This study is devoted to the trials of wearable diagnostic system that implements the laser Doppler flowmetry technique to analyse the blood microcirculation. We do preliminary test with involvement of limited group of healthy volunteers of different age and in patients with type 2 diabetes. During the series of measurements, the microcirculation parameters was measured for 10 minutes in the palmar surfaces of the big toes and in the inner sides of the upper thirds of the shins. A statistically significant differences was found in bypass index, nutritive and shunt blood ow in shins between older group of volunteers and patients' group as well as in shunt blood flow in fingers between younger and older groups of volunteers.
Early diagnostics of microcirculation complications is an important area for biomedical photonics application. The blood perfusion measurements are capable of identification of particular markers for diagnostics of many pathological conditions of blood microcirculation in the skin. In this work, we apply the laser Doppler flowmetry method with the ability to record and process the power spectra of registered photocurrent. This approach provides the estimation of signal amplitude distribution along with the frequencies of Doppler-broadened laser radiation and blood perfusion distribution. In this work, we investigate the blood ow in the skin by the time- frequency analysis of the recorded laser Doppler spectra. The conducted studies allowed us to propose new diagnostic criteria for the diagnosis of diabetes mellitus type 2 complications. The diagnostic parameters have been tested together with binary classifiers based on the linear discriminant analysis and demonstrated to be able to successfully distinguish the groups of volunteers of different age and patients with microvascular complications.
The article is aimed at conducting pilot studies of microcirculation changes in patients with diabetes mellitus during the course of intravenous infusions of alpha lipoic acid. The study was conducted with patients with diabetes during the passage of a standard course of treatment. The change in parameters was compared before the start of the infusion course, during and after the course. A system of wearable laser Doppler monitors was used to conduct the study. The study showed that although the microcirculation index does not undergo significant changes during the treatment process, spectral analysis of the recorded signal has potential applicability. Further studies with a larger sample group are required for a qualitative analysis of the observed effects.
Presently, in the modern laser Doppler flowmetry (LDF) the distribution of blood perfusion and its changes along the Doppler shift frequencies are simply ignored and/or not properly addressed. Utilizing the registered power spectrum of photocurrent, we introduce an LDF signal processing approach suitable for expanding of diagnostic capabilities of the technique. In particular, we demonstrate that it is possible to determine how the oscillations of blood ow (cardiac, breathe, myogenic, etc.) are distributed along the Doppler shift frequency. Wavelet analysis is utilized to extract the oscillations corresponded to the particular frequency sub-bands of blood perfusion. The main purpose of this study is to identify influence of local pressure by fiber optic probe on cardiac oscillations and their distribution along frequency of Doppler shift.
The growing interest in the development of new wearable electronic devices for mobile healthcare provides great opportunities for the development of methods for assessing blood perfusion in this direction. Laser Doppler flowmetry (LDF) is one of the promising methods. A fine analysis of capillary blood ow structure and rhythm in the time and frequency domains, coupled with a new possibility of round-the-clock monitoring can provide valuable diagnostic information about the state of microvascular blood ow. In this study, wearable implementation of laser Doppler flowmetry was utilised for microcirculatory function assessment in patients with diabetes and healthy controls of two distinct age groups. Four wearable laser Doppler flowmetry monitors were used for the analysis of blood microcirculation. Thirty-seven healthy volunteers and 18 patients with type 2 diabetes mellitus participated in the study. The results of the studies have shown that the average perfusion differs between healthy volunteers of distinct age groups and between healthy volunteers of the younger age group and patients with diabetes mellitus. It was noted that the average level of perfusion measured on the wrist in the two groups of healthy volunteers has no statistically significant differences found in similar measurements on the fingertips. The wearable implementation of LDF can become a truly new diagnostic interface to monitor cardiovascular parameters, which could be of interest for diagnostics of conditions associated with microvascular disorders.
Laser Doppler flowmetry (LDF) was used for detection of age-related changes in the blood microcirculation. The LDF signal was simultaneously recorded from the 3rd fingers' pads of both hands. Amplitudes of the blood flow oscillations and wavelet coherence of the signals were used for the data analysis. A statistical difference in the synchronisation of myogenic oscillations was found between the two studied age groups. Myogenic oscillations of blood perfusion in the younger group had a higher wavelet coherence parameter than in the older group. Observed site-specific and age-related differences in blood perfusion can be used in the future in the design of experimental studies of the blood microcirculation system in patients with different pathologies.
Laser Doppler flowmetry (LDF) was utilized to assess age-related changes in the blood microcirculation at the skin sites with different morphology and regulation. The LDF signals obtained from the glabrous skin of the middle finger pad and nonglabrous skin on the dorsal wrist surface were analyzed. Statistically higher baseline perfusion was observed in the zone with glabrous skin in the older group of volunteers compared to younger participants. Observed site-specific and age-related differences in perfusion can be used in the future experimental design for the studies of the blood microcirculation system in patients with different pathologies.
A novel non-invasive, wearable VCSEL-based system for multipoint in − vivo measurements of blood perfusion was introduced. The system operates on the basis of the laser Doppler flowmetry (LDF) method and allows for microcirculation studies. The sensors developed were used to analyse the skin blood flow synchronization in homologous regions of the contralateral limbs, both in the basal state and during various functional tests. A high synchronisation of blood flow rhythms in the contralateral limbs of healthy volunteers was shown in the studies presented.
Laser Doppler flowmetry (LDF) is widely used to study blood microcirculation in the skin. However, during tradition signal processing based on the integral estimations of the power spectrum of detector photocurrent, the significant part of the information about the skin blood ow is lost. In this study, we propose to analyse the distribution of the blood perfusion over the Doppler shift frequencies, which correlate with the RBC velocity. This approach provides localisation of the blood ow oscillations in different subranges of the Doppler shift. The method applied together with the wavelet analysis has been tested in healthy volunteers and patients with psoriasis on the unaffected surface of the skin. It was revealed, that the significant difference in the amplitude of myogenic oscillations is allocated in the region of the low frequency Doppler shift (1-200 Hz). This frequency region can be associated with the signal from slow components of the skin microcirculation, that can point out on a different state of the lymphatic system of the skin in psoriasis.
Laser Doppler flowmetry (LDF), tissue reflectance oximetry (TRO) and pulse oximetry (PO) and cold pressor test (CPT) were used to assess the microcirculation parameters and the activation of regulatory mechanisms. LDF and TRO samples wavelet transform in the frequency bands 0.01-2 Hz was used to evaluate microvascular disturbances in rheumatic diseases and to assess the vascular involvement in the pathological process. The spectral components of LDF and TRO signals associated with endothelial, adrenergic, intrinsic smooth muscle, respiratory and cardiac activities were analyzed. Significant difference between healthy and rheumatology subjects was identified in perfusion parameters. Spectral analysis of the LDF signal revealed significant difference between two group of high (<0.1 Hz) frequency pulsations. Based on the analysed of the perfusion and amplitudes oscillation in the frequency band the decision rule for detection microvascular disturbances were synthesized. The perfusion parameter and amplitude oscillation associated with cardiac activities included in the decision rule. Based on the measured parameters and the result of wavelet transform LDF- and TRO-signals the parameters for detection of complications associated with microvascular disturbances and their possible causes were proposed..
KEYWORDS: Blood, Luminescence, Skin, Diffuse reflectance spectroscopy, Tissue optics, Diagnostics, Monte Carlo methods, Absorption, In vivo imaging, Neural networks
To minimise the influence of blood content on the fluorescence measurements in vivo, a fibre optical probe combining fluorescence and diffuse reflectance measurements was developed. For the inverse solution of the blood content recovery, a set of neural networks trained by the Monte Carlo generated learning set was used. An approach of fluorescence measurements triggered by simultaneous real-time measurements of blood content in living tissue during moderate changes in contact pressure of the optic probe is proposed. The method allows one to decrease the necessary pressure on the probe as well as increase the repeatability of the measurements. The developed approach was verified in a series of experiments on volunteers with fluorescence excitation at 365 nm and 450 nm. The proposed technology is of particular interest in the development of new fluorescence-based optical biopsy systems.
According to the International Diabetes Federation, the challenge of early stage diagnosis and treatment effectiveness monitoring in diabetes is currently one of the highest priorities in modern healthcare. The potential of combined measurements of skin fluorescence and blood perfusion by the laser Doppler flowmetry method in diagnostics of low limb diabetes complications was evaluated. Using Monte Carlo probabilistic modeling, the diagnostic volume and depth of the diagnosis were evaluated. The experimental study involved 76 patients with type 2 diabetes mellitus. These patients were divided into two groups depending on the degree of complications. The control group consisted of 48 healthy volunteers. The local thermal stimulation was selected as a stimulus on the blood microcirculation system. The experimental studies have shown that diabetic patients have elevated values of normalized fluorescence amplitudes, as well as a lower perfusion response to local heating. In the group of people with diabetes with trophic ulcers, these parameters also significantly differ from the control and diabetes only groups. Thus, the intensity of skin fluorescence and level of tissue blood perfusion can act as markers for various degrees of complications from the beginning of diabetes to the formation of trophic ulcers.
We introduce a noninvasive diagnostic approach for functional monitoring of blood microflows in capillaries and thermoregulatory vessels within the skin. The measuring system is based on the combined use of laser Doppler flowmetry and skin contact thermometry. The obtained results suggest that monitoring of blood microcirculation during the occlusion, performed in conjunction with the skin temperature measurements in the thermally stabilized medium, has a great potential for quantitative assessment of angiospatic dysfunctions of the peripheral blood vessels. The indices of blood flow reserve and temperature response were measured and used as the primarily parameters of the functional diagnostics of the peripheral vessels of skin. Utilizing these parameters, a simple phenomenological model has been suggested to identify patients with angiospastic violations in the vascular system.
The studies were carried out on groups of clinically healthy mice line of outbred CD-1 stock. The model animals were divided into 2 groups and received experimental liposomal formulations. Using the method of fluorescence spectroscopy, we investigated the effectiveness of penetration into the circulatory system of fluorescently stained liposomes with polyethylene glycol (PEG) and without PEG when administered orally. Fluorescence channel with a fiber probe series of multifunctional laser non-invasive diagnostic system “LAKK-M” (SPE “LAZMA” Ltd, Russia) was used as the measuring equipment.
This article presents the results of the study of the pressure applied on optical diagnostic probes as a significant factor affecting the results of measurements. During stepwise increasing and decreasing of local pressure on skin we conducted measurements using the methods of laser Doppler flowmetry and fluorescence spectroscopy. It was found out that pressure on optical probe has sufficient impact on skin microcirculation to affect registered fluorescence intensity. Data obtained in this study are of interest for design and development of diagnostic technologies for wearable devices. This data will also inform further investigation into issues of compensation of blood absorption influence on fluorescence spectrum, allowing increased accuracy and reproducibility of measurements by fluorescence spectroscopy methods in optical diagnosis.
This study examines the effect of blood absorption on the endogenous fluorescence signal intensity of biological tissues. Experimental studies were conducted to identify these effects. To register the fluorescence intensity, the fluorescence spectroscopy method was employed. The intensity of the blood flow was measured by laser Doppler flowmetry.
We proposed one possible implementation of the Monte Carlo method for the theoretical analysis of the effect of blood on the fluorescence signals. The simulation is constructed as a four-layer skin optical model based on the known optical parameters of the skin with different levels of blood supply. With the help of the simulation, we demonstrate how the level of blood supply can affect the appearance of the fluorescence spectra.
In addition, to describe the properties of biological tissue, which may affect the fluorescence spectra, we turned to the method of diffuse reflectance spectroscopy (DRS). Using the spectral data provided by the DRS, the tissue attenuation effect can be extracted and used to correct the fluorescence spectra.
Vasospastic disorders are a common class of rheumatic disease. These include syndromes such as vegetative dystonia, Raynaud's syndrome, vibration disease and rheumatoid arthritis among others. The aim of this work is to develop an original method of diagnosing the functional state of peripheral vessels of the fingers, based on the simultaneous recording of LDF- and thermograms during the occlusion test, for determining vascular disorders of rheumatological patients.
A diagnostic method was developed for assessing the functional state of the peripheral vessels of fingers, based on carrying out occlusion test in a thermally stabilized environment, with simultaneous recording of signals of laser Doppler flowmetry and skin thermometry. To verify the diagnostic value of the proposed method, a series of experiments were carried out on 41 rheumatological patients: 5 male and 36 females (average age 56.0±12.2 years). The most common diagnoses in the patient group were rheumatoid arthritis, arthrosis, gout and systemic lupus erythematosus. The laser analyser of blood microcirculation “LAKK-02” (SPE “LAZMA” Ltd, Russia) and a custom developed multi-channel thermometry device for low inertia thermometry were used for experimental measurements. The measurements of cutaneous temperature and the index of microcirculation were performed on the distal phalanx of the third finger of the right hand. Occlusion tests were performed with water baths at 25 and 42 °C and a tonometer cuff with a pressure of 200-220 mmHg for 3 min on the upper arm.
The results of experimental studies are presented and interpreted. These data indicate a violation of the blood supply regulation in the form of a pronounced tendency towards microvascular vasoconstriction in the fingers. Thus, the response displaying a tendency toward angiospasm among patients in the rheumatological diseases profile group was observed mainly in the most severe cases (49 % of this group). The prospects of the developed diagnostic method of microcirculatory disorders in rheumatic diseases are evaluated. Thus, cutaneous blood microcirculation and temperature measurements performed together can help in diagnosis of the functional state of peripheral vessels both in a healthy state and when expressing pathology.
Skin blood microcirculation and the metabolism activity of tissue were examined on the patients with type 2 diabetes. Laser Doppler flowmetry (LDF) with 1064 nm laser light source and fluorescence spectroscopy (FS) with excitation light of 365 nm and 450 nm have been used to monitor the blood perfusion and the content of coenzymes NADH and FAD. Concluding, the proposed combined LDF and tissue FS approach allows to identify the significant violations in the blood microcirculation and metabolic activity for type 2 diabetes patients.
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