, range: 11.7-15.7 years) the relationship between pulmonary oxygen uptake ( V ̇ O 2 ) and muscle deoxygenation kinetics during moderate- and very heavy-intensity 'step' cycling initiated from unloaded pedalling (i.e. U → M and U → VH) and moderate to very heavy-intensity step cycling (i.e. M → VH). Pulmonary V ̇ O 2 was measured breath-by-breath along with the tissue oxygenation index (TOI) of the vastus lateralis using near-infrared spectroscopy. There were no significant differences in the phase II time constant ( τ V ̇ O 2 p ) between U → M and U → VH (23 ± 6 vs. 25 ± 7 s; P = 0.36); however, the τ V ̇ O 2 p was slower during M → VH (42 ± 16 s) compared to other conditions (P < 0.001). Quadriceps TOI decreased with a faster (P < 0.01) mean response time (MRT; i.e. time delay + τ) during U → VH (14 ± 2 s) compared to U → M (22 ± 4 s) and M → VH (20 ± 6 s). The difference (Δ) between the τ V ̇ O 2 p and MRT-TOI was greater during U → VH compared to U → M (12 ± 7 vs. 2 ± 7 s, P < 0.001) and during M → VH (23 ± 15 s) compared to other conditions (P < 0.02), suggesting an increased proportional speeding of fractional O₂ extraction. The slowing of the τ V ̇ O 2 p during M → VH relative to U → M and U → VH correlated positively with chronological age (r = 0.68 and 0.57, respectively, P < 0.01). In youths, 'work-to-work' transitions slowed microvascular O₂ delivery-to-O₂ utilization with alterations in phase II V ̇ O 2 dynamics accentuated between the ages of 11 and 15 years.

Effect of priming exercise and body position on pulmonary oxygen uptake and muscle deoxygenation kinetics during cycle exercise

We hypothesized that the performance of prior heavy exercise would speed pulmonary oxygen uptake (V̇o₂) kinetics (i.e., as described by the time constant, [Formula: see text]) and reduce the amplitude of muscle deoxygenation (deoxy[heme]) kinetics in the supine (S) but not upright (U) body position. Seventeen healthy men completed heavy-intensity constant-work rate exercise tests in S and U consisting of two bouts of 6-min cycling separated by 6-min cycling at 20 W. Pulmonary V̇o₂ was measured breath by breath; total and deoxy[heme] were determined via time-resolved near-infrared spectroscopy (NIRS) at three muscle sites. Priming exercise reduced [Formula: see text] in S (bout 1: 36 ± 10 vs. bout 2: 28 ± 10 s, P < 0.05) but not U (bout 1: 27 ± 8 s vs. bout 2: 25 ± 7 s, P > 0.05). Deoxy[heme] amplitude was increased after priming in S (bout 1: 25-28 μM vs. bout 2: 30-35 μM, P < 0.05) and U (bout 1: 13-18 μM vs. bout 2: 17-25 μM, P > 0.05), whereas baseline total[heme] was enhanced in S (bout 1: 110-179 μM vs. bout 2: 121-193 μM, P < 0.05) and U (bout 1: 123-186 μM vs. bout 2: 137-197 μM, P < 0.05). Priming exercise increased total[heme] in both S and U, likely indicating enhanced diffusive O₂ delivery. However, the observation that after priming the amplitude of the deoxy[heme] response was increased in S suggests that the reduction in [Formula: see text] subsequent to priming was related to a combination of both enhanced intracellular O₂ utilization and increased O₂ delivery.NEW & NOTEWORTHY Here we show that oxygen uptake (V̇o₂) kinetics are slower in the supine compared with upright body position, an effect that is associated with an increased amplitude of skeletal muscle deoxygenation in the supine position. After priming in the supine position, the amplitude of muscle deoxygenation remained markedly elevated above that observed during upright exercise. Hence, the priming effect cannot be solely attributed to enhanced O₂ delivery, and enhancements to intracellular O₂ utilization must also be contributory.

All about oxygen: using near-infrared spectroscopy to understand bioenergetics

The interchange among the energy-providing phosphagen, glycolytic, and aerobic systems during exercise is often poorly understood by beginning students in exercise physiology. Exercise is oftentimes thought of as being aerobic or anaerobic, with the body progressing sequentially from one system to the next, although the energy systems work synergistically to produce energy from the onset of exercise, and all ultimately use oxygen. Traditional methods of teaching these concepts using only indirect calorimetry and a metabolic cart can be misleading. Relatively inexpensive noninvasive monitors of muscle oxygenation levels ([Formula: see text]) provide a useful tool to help students better understand the contribution and timing of these three systems of ATP generation and convey the concept that ultimately all energy production in the human body is oxygen dependent. In this laboratory, students use near-infrared spectroscopy (NIRS) to visualize oxygen utilization by skeletal muscle during exercise by devising three exercise unique protocols, with each designed to stress a different energy system. Students then perform their protocols while using NIRS to measure and analyze [Formula: see text]. Students generate graphs with collected data, allowing them to visualize and appreciate oxygen consumption during all three protocols as well as elevated oxygen consumption after exercise. The students learn that any exercise is really all about oxygen.NEW & NOTEWORTHY Traditional methods of teaching bioenergetics using indirect calorimetry and a metabolic cart may be misleading. Recent advances in technology have made near-infrared spectroscopy (NIRS) a relatively inexpensive, noninvasive means of monitoring muscle oxygen levels during exercise. In this laboratory activity, NIRS devices are used for hands-on exploration of the synergistic nature of the energy systems, allowing students to appreciate the synergistic nature of the energy systems and how all exercise is really all about oxygen.

Long-Term Alterations in Pulmonary V˙O2 and Muscle Deoxygenation On-Kinetics During Heavy-Intensity Exercise in Competitive Youth Cyclists: A Cohort Study

PURPOSE

The aim of this investigation was to assess alterations of pulmonary oxygen uptake (V˙O2) and muscle deoxygenation on-kinetics during heavy-intensity cycling in youth cyclists over a period of 15 months.

METHODS

Eleven cyclists (initial age, 14.3 [1.6] y; peak V˙O2, 62.2 [4.5] mL·min-1·kg-1) visited the laboratory twice on 3 occasions within 15 months. Participants performed an incremental ramp exercise test and a constant workrate test within the heavy-intensity domain during the first visit and second visit, respectively. Subsequently, parameter estimates of the V˙O2 and muscle deoxygenation on-kinetics were determined with mono-exponential models.

RESULTS

The V˙O2 phase II time constant decreased from occasion 1 (34 [4] s) to occasion 2 (30 [4] s, P = .005) and 3 (28 [4] s, P = .010). However, no significant alteration was observed between occasions 2 and 3 (P = .565). The V˙O2 slow component amplitude either expressed in absolute values (ie, L·min-1) or relative to end exercise V˙O2 (ie, %) showed no significant changes throughout the study (P = .972 and .996). Furthermore, the muscle deoxygenation on-kinetic mean response time showed no significant changes throughout the study (18 [8], 18 [3], and 16 [5] s for occasions 1, 2, and 3, respectively; P = .279).

CONCLUSION

These results indicate proportional enhancements of local muscle oxygen distribution and utilization, which both contributed to the speeding of the V˙O2 on-kinetics herein.