Laser Doppler imaging in the detection of peripheral neuropathy

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• 作者：Ben M.W. Illigens ; Timo Siepmann ; Joseph Roofeh ; Christopher H. Gibbons
• 关键词：Laser Doppler imaging ; LDI ; Vasomotor axon-reflex ; Small fiber neuropathy ; Capsaicin ; Iontophoresis
• 刊名：Autonomic Neuroscience
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：177
• 期：2
• 页码：286-290
• 全文大小：611 K

文摘

Small fiber neuropathy is common in a number of systemic diseases and is often challenging to diagnose. Laser Doppler imaging (LDI) is a test of small fiber neurovascular function that can quantify the integrity of the vasomotor C-fiber mediated axon-reflex, but no standardized method of analysis exists. We developed a novel LDI analysis technique and tested it in a human model of small fiber neuropathy. Eighteen healthy subjects (age 24 ¡À 3 years) underwent LDI testing to assess the axon-mediated flare area in response to 10 % acetylcholine iontophoresis. LDI measurements were taken before and longitudinally after a 48-hour application of 0.1 % capsaicin (to cause a transient small fiber neuropathy) on the skin of the thigh; placebo cream was placed on the contralateral thigh as a control. We compared our new LDI image analysis technique to two previously published methods. The new LDI analysis technique was the only method to show a consistent difference in axon-reflex area between capsaicin treated and placebo treated skin on all testing days (p < 0.05) with maximum attenuation of the flare area immediately post-application (438 ¡À 298 mm² vs. 824 ¡À 375 mm², p < 0.05). In conclusion, this study demonstrates that our novel flare area method for LDI analysis can detect neurovascular dysfunction in a model of small fiber neuropathy, is an improvement over existing methods, and may supplement clinical assessment of small fiber neuropathy.