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Fujita Y, Kamijo YI, Kinoshita T, Hashizaki T, Murai K, Yoshikawa T, Umemoto Y, Kaminaka C, Shibasaki M, Tajima F, Nishimura Y. Observations of cold-induced vasodilation in persons with spinal cord injuries. Spinal Cord 2024; 62:170-177. [PMID: 38388759 PMCID: PMC11003866 DOI: 10.1038/s41393-024-00960-3] [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: 08/15/2022] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024]
Abstract
STUDY DESIGN Acute experimental study. OBJECTIVES Cold-induced vasodilation is a local mechanism of protection against frostbite in non-injured persons. We assessed whether an increase in skin blood flow (SkBF) during local cooling (LC) was observed in individuals with spinal cord injuries (SCIs) and if the response patterns differed between region levels or sites. SETTING Laboratory of Wakayama Medical University and the affiliated clinics, Japan. METHODS A local cooler device (diameter 4 cm) was placed on the chest (sensate) and right thigh (non-sensate) in persons with cervical (SCIC; n = 9) and thoracolumbar SCIs (SCITL; n = 9). After the surface temperature under the device was controlled at 33 °C for 10 min (baseline), LC (-0.045 °C/s) was applied and the skin temperature was maintained at 15 and 8 °C for 15 min of each stage. SkBF (laser Doppler flowmetry) was monitored using a 1-mm needle-type probe inserted into its center. RESULTS The percent change in SkBF (%ΔSkBF) on the chest remained unchanged until the end of 15 °C stage; thereafter, it increased to a level at least 70% greater than the baseline during the 8 °C stage in both groups. The %ΔSkBF on the thigh in both SCIC and SCITL notably increased from 8 and 6 min respectively, during the 8°C stage, compared to 1 min before the stage; however, it did not exceed the baseline level. CONCLUSIONS An increase in SkBF during LC was observed both in the sensate and non-sensate areas in SCIs, although the magnitude was larger in the sensate area.
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Affiliation(s)
- Yasuhisa Fujita
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoshi-Ichiro Kamijo
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.
- Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
| | - Tokio Kinoshita
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takamasa Hashizaki
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kouta Murai
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tatsuya Yoshikawa
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasunori Umemoto
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Chikako Kaminaka
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | | | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
- Department of Rehabilitation Medicine, Iwate Medical University, Yahaba-cho, Japan
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Hollis D, Mendis MD, Ng SK, Thomas M, Marks D, Lewis J, Hides J, Bisset L. Are clinical outcomes associated with baseline sensory profiles in people with musculoskeletal shoulder pain? Protocol for a prospective longitudinal observational study. Musculoskeletal Care 2023; 21:895-907. [PMID: 37139704 DOI: 10.1002/msc.1770] [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: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Musculoskeletal shoulder pain is a common problem and its symptoms often become persistent. The experience of pain is multidimensional, and therefore, a range of patient characteristics may influence treatment response. An altered sensory processing has been associated with persistent musculoskeletal pain states and may contribute to outcomes in patients with musculoskeletal shoulder pain. The presence and potential impact of altered sensory processing in this patient cohort is not currently known. The aim of this prospective longitudinal cohort study is to investigate if baseline sensory characteristics are associated with clinical outcomes in patients presenting to a tertiary hospital with persistent musculoskeletal shoulder pain. If found, a relationship between sensory characteristics and outcome may lead to the creation of more effective treatment strategies and improvements in risk adjustment and prognosis. METHODS This is a single-centre prospective cohort study with 6-, 12- and 24-month follow-up. A total of 120 participants aged ≥18 years with persistent musculoskeletal shoulder pain (≥3 months) will be recruited from an Australian public tertiary hospital orthopaedic department. Baseline assessments, including quantitative sensory tests and a standardised physical examination, will be performed. In addition, information will be obtained from patient interviews, self-report questionnaires and medical records. Follow-up outcome measures will comprise information from the Shoulder Pain and Disability Index and a six-point Global Rating of Change scale. ANALYSIS Descriptive statistics will be used to report baseline characteristics and outcome measures over time. Change in outcome measures at the primary endpoint of six months from baseline will be calculated using paired t-tests. Associations between baseline characteristics and outcomes at a 6-month follow-up will be reported using multivariable linear and logistic regression models. DISCUSSION Understanding the relationship between sensory profile and the variable response to treatment in people with persistent musculoskeletal shoulder pain may enhance our understanding of the mechanisms contributing to the presentation. In addition, through better understanding of the contributing factors, the results of this study may contribute to the development of an individualised, patient-centred approach to treatment for people with this highly prevalent and debilitating condition.
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Affiliation(s)
- Danielle Hollis
- School of Health Sciences and Social Work, Griffith University, Nathan, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - M Dilani Mendis
- School of Health Sciences and Social Work, Griffith University, Nathan, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- Physiotherapy Department, Mater Health, South Brisbane, Queensland, Australia
| | - Shu-Kay Ng
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia
| | - Michael Thomas
- Orthopaedic Department, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Darryn Marks
- Orthopaedic Department, Gold Coast University Hospital, Gold Coast, Queensland, Australia
- Department of Physiotherapy, Bond University, Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Gold Coast, Queensland, Australia
| | - Jeremy Lewis
- Therapy Department, Central London Community Healthcare National Health Service Trust, Finchley Memorial Hospital, London, UK
- Musculoskeletal Research, Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Julie Hides
- School of Health Sciences and Social Work, Griffith University, Nathan, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- Physiotherapy Department, Mater Health, South Brisbane, Queensland, Australia
| | - Leanne Bisset
- School of Health Sciences and Social Work, Griffith University, Nathan, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
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Xia Y, Shimomura Y. Relationship between anxiety and monotonous task performance in response to local cooling: an experimental study in healthy young men. ERGONOMICS 2023; 66:366-376. [PMID: 35722776 DOI: 10.1080/00140139.2022.2087908] [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: 11/03/2021] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
There are limited studies on monotonous task performance and its relationship with anxiety and stress traits. This study aimed to determine if local cooling exerts physiological effects and positively affects task performance. Ten male participants performed monotonous work for 24 min under control and local cooling conditions. We measured physiological arousal and anxiety using electroencephalography and the State-Trait Anxiety Inventory, respectively. The participants rated their drowsiness, the thermal sensation of the seat and whole-body thermal sensation. Despite the lack of significant differences in physiological arousal, the state anxiety score, which reflects the current stressful situation, was significantly lower in the local cooling condition. Therefore, cooling might help relieve stress during monotonous tasks, without impairing task performance. In addition, individuals with higher state anxiety scores tended to experience a faster increase in their arousal level. Thus, individual anxiety traits may modulate attentional resources during monotonous task performance.Practitioner summary: The study on topic related to monotonous task performance and its relationship with anxiety and stress traits is novel. Minimising negative emotions is key to monotonous task execution under stress. Individual anxiety might modulate resource allocation for monotonous task execution.
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Affiliation(s)
- Yali Xia
- Design Research Institute, Chiba University, Chiba, Japan
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Broatch JR, Petersen A, Bishop DJ. The Influence of Post-Exercise Cold-Water Immersion on Adaptive Responses to Exercise: A Review of the Literature. Sports Med 2018; 48:1369-1387. [PMID: 29627884 DOI: 10.1007/s40279-018-0910-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Post-exercise cold-water immersion (CWI) is used extensively in exercise training as a means to minimise fatigue and expedite recovery between sessions. However, debate exists around its merit in long-term training regimens. While an improvement in recovery following a single session of exercise may improve subsequent training quality and stimulus, reports have emerged suggesting CWI may attenuate long-term adaptations to exercise training. Recent developments in the understanding of the molecular mechanisms governing the adaptive response to exercise in human skeletal muscle have provided potential mechanistic insight into the effects of CWI on training adaptations. Preliminary evidence suggests that CWI may blunt resistance signalling pathways following a single exercise session, as well as attenuate key long-term resistance training adaptations such as strength and muscle mass. Conversely, CWI may augment endurance signalling pathways and the expression of genes key to mitochondrial biogenesis following a single endurance exercise session, but have little to no effect on the content of proteins key to mitochondrial biogenesis following long-term endurance training. This review explores current evidence regarding the underlying molecular mechanisms by which CWI may alter cellular signalling and the long-term adaptive response to exercise in human skeletal muscle.
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Affiliation(s)
- James R Broatch
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
- Department of Physiology, Australian Institute of Sport, Canberra, ACT, Australia.
| | - Aaron Petersen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - David J Bishop
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Kim S, Lee JY. L-Menthol attenuates the magnitude of cold-induced vasodilation on the extremities of young females. J Physiol Anthropol 2018; 37:14. [PMID: 29739454 PMCID: PMC5941682 DOI: 10.1186/s40101-018-0174-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/19/2018] [Indexed: 11/20/2022] Open
Abstract
Background Menthol chemically triggers cold-sensitive receptors in the skin without conductive skin cooling. We investigated the effects of menthol-induced activation of cutaneous cold receptors on the cold-induced vasodilation (CIVD) of the finger. We hypothesized that the menthol application would attenuate typical CIVD responses. Methods 1.5% l-menthol was fully applied over the left hand and forearm, and then, the middle finger of the left hand was immersed into 4 °C water for 30 min. A trial consisted of 10-min rest followed by 30-min immersion and 20-min recovery in 28 °C air temperature with 20% relative humidity. Another trial without the menthol application was carried out as a control. Seventeen females (24.2 ± 2.6 years in age, 160.5 ± 5.1 cm in height, and 51.2 ± 5.7 kg in body weight) participated in the two trials. Results The results showed that the maximum and average temperatures of the finger during the water immersion were lower in the menthol application when compared to control (P < 0.05), whereas no significant differences appeared in the onset time of CIVD, the frequency of CIVD, and minimum finger temperature. These results imply that stronger stimulation of cold receptors without additional conductive skin cooling did not attenuate the triggering of CIVD responses but intensified vasoconstriction after the first occurrence of CIVD. Conclusion It is suggested that substantial and conductive heat loss through the skin along with activation of cold receptors may be required to retain rewarming at a certain level.
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Affiliation(s)
- Siyeon Kim
- COM:FORT Laboratory, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Joo-Young Lee
- COM:FORT Laboratory, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea. .,Research Institute of Human Ecology, Seoul National University, Seoul, Korea.
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Henni S, Ammi M, Abraham P. Use of Local Thermal Load for Patients with Critical Limb Ischemia. Ann Vasc Surg 2018; 49:319-320. [PMID: 29481942 DOI: 10.1016/j.avsg.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Samir Henni
- Department of vascular medicine, University Hospital, Angers, France
| | - Myriam Ammi
- Department of vascular medicine, University Hospital, Angers, France
| | - Pierre Abraham
- Department of vascular medicine, University Hospital, Angers, France.
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Effects of plantar hypothermia on quasi-static balance: Two different hypothermic procedures. Gait Posture 2018; 60:194-199. [PMID: 29253809 DOI: 10.1016/j.gaitpost.2017.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/06/2017] [Accepted: 12/08/2017] [Indexed: 02/02/2023]
Abstract
Inducing hypothermia to examine its effects on balance is performed with various approaches. However, data interpretations of underlying postural mechanisms often do not consider the applied hypothermic protocol. In this context, the effects of diminished plantar mechanoreceptor activity on quasi-static balance performance were investigated, examining the applicability of a continuously cooling thermal platform in comparison with conventional ice pads. Increased instability for the thermal platform compared to cooling with ice pads was hypothesized, since we expected increased temperatures for the ice pad group directly after balance tests. Similar scores on a Visual Analogue Scale (VAS) were predicted regarding subjective pain. Results showed that both cooling procedures successfully induced plantar hypothermia. However, the thermal platform was more effective with respect to reaching and maintaining the desired temperature throughout the trials, especially when comparing temperatures before and after balance tests. Therefore, balance tests indeed demonstrated increased COP parameters exclusively after permanent cooling via the thermal platform as early as after the first 10 min of cooling. Reduced plantar input may result in this postural instability, but without the need of other sensory systems to compensate. The VAS generally demonstrated higher pain scores for the ice pads, rejecting our hypothesis. This is an important finding, since pain is known to influence balance. Therefore, permanent and controllable cooling via the thermal platform should be taken into consideration when conducting related research.
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Mizeva I, Frick P, Podtaev S. Relationship of oscillating and average components of laser Doppler flowmetry signal. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:85002. [PMID: 27548769 DOI: 10.1117/1.jbo.21.8.085002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 07/18/2016] [Indexed: 06/06/2023]
Abstract
Signals from laser Doppler flowmeters widely used in intravital studies of skin blood flow include, along with a slowly varying average component, an oscillating part. However, in most clinical studies, pulsations are usually smoothed by data preprocessing and only the mean blood flow is analyzed. To reveal the relationship between average and oscillating perfusion components measured by a laser Doppler flowmeter, we examined the microvascular response to the contralateral cold pressor test recorded at two different sites of the hand: dorsal part of the arm and finger pad. Such a protocol makes it possible to provide a wide range of perfusion. The average perfusion always decreases during cooling, while the oscillating component demonstrates a differently directed response. The wavelet analysis of laser Doppler flowmetry (LDF) signals shows that the pulsatile component is nonlinearly related to the average perfusion. Under low perfusion, the amplitude of pulsations is proportional to its mean value, but, as perfusion increases, the amplitude of pulsations becomes lower. The type of response is defined by the basal perfusion and the degree of vasoconstriction caused by cooling. Interpretation of the results is complicated by the nonlinear transfer function of the LDF device, the contribution of which is studied using artificial examples.
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Germano AMC, Schmidt D, Milani TL. Effects of hypothermically reduced plantar skin inputs on anticipatory and compensatory balance responses. BMC Neurosci 2016; 17:41. [PMID: 27357844 PMCID: PMC4928340 DOI: 10.1186/s12868-016-0279-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/21/2016] [Indexed: 12/28/2022] Open
Abstract
Background Anticipatory and compensatory balance responses are used by the central nervous system (CNS) to preserve balance, hence they significantly contribute to the understanding of physiological mechanisms of postural control. It is well established that various sensory systems contribute to the regulation of balance. However, it is still unclear which role each individual sensory system (e.g. plantar mechanoreceptors) plays in balance regulation. This becomes also evident in various patient populations, for instance in diabetics with reduced plantar sensitivity. To investigate these sensory mechanisms, approaches like hypothermia to deliberately reduce plantar afferent input have been applied. But there are some limitations regarding hypothermic procedures in previous studies: Not only plantar aspects of the feet might be affected and maintaining the hypothermic effect during data collection. Therefore, the aim of the present study was to induce a permanent and controlled plantar hypothermia and to examine its effects on anticipatory and compensatory balance responses. We hypothesized deteriorations in anticipatory and compensatory balance responses as increased center of pressure excursions (COP) and electromyographic activity (EMG) in response to the hypothermic plantar procedure. 52 healthy and young subjects (23.6 ± 3.0 years) performed balance tests (unexpected perturbations). Subjects’ foot soles were exposed to three temperatures while standing upright: 25, 12 and 0 °C. COP and EMG were analyzed during two intervals of anticipatory and one interval of compensatory balance responses (intervals 0, 1 and 2, respectively). Results Similar plantar temperatures confirmed the successful implementation of the thermal platform. No significant COP and EMG differences were found for the anticipatory responses (intervals 0 and 1) under the hyperthermia procedure. Parameters in interval 2 showed generally decreased values in response to cooling. Conclusion No changes in anticipatory responses were found possibly due to sensory compensation processes of other intact afferents. Decreased compensatory responses may be interpreted as the additional balance threat, creating a more cautious behavior causing the CNS to generate a kind of over-compensatory behavior. Contrary to the expectations, there were different anticipatory and compensatory responses after reduced plantar inputs, thereby, revealing alterations in the organization of CNS inputs and outputs according to different task difficulties.
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Affiliation(s)
- Andresa M C Germano
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Reichenhainer Straße 29a, 09126, Chemnitz, Germany.
| | - Daniel Schmidt
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Reichenhainer Straße 29a, 09126, Chemnitz, Germany
| | - Thomas L Milani
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Reichenhainer Straße 29a, 09126, Chemnitz, Germany
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Germano AMC, Schlee G, Milani TL. Effect of cooling foot sole skin receptors on achilles tendon reflex. Muscle Nerve 2016; 53:965-71. [PMID: 27113729 DOI: 10.1002/mus.24994] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 06/11/2015] [Accepted: 11/20/2015] [Indexed: 11/06/2022]
Abstract
INTRODUCTION This study investigated whether a controlled reduction of foot sole temperature affects the Achilles tendon stretch reflex and plantar flexion. Methods Five stretch reflexes in 52 healthy subjects were evoked by Achilles tendon taps. Short latency responses of 3 muscles of the lower limb and maximal force of plantar flexion were analyzed. Foot sole hypothermia was induced by a thermal platform at various foot temperature conditions: Stage I (25°C), Stage II (12°C), Stage IIIa (0°C), and Stage IIIb (0°C). Results Reduction of plantar cutaneous inputs resulted in a decrease in amplitude of medial gastrocnemius and soleus as well as delays in time to maximal force of plantar flexion. Medial gastrocnemius, lateral gastrocnemius, and soleus were affected differently by induced cooling. No inhibition effects in reflexes were observed at 12°C. Conclusions The results suggest that input on the plantar foot sole participates complementarily in the Achilles stretch reflex Muscle Nerve, 2015. Muscle Nerve 53: 965-971, 2016.
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Affiliation(s)
- Andresa M C Germano
- Technische Universitaet Chemnitz/Department of Human Locomotion, Thueringer Weg, 5 Raum 08, 09126, Chemnitz, Germany
| | - Günther Schlee
- Technische Universitaet Chemnitz/Department of Human Locomotion, Thueringer Weg, 5 Raum 08, 09126, Chemnitz, Germany
| | - Thomas L Milani
- Technische Universitaet Chemnitz/Department of Human Locomotion, Thueringer Weg, 5 Raum 08, 09126, Chemnitz, Germany
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Park J, Lee JY. Relationships of self-identified cold tolerance and cold-induced vasodilatation in the finger. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:521-529. [PMID: 26266483 DOI: 10.1007/s00484-015-1048-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/15/2015] [Accepted: 08/01/2015] [Indexed: 06/04/2023]
Abstract
This study was conducted to investigate relationships of self-identified cold tolerance and cold-induced vasodilatation (CIVD) in the finger. Nine males and 34 females participated in the following 2 tests: a CIVD test and a self-reported survey. The CIVD test was conducted 30-min cold-water immersion (3.8 ± 0.3 °C) of the middle finger at an air temperature of 27.9 ± 0.1 °C. The self-reported questionnaire consisted of 28 questions about whole and local body cold and heat tolerances. By a cluster analysis on the survey results, the participants were divided into two groups: high self-identified cold tolerance (HSCT, n = 25) and low self-identified cold tolerance (LSCT, n = 18). LSCT had lower self-identified cold tolerance (P < 0.001), preferred hot thermal stimulation (P = 0.006), and wore heavier clothing during daily life (P < 0.001) than HSCT. LSCT had significantly lower maximal finger temperatures (T max) (P = 0.040), smaller amplitude (P = 0.029), and delayed onset time of CIVD (P = 0.080) when compared to HSCT. Some questions examining the self-identified cold or heat tolerance had relationships with cold tolerance index, T max, and amplitude (P < 0.1). These results indicate that self-identified cold tolerance classified through a standardized survey could be a good index to predict physiological cold tolerance.
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Affiliation(s)
- Joonhee Park
- Research Institute of Human Ecology, Seoul National University, Seoul, South Korea
| | - Joo-Young Lee
- Research Institute of Human Ecology, Seoul National University, Seoul, South Korea.
- College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, Republic of Korea.
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Ihsan M, Watson G, Choo HC, Lewandowski P, Papazzo A, Cameron-Smith D, Abbiss CR. Postexercise muscle cooling enhances gene expression of PGC-1α. Med Sci Sports Exerc 2015; 46:1900-7. [PMID: 24561815 DOI: 10.1249/mss.0000000000000308] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate the influence of localized muscle cooling on postexercise vascular, metabolic, and mitochondrial-related gene expression. METHODS Nine physically active males performed 30 min of continuous running at 70% of their maximal aerobic velocity, followed by intermittent running to exhaustion at 100% maximal aerobic velocity. After exercise, subjects immersed one leg in a cold water bath (10°C, COLD) to the level of their gluteal fold for 15 min. The contralateral leg remained outside the water bath and served as control (CON). Core body temperature was monitored throughout the experiment, whereas muscle biopsies and muscle temperature (Tm) measurements were obtained from the vastus lateralis before exercise (PRE), immediately postexercise (POST-EX, Tm only), immediately after cooling, and 3 h postexercise (POST-3H). RESULTS Exercise significantly increased core body temperature (PRE, 37.1°C ± 0.4°C vs POST-EX, 39.3°C ± 0.5°C, P < 0.001) and Tm in both CON (PRE, 33.9°C ± 0.7°C vs POST-EX, 39.1°C ± 0.5°C) and COLD legs (PRE, 34.2°C ± 0.9°C vs POST-EX, 39.4°C ± 0.3°C), respectively (P < 0.001). After cooling, Tm was significantly lower in COLD (28.9°C ± 2.3°C vs 37.0°C ± 0.8°C, P < 0.001) whereas PGC-1α messenger RNA expression was significantly higher in COLD at POST-3H (P = 0.014). Significant time effects were evident for changes in vascular endothelial growth factor (P = 0.038) and neuronal nitric oxide synthase (P = 0.019) expression. However, no significant condition effects between COLD and CON were evident for changes in both vascular endothelial growth factor and neuronal nitric oxide synthase expressions. CONCLUSIONS These data indicate that an acute postexercise cooling intervention enhances the gene expression of PGC-1α and may therefore provide a valuable strategy to enhance exercise-induced mitochondrial biogenesis.
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Affiliation(s)
- Mohammed Ihsan
- 1Centre for Sports and Exercise Science Research, School of Exercise and Health Sciences, Edith Cowan University, Perth, AUSTRALIA; 2School of Human Life Sciences, University of Tasmania, Launceston, AUSTRALIA; 3School of Medicine, Deakin University, Melbourne, AUSTRALIA; and 4Liggins Institute, University of Auckland, Auckland, NEW ZEALAND
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Filingeri D, Fournet D, Hodder S, Havenith G. Body mapping of cutaneous wetness perception across the human torso during thermo-neutral and warm environmental exposures. J Appl Physiol (1985) 2014; 117:887-97. [PMID: 25103965 DOI: 10.1152/japplphysiol.00535.2014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sensing skin wetness is linked to inputs arising from cutaneous cold-sensitive afferents. As thermosensitivity to cold varies significantly across the torso, we investigated whether similar regional differences in wetness perception exist. We also investigated the regional differences in thermal pleasantness and whether these sensory patterns are influenced by ambient temperature. Sixteen males (20 ± 2 yr) underwent a quantitative sensory test under thermo-neutral [air temperature (Tair) = 22°C; relative humidity (RH) = 50%] and warm conditions (Tair = 33°C; RH = 50%). Twelve regions of the torso were stimulated with a dry thermal probe (25 cm(2)) with a temperature of 15°C below local skin temperature (Tsk). Variations in Tsk, thermal, wetness, and pleasantness sensations were recorded. As a result of the same cold-dry stimulus, the skin-cooling response varied significantly by location (P = 0.003). The lateral chest showed the greatest cooling (-5 ± 0.4°C), whereas the lower back showed the smallest (-1.9 ± 0.4°C). Thermal sensations varied significantly by location and independently from regional variations in skin cooling with colder sensations reported on the lateral abdomen and lower back. Similarly, the frequency of perceived skin wetness was significantly greater on the lateral and lower back as opposed to the medial chest. Overall wetness perception was slightly higher under warm conditions. Significantly more unpleasant sensations were recorded when the lateral abdomen and lateral and lower back were stimulated. We conclude that humans present regional differences in skin wetness perception across the torso, with a pattern similar to the regional differences in thermosensitivity to cold. These findings indicate the presence of a heterogeneous distribution of cold-sensitive thermo-afferent information.
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Affiliation(s)
- Davide Filingeri
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom;
| | - Damien Fournet
- Thermal Sciences Laboratory, Oxylane Research, Villeneuve d'Ascq, France
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
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Kim BJ, Seo Y, Kim JH, Lee DT. Effect of caffeine intake on finger cold-induced vasodilation. Wilderness Environ Med 2014; 24:328-36. [PMID: 24238217 DOI: 10.1016/j.wem.2013.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 04/25/2013] [Accepted: 06/19/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of the study was to investigate the effect of caffeine intake on finger cold-induced vasodilation (CIVD). METHODS Ten healthy men underwent 6 experimental trials characterized by control (NCAFF) or caffeine intake (CAFF) via chewing gum (300 mg of caffeine) while resting on a chair or performing submaximal (70% maximal oxygen consumption) or maximal (100% maximal oxygen consumption) treadmill exercise (Bruce protocol) followed by immersion of the middle finger in a water bath (5°C) for 20 minutes. Finger temperature (Tf ) and time parameters of the first CIVD cycle and post-test norepinephrine were measured. RESULTS Exercise duration for submaximal and maximal exercise was 8.9 ± 0.9 and 12.4 ± 0.8 minutes, respectively. CAFF had no effect on Tf, but exercise increased minimal Tf in NCAFF (9.08 ± 1.27°C, 13.02 ± 2.13°C, and 13.25 ± 1.63°C in rest, submaximal, and maximal exercise, respectively) and CAFF (8.76 ± 1.39°C, 12.50 ± 1.91°C, and 12.79 ± 1.20°C). Maximal Tf was significantly higher in NCAFF (15.98 ± 1.04°C, 16.18 ± 1.56°C, and 15.14 ± 1.52°C) than in CAFF (13.56 ± 1.19°C, 15.52 ± 1.31°C, and 14.39 ± 1.43°C), resulting in a significant difference between minimal and maximal Tf in rest (NCAFF, 6.89 ± 1.56°C and CAFF, 4.79 ± 1.23°C), but not in exercise conditions. CAFF had no effect on CIVD time responses, but exercise significantly shortened CIVD onset and peak time compared with rest in both NCAFF and CAFF. Norepinephrine concentration was significantly greater in CAFF (290.6 ± 113.0 pg/mL, 278.1 ± 91.4 pg/mL, and 399.8 ± 125.5 pg/mL) than NCAFF (105.6 ± 29.5 pg/mL, 199.6 ± 89.6 pg/mL, and 361.5 ± 171.3 pg/mL). CONCLUSIONS Caffeine intake before finger immersion in cold water does not result in a thermogenic effect and adversely affects CIVD responses, whereas exercise modifies CIVD temperature and time responses.
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Affiliation(s)
- Byeong Jo Kim
- College of Physical Education, Kookmin University, Seoul, South Korea
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15
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Morelle M, Cardon F, Beuscart JB, Campagne JB, Wiel E, Boulanger E, Assez N. Intérêt de la neurocryostimulation dans la prise en charge de la douleur post-traumatique en médecine d’urgence. ANNALES FRANCAISES DE MEDECINE D URGENCE 2014. [DOI: 10.1007/s13341-013-0400-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Cardiovascular influences on conditioned pain modulation. Pain 2013; 154:1377-82. [DOI: 10.1016/j.pain.2013.04.027] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 04/09/2013] [Accepted: 04/11/2013] [Indexed: 01/07/2023]
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17
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Cold-induced vasodilation and vasoconstriction in the finger of tropical and temperate indigenes. J Therm Biol 2013. [DOI: 10.1016/j.jtherbio.2012.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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18
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Lowrey CR, Strzalkowski NDJ, Bent LR. Cooling reduces the cutaneous afferent firing response to vibratory stimuli in glabrous skin of the human foot sole. J Neurophysiol 2012; 109:839-50. [PMID: 23155170 DOI: 10.1152/jn.00381.2012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Skin on the foot sole plays an important role in postural control. Cooling the skin of the foot is often used to induce anesthesia to determine the role of skin in motor and balance control. The effect of cooling on the four classes of mechanoreceptor in the skin is largely unknown, and thus the aim of the present study was to characterize the effects of cooling on individual skin receptors in the foot sole. Such insight will better isolate individual receptor contributions to balance control. Using microneurography, we recorded 39 single nerve afferents innervating mechanoreceptors in the skin of the foot sole in humans. Afferents were identified as fast-adapting (FA) or slowly adapting (SA) type I or II (FA I n = 16, FA II n = 7, SA I n = 6, SA II n = 11). Receptor response to vibration was compared before and after cooling of the receptive field (2-20 min). Overall, firing response was abolished in 30% of all receptors, and this was equally distributed across receptor type (P = 0.69). Longer cooling times were more likely to reduce firing response below 50% of baseline; however, some afferent responses were abolished with shorter cooling times (2-5 min). Skin temperature was not a reliable indicator of the level of receptor activation and often became uncoupled from receptor response levels, suggesting caution in the use of this parameter as an indicator of anesthesia. When cooled, receptors preferentially coded lower frequencies in response to vibration. In response to a sustained indentation, SA receptors responded more like FA receptors, primarily coding "on-off" events.
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Affiliation(s)
- Catherine R Lowrey
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Brändström H, Wiklund U, Karlsson M, Ängquist KA, Grip H, Haney M. Autonomic nerve system responses for normal and slow rewarmers after hand cold provocation: effects of long-term cold climate training. Int Arch Occup Environ Health 2012; 86:357-65. [PMID: 22526086 DOI: 10.1007/s00420-012-0767-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 03/22/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE Differences among individuals concerning susceptibility to local cold injury following acute cold exposure may be related to function of the autonomic nervous system. We hypothesized that there are differences in heart rate variability (HRV) between individuals with normal or more pronounced vasoconstriction following cold exposure and that there is an adaptation related to prolonged cold exposure in autonomic nervous system response to cold stimuli. METHODS Seventy-seven young men performed a cold provocation test, where HRV was recorded during cold hand immersion and recovery. Forty-three subjects were re-examined 15 months later, with many months of cold weather training between the tests. Subjects were analyzed as 'slow' and 'normal' rewarmers according to their thermographic rewarming pattern. RESULTS For the 'pre-training' test, before cold climate exposure, normal rewarmers had higher power for low-frequency (PLF) and high-frequency (PHF) HRV components during the cold provocation test (ANOVA for groups: p = 0.04 and p = 0.005, respectively). There was an approximately 25 % higher PHF at the start in normal rewarmers, in the logarithmic scale. Low frequency-to-high frequency ratio (PLF/PHF) showed lower levels for normal rewarmers (ANOVA for groups: p = 0.04). During the 'post-training' cold provocation test, both groups lacked the marked increase in heart rate that occurred during cold exposure at the 'pre-training' setting. After cold acclimatization (post-training), normal rewarmers showed lower resting power values for the low-frequency and high-frequency HRV components. After winter training, the slow rewarmers showed reduced low-frequency power for some of the cold provocation measurements but not all (average total PLF, ANOVA p = 0.05), which was not present before winter training. CONCLUSIONS These HRV results support the conclusion that cold adaptation occurred in both groups. We conclude that further prospective study is needed to determine whether cold adaptation provides protection to subjects at higher risk for cold injury, that is, slow rewarmers.
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Affiliation(s)
- Helge Brändström
- Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, 901 87 Umeå, Sweden.
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Effects of 29-h total sleep deprivation on local cold tolerance in humans. Eur J Appl Physiol 2012; 112:3239-50. [DOI: 10.1007/s00421-011-2297-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 12/20/2011] [Indexed: 10/14/2022]
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21
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Casiglia E, Tikhonoff V, Giordano N, Andreatta E, Regaldo G, Tosello MT, Rossi AM, Bordin D, Giacomello M, Facco E. Measured outcomes with hypnosis as an experimental tool in a cardiovascular physiology laboratory. Int J Clin Exp Hypn 2012; 60:241-61. [PMID: 22443528 DOI: 10.1080/00207144.2012.648078] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The authors detail their multidisciplinary collaboration of cardiologists, physiologists, neurologists, psychologists, engineers, and statisticians in researching the effects of hypnosis on the cardiovascular system and their additions to that incomplete literature. The article details their results and provides guidelines for researchers interested in replicating their research on hypnosis' effect on the cardiovascular system.
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Krite Svanberg E, Wollmer P, Andersson-Engels S, Åkeson J. Physiological influence of basic perturbations assessed by non-invasive optical techniques in humans. Appl Physiol Nutr Metab 2011; 36:946-57. [DOI: 10.1139/h11-119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
New non-invasive techniques enabling frequent or continuous assessments of various pathophysiological conditions might be used to improve in-hospital outcome by enabling earlier and more reliable bedside detection of medical deterioration. In this preclinical study, three modern non-invasive optical techniques, laser Doppler imaging (LDI), near-infrared spectroscopy (NIRS), and tissue viability imaging (TVI), were all evaluated with respect to the influence of basic physiological perturbations (including local changes in arm positioning, skin temperature, and regional blood flow conditions) on quasi simultaneously obtained values of skin perfusion, muscle tissue oxygenation (StO2), and skin blood volume, recorded in eighteen healthy volunteers. Skin perfusion measured by LDI responded prominently to changes in positioning of the arm, whereas muscle StO2 measured by NIRS did not change significantly. Total haemoglobin count (HbT) measured by NIRS and blood volume estimated by TVI both increased significantly on lowering of the limb. On local cooling, the perfusion and blood volume were both found to increase considerably, while StO2 and HbT did not change. Local heating induced a more than 10-fold increase in skin perfusion and a small increase in blood volume. On progressive venoarterial occlusion, the perfusion, StO2, HbT, and blood volume values decreased, after transient increases in HbT and blood volume before full arterial occlusion occurred, and all values approached the baseline level on release of the occlusion with a slight overshoot of the StO2. The results obtained have potential bearing on future utilization of these non-invasive techniques in the management of severely injured and (or) critically ill patients.
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Affiliation(s)
- Emilie Krite Svanberg
- Department of Anaesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, entrance 42, 3rd floor, SE – 205 02 Malmö, Sweden
| | - Per Wollmer
- Clinical Physiology and Nuclear Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Jonas Åkeson
- Department of Anaesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, entrance 42, 3rd floor, SE – 205 02 Malmö, Sweden
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Ruijs ACJ, Niehof SP, Hovius SER, Selles RW. Cold-induced vasodilatation following traumatic median or ulnar nerve injury. J Hand Surg Am 2011; 36:986-93. [PMID: 21514740 DOI: 10.1016/j.jhsa.2011.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 02/14/2011] [Accepted: 02/15/2011] [Indexed: 02/02/2023]
Abstract
PURPOSE Peripheral nerve injury of the upper extremity frequently causes changes in the thermoregulatory system of the hands and fingers and leads to reports of cold intolerance. In this study, we aimed to measure the influence of median or ulnar nerve injury on cold-induced vasodilatation (CIVD) during prolonged cooling at low temperatures. METHODS We tested 12 patients with a median (n = 6) or ulnar (n = 6) injury 4 to 76 months after nerve repair. The palmar sides of both hands were cooled continuously using a cold plate at 5°C. We measured the skin temperature of the fingers using videothermography and plotted graphs of the temperature changes of the nailbed. The presence of a CIVD reaction was defined as a minimum increase in temperature of 2.5°C starting at the distal phalanx. Furthermore, we measured self-reported symptoms of cold intolerance using the Cold Intolerance Severity Scale questionnaire. RESULTS A CIVD reaction was absent in the affected digits of 4 patients (follow-up, 6-37 mo), whereas the CIVD reaction in the uninjured hand was present. The CIVD was present in 6 patients after 50 months' follow-up (range, 24-76 mo). Two patients had no CIVD reaction in the injured or uninjured fingers. All patients with a CIVD response had at least diminished protective sensation. Presence of the CIVD reaction did not exclude self-reported symptoms of cold intolerance. CONCLUSIONS After peripheral nerve injury, it is possible to recover the CIVD reaction. This might be an indication of nerve recovery. However, a positive CIVD reaction does not exclude subjective symptoms of posttraumatic cold intolerance. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic III.
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Affiliation(s)
- Aleid C J Ruijs
- Department of Plastic, and the Department of Anesthesiology, Pain Treatment Centre, Erasmus MC, Rotterdam, The Netherlands.
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Yanagisawa O, Fukubayashi T. Diffusion-weighted magnetic resonance imaging reveals the effects of different cooling temperatures on the diffusion of water molecules and perfusion within human skeletal muscle. Clin Radiol 2010; 65:874-80. [DOI: 10.1016/j.crad.2010.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Revised: 06/08/2010] [Accepted: 06/23/2010] [Indexed: 11/25/2022]
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Flouris AD, Cheung SS. Influence of thermal balance on cold-induced vasodilation. J Appl Physiol (1985) 2009; 106:1264-71. [PMID: 19213938 DOI: 10.1152/japplphysiol.91426.2008] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We examined the effect of thermal balance perturbation on cold-induced vasodilation through a dynamic A-B-A-B design applying heat ( condition A) and cold ( condition B) to the body's core, while the hand is exposed to a stable cold stimulus. Fifteen healthy adults (8 men, 7 women) volunteered. Applications of heat and cold were achieved through water immersions in two tanks maintained at 42 and 12°C water temperature, respectively, in an A-B-A-B fashion. Throughout the experiment, the participants’ right hand up to the ulnar styloid process was placed inside a temperature-controlled box set at 0°C air temperature. Results demonstrated that cold-induced vasodilation occurred only during condition B and at times when body heat content was decreasing but rectal temperature had not yet dropped to baseline levels. Following the occurrence of all cold-induced vasodilation events, rectal temperature was reduced, and the phenomenon ceased when rectal temperature fell below baseline. Heart rate variability data obtained before and during cold-induced vasodilation demonstrated a shift of autonomic interaction toward parasympathetic dominance, which, however, was attributed to a sympathetic withdrawal. Receiver operating characteristics curve analyses demonstrated that the cold-induced vasodilation onset cutoff points for rectal temperature change and finger temperature were 0.62 and 16.76°C, respectively. It is concluded that cold-induced vasodilation is a centrally originating phenomenon caused by sympathetic vasoconstrictor withdrawal. It is dependent on excess heat, and it may be triggered by excess heat with the purpose of preserving thermal balance.
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26
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Yanagisawa O, Shimao D, Maruyama K, Nielsen M. Evaluation of exercised or cooled skeletal muscle on the basis of diffusion-weighted magnetic resonance imaging. Eur J Appl Physiol 2008; 105:723-9. [PMID: 19084988 DOI: 10.1007/s00421-008-0954-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2008] [Indexed: 10/21/2022]
Abstract
In this study, we assessed the physiological changes after exercising or cooling skeletal muscles on the basis of the apparent diffusion coefficient (ADC) values in magnetic resonance (MR) diffusion-weighted images (DWIs). DWIs of the ankle dorsiflexors were acquired with a 1.5-T MR device before and after exercising (22 subjects) or cooling (19 subjects). The exercise comprised a 5-min walk with the ankles dorsiflexed and a 30-time ankle dorsiflexion. Cooling (0 degrees C) of the ankle dorsiflexors was performed for 30 min. ADC values were calculated as ADC1-reflecting diffusion and perfusion and ADC2-approximating the true diffusion coefficient of the ankle dorsiflexors before and after exercising or cooling. ADC1 and ADC2 significantly increased with exercise and decreased with cooling (P < 0.05). Considering both diffusion and perfusion, ADC values allowed us to evaluate the intramuscular changes induced by exercising or cooling in terms of the motion of water molecules and microcirculation.
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Affiliation(s)
- Osamu Yanagisawa
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan,
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27
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Flouris AD, Westwood DA, Mekjavic IB, Cheung SS. Effect of body temperature on cold induced vasodilation. Eur J Appl Physiol 2008; 104:491-9. [PMID: 18568361 DOI: 10.1007/s00421-008-0798-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
Abstract
Cold-induced vasodilation (CIVD) is an acute increase in peripheral blood flow observed during cold exposures. It is hypothesized to protect against cold injuries, yet despite continuous research it remains an unexplained phenomenon. Contrary to the traditionally held view, we propose that CIVD is a thermoregulatory reflex mechanism contributing to heat loss. Ten adults (4 females; 23.8 +/- 2.0 years) randomly underwent three 130-min exposures to -20 degrees C incorporating a 10-min moderate exercise period at the 65th min, while wearing a liquid conditioning garment (LCG) and military arctic clothing. In the pre-warming condition, rectal temperature was increased by 0.5 degrees C via the LCG before the cold exposure. In the warming condition, participants regulated the LCG throughout the cold exposure to subjective comfort. In the control condition, the LCG was worn but was not operated either before or during the cold exposure. Results demonstrated that the majority of CIVD occurred during the warming condition when the thermometrically-estimated mean body temperature (T (b)) was at its highest. A thermoregulatory pattern was identified whereby CIVD occurred soon after T (b) increased past a threshold (approximately 36.65 degrees C in warming and pre-warming; approximately 36.4 degrees C in control). When CIVD occurred, T (b) was reduced and CIVD ceased when T (b) fell below the threshold. These findings were independent of extremity temperature since CIVD episodes occurred at a large range of finger temperatures (7.2-33.5 degrees C). These observations were statistically confirmed by auto-regressive integrated moving average analysis (t = 9.602, P < 0.001). We conclude that CIVD is triggered by increased T (b) supporting the hypothesis that CIVD is a thermoregulatory mechanism contributing to heat loss.
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Affiliation(s)
- Andreas D Flouris
- School of Health and Human Performance, Dalhousie University, Halifax, Canada.
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Yanagisawa O, Homma T, Okuwaki T, Shimao D, Takahashi H. Effects of cooling on human skin and skeletal muscle. Eur J Appl Physiol 2007; 100:737-45. [PMID: 17479279 DOI: 10.1007/s00421-007-0470-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2007] [Indexed: 11/28/2022]
Abstract
To investigate the effects of cooling on local temperature and circulation in the skin and skeletal muscle at different cooling temperatures. Ten male subjects (mean age 24.9 years) participated in this study. Intramuscular temperatures were measured by inserting two 22-gauge temperature probes (needle length; 8 and 18 mm) into the ankle dorsiflexors, while skin temperature was measured using a thermocouple attached to the leg skin anteriorly. Near-infrared spectroscopy was also used to evaluate the concentration changes in oxygenated, deoxygenated, and total hemoglobin/myoglobin in local skin and skeletal muscle. These measurements were simultaneously performed during the 10-min noncooling, 30-min cooling (cooling pad temperature; 0, 10, or 20 degrees C), and 60-min recovery periods. Under all cooling conditions, skin and intramuscular temperatures decreased during cooling (P < 0.01) and began to increase after the cooling pad was removed. However, these values did not return to baseline values during the recovery period (P < 0.01). Moreover, tissue temperatures tended to show lower values during cooling at lower cooling temperatures. All hemoglobin/myoglobin concentrations also showed a concomitant significant decrease during cooling under three cooling conditions (P < 0.01); the oxygenated and total hemoglobin/myoglobin concentrations did not return to the exact values before cooling during the recovery period. This study suggested that the rate of decrease in tissue temperature depends on the cooling temperature and the effects of cooling on tissue temperatures and circulation tend to be maintained during 60 min post-cooling period despite the cooling temperature.
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Affiliation(s)
- Osamu Yanagisawa
- Department of Sports Sciences, Japan Institute of Sports Sciences, 3-15-1 Nishigaoka, Kita-ku, Tokyo, Japan.
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Terada K, Miyai N, Maejima Y, Sakaguchi S, Tomura T, Yoshimasu K, Morioka I, Miyashita K. Laser Doppler imaging of skin blood flow for assessing peripheral vascular impairment in hand-arm vibration syndrome. INDUSTRIAL HEALTH 2007; 45:309-17. [PMID: 17485876 DOI: 10.2486/indhealth.45.309] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The objective of this study was to evaluate the usefulness of laser Doppler imaging (LDPI) of the skin blood flow for assessing peripheral vascular impairment in the hand-arm vibration syndrome (HAVS). The subjects were 46 male patients with HAVS, aged 50 to 69 yr, and 31 healthy male volunteers of similar age as controls. A cold provocation test was carried out by immersing a subject's hand on his more severely affected side into cold water at a temperature of 10 degrees C for 10 min. Repeated image scanning of skin blood flow of the index, middle, and ring fingers was performed every 2 min before, during, and after the cold water immersion using a PMI-II laser Doppler perfusion imager. The mean blood perfusion values in the distal phalanx area of the fingers were calculated on each image. The patients suffering from vibration-induced white finger (VWF, n=20) demonstrated significantly lower skin blood perfusion at each interval of the test as compared with those without VWF (n=26) and the controls (p<0.01, ANOVA). The blood perfusions in the HAVS patients were associated with the severity of the symptoms as classified by the Stockholm Workshop scale for vascular staging. When a subject was considered to be positive if any of the tested fingers showing a decreased blood perfusion and/or a delayed recovery pattern, the sensitivity was 80.0%, and the specificity was 84.6% and 93.5% for patients without VWF and the controls, respectively. These results suggest that the LDPI technique could provide detailed and accurate information that may help detect the existence of impaired vascular regulation to cold exposure in the fingers of workers exposed to hand-transmitted vibration.
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Affiliation(s)
- Kazufumi Terada
- Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan
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Casiglia E, Schiavon L, Tikhonoff V, Haxhi Nasto H, Azzi M, Rempelou P, Giacomello M, Bolzon M, Bascelli A, Scarpa R, Lapenta AM, Rossi AM. Hypnosis prevents the cardiovascular response to cold pressor test. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2007; 49:255-66. [PMID: 17444363 DOI: 10.1080/00029157.2007.10524503] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
To highlight the effects of hypnotic focused analgesia (HFA), 20 healthy participants underwent a cold pressor test (CPT) in waking basal conditions (WBC) by keeping the right hand in icy water until tolerable (pain tolerance); subjective pain was quantified by visual scale immediately before extracting the hand from water. The test was then repeated while the participants were under hypnosis and underwent HFA suggestions. Cardiovascular parameters were continuously monitored. Pain tolerance was 121.5+/-96.1 sec in WBC and 411.0+/-186.7 sec during HFA (p < 0.0001), and visual rating score 7.75+/-2.29 and 2.45+/-2.98 (p < 0.0001), respectively. CPT-induced increase of total peripheral resistance was non significant during HFA and +21% (p < 0.01) in WBC. HFA therefore reduced both perception and the reflex cardiovascular consequences of pain as well. This indicates that hypnotic analgesia implies a decrease of sensitivity and/or a block of transmission of painful stimuli, with depression of the nervous reflex arc.
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Affiliation(s)
- Edoardo Casiglia
- Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani No. 2, Padova, Italy.
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Isii Y, Matsukawa K, Tsuchimochi H, Nakamoto T. Ice-Water Hand Immersion Causes a Reflex Decrease in Skin Temperature in the Contralateral Hand. J Physiol Sci 2007; 57:241-8. [PMID: 17854512 DOI: 10.2170/physiolsci.rp007707] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Accepted: 09/13/2007] [Indexed: 11/05/2022]
Abstract
Cutaneous receptors stimulated by ice-water immersion of one hand will increase sympathetic nerve activity to the palm skin in the nonimmersed contralateral hand and reduce blood flow, reflecting on a decrease in skin surface temperature under a constant ambient environment. To test the hypothesis that gender might affect the contralateral vasoconstrictor response, we analyzed the spatiotemporal pattern of palm skin surface temperature during ice-water immersion for 10 min using thermography in eight males and eight females. As soon as the left hand was immersed in ice-water, palm skin temperature in the nonimmersed right hand quickly decreased in all subjects, particularly in the periphery of the digits and palm. The reduction in skin temperature was short-lasting in 63% of males and 38% of females, but it lasted throughout immersion in the remaining subjects. The average decrease in palm skin temperature was not significantly different between males and females, though it tended to be greater in males. The mean arterial blood pressure significantly increased and heart rate decreased during immersion in males, whereas no substantial cardiovascular changes were observed in females. Cold sensation was well coincident with the appearance of a reduction in the palm skin temperature. In consideration of all these results, we suggest that cutaneous cold stimuli increased skin sympathetic nerve activity in the nonimmersed hand and reduced skin blood flow. We also contend that gender difference in the contralateral vasoconstrictor response was denied because the time course and magnitude of the decrease in palm skin temperature were not different between males and females.
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Affiliation(s)
- Youzou Isii
- Department of Physiology, Graduate School of Health Sciences, Hiroshima University, Hiroshima, 734-8551 Japan
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Geurts CLM, Sleivert GG, Cheung SS. Central and peripheral factors in thermal, neuromuscular, and perceptual adaptation of the hand to repeated cold exposures. Appl Physiol Nutr Metab 2006; 31:110-7. [PMID: 16604128 DOI: 10.1139/h05-007] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We investigated the role of central and peripheral factors in repeated cold exposure of the hand and their effects on temperature response, neuromuscular function, and subjective thermal sensation. Eleven subjects immersed their left hand repeatedly in 8 °C cold water for 30 min, 5 d/week, for 2 weeks. Before and following the 2 weeks of exposure, neuromuscular function, blood markers, thermal sensation, and temperature responses of both acclimated (left) and control (right) hands were tested. Minimum index finger temperature pre-acclimation was 10.9 ± 3.4 °C and 10.0 ± 2.0 °C in the left and right hand, respectively, and did not change significantly post-acclimation (left, 12.8 ± 4.2 °C; right, 10.2 ± 1.1 °C). Neuromuscular function was impaired with cooling, but this was significantly different neither between the hands nor over time. Central factors, measured by catecholamines and changes in temperature and cardiovascular response over time, did not change and there were no differences in responses between the exposed and non-exposed hand over time (peripheral adaptation) nor were there any differences in local factors endothelian-1 and nitric oxide. Subjective thermal comfort was improved and the discepancy that was found between the change in actual and perceived temperature may increase the risk of cold injury in partially acclimatized individuals, owing to an adjustment in behavioural thermoregulation.Key words: hand, skin temperature, cold-induced vasodilatation, neuromuscular function, manual dexterity.
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Affiliation(s)
- Carla L M Geurts
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
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Kim SH, Kim KN, Lee DG, Chae WS, Kim YI. Follow-up Evaluation of the Effect of Stellate Ganglion Block Using Thermography -A case report-. Korean J Pain 2006. [DOI: 10.3344/kjp.2006.19.1.115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sang Hyun Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Kyoo Nam Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Dong Gi Lee
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Gumi Hospital, Gumi, Korea
| | - Won Seok Chae
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Yong Ik Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Hachiya Y, Arai H, Hayashi M, Kumada S, Furushima W, Ohtsuka E, Ito Y, Uchiyama A, Kurata K. Autonomic dysfunction in cases of spinal muscular atrophy type 1 with long survival. Brain Dev 2005; 27:574-8. [PMID: 15876504 DOI: 10.1016/j.braindev.2005.02.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2004] [Revised: 02/03/2005] [Accepted: 02/21/2005] [Indexed: 11/30/2022]
Abstract
In Japan, quite a few patients with spinal muscular atrophy type 1 (SMA type 1) survive with mechanical ventilation. Since a patient with SMA type 1 and continuous artificial ventilation exhibited excessive perspiration and tachycardia, we examined the autonomic functions in three cases of SMA type 1, undergoing mechanical ventilation. Two cases exhibited the common sympathetic-vagal imbalance on R-R interval analysis involving 24-h Holter ECG recordings in addition to an abnormality in finger cold-induced vasodilatation. Furthermore, one case showed blood pressure and heart rate fluctuation with the paroxysmal elevation, and a high plasma concentration of norepinephrine during tachycardia. These findings suggest that autonomic dysfunction should be examined in SMA type 1 patients with long survival, although the pathogenesis remains to be clarified.
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Affiliation(s)
- Yasuo Hachiya
- Department of Pediatrics, Tokyo Metropolitan Fuchu Medical Center for SMID, 2-9-2 Musashi-dai, Fuchu-shi, Tokyo 183-0042, Japan.
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Feger J, Braune S. Measurement of skin vasoconstrictor response in healthy subjects. Auton Neurosci 2005; 120:88-96. [PMID: 15951246 DOI: 10.1016/j.autneu.2005.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2003] [Revised: 04/06/2005] [Accepted: 04/13/2005] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Laser Doppler flowmetry enables non-invasive quantification of skin blood flow and its sympathetically mediated change. Four different maneuvers were performed in 60 healthy subjects aged 20-78 years to investigate their variability, reproducibility and to determine the influence of gender, age and height. MATERIAL AND METHODS Skin blood flow was measured on the pulp of both index fingers using laser Doppler flowmetry. Vasoconstriction was induced by deep inspiratory gasp, arm dependency, acoustic stimulation and a modified cold pressor test. RESULTS More than 95% of normal subjects showed a vasoconstrictor response to cold pressure test and 100% to inspiratory gasp. In all other maneuvers vasoconstrictor response was less reliable. The magnitude of vasoconstrictor responses decreased with age in all maneuvers, while latencies remained unchanged. Only during inspiratory gasp men showed more pronounced vasoconstrictor response compared with women. Body height influenced latencies if peripheral stimuli were applied like in the cold pressor and arm dependency tests. CONCLUSIONS Inspiratory gasp and the modified cold pressor test were found to be more suitable maneuvers for routine clinical testing than arm dependency and acoustic stimulation. Normal data also for side differences are provided as a base for routine clinical testing in systemic and unilateral neurological disorders.
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Affiliation(s)
- J Feger
- Neurologische Universitätsklinik Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany.
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O'Brien C. Reproducibility of the cold-induced vasodilation response in the human finger. J Appl Physiol (1985) 2005; 98:1334-40. [PMID: 15579576 DOI: 10.1152/japplphysiol.00859.2004] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cold-induced vasodilation (CIVD) is a cyclic oscillation in blood flow that occurs in the extremities on cold exposure and that is likely associated with reduced risk of cold injury (e.g., frostbite) as well as improved manual dexterity and less pain while working in the cold. The CIVD response varies between individuals, but the within-subject reproducibility has not been adequately described. The purpose of this study was to quantify the within-subject variability in the CIVD response under standardized conditions. Twenty-one volunteers resting in a controlled environment (27°C) immersed the middle finger in warm water (42°C) for 15 min to standardize initial finger temperature and then in cold water (4°C; CWI) for 30 min, on five separate occasions. Skin temperature (Tf) and blood flow (laser-Doppler; expressed as percent change from warm-water peak) responses that describe CIVD were identified, including initial nadir reached during CWI, onset time of CIVD, initial apex during CIVD, time of that apex, and overall mean during CWI. Within-subject coefficient of variation for Tfacross the five tests for the nail bed and pad, respectively, were as follows: nadir, 9 and 21%; onset, 18 and 19%; apex, 12 and 17%; apex time, 23 and 24%; mean 10 and 15%. For blood flow, these values were as follows: nadir 52 and 64%; onset, 6 and 5%; apex, 33 and 31%; apex time 9 and 8%; and mean 43 and 34%. Greater variability was found in the temperature response of the finger pad than the nail bed, but for blood flow the variability was similar between locations. Variability in onset and apex time between sites was similar for both temperature and blood flow responses. The reproducibility of the time course of CIVD suggests this methodology may be of value for further studies examining the mechanism of the response.
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Affiliation(s)
- Catherine O'Brien
- Thermal and Mountain Medicine Div., U.S. Army Research Institute of Environmental Medicine Natick, MA 01760-5007, USA.
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Abstract
Cardiac positron emission tomography (PET) imaging has advanced from primarily a research tool to a practical, high-performance clinical imaging modality. The widespread availability of state-of-the-art PET gamma cameras, the commercial availability of perfusion and viability PET imaging tracers, reimbursement for PET perfusion and viability procedures by government and private health insurance plans, and the availability of computer software for image display of perfusion, wall motion, and viability images have all been a key to cardiac PET imaging becoming a routine clinical tool. Although myocardial perfusion PET imaging is an option for all patients requiring stress perfusion imaging, there are identifiable patient groups difficult to image with conventional single-photon emission computed tomography imaging that are particularly likely to benefit from PET imaging, such as obese patients, women, patients with previous nondiagnostic tests, and patients with poor left ventricular function attributable to coronary artery disease considered for revascularization. Myocardial PET perfusion imaging with rubidium-82 is noteworthy for high efficiency, rapid throughput, and in a high-volume setting, low operational costs. PET metabolic viability imaging continues to be a noninvasive standard for diagnosis of viability imaging. Cardiac PET imaging has been shown to be cost-effective. The potential of routine quantification of resting and stress blood flow and coronary flow reserve in response to pharmacologic and cold-pressor stress offers tantalizing possibilities of enhancing the power of PET myocardial perfusion imaging. This can be achieved by providing assurance of stress quality control, in enhancing diagnosis and risk stratification in patients with coronary artery disease, and expanding diagnostic imaging into the realm of detection of early coronary artery disease and endothelial dysfunction subject to risk factor modification. Combined PET and x-ray computed tomography imaging (PET-CT) results in enhanced patient throughput and efficiency. The combination of multislice computed tomography scanners with PET opens possibilities of adding coronary calcium scoring and noninvasive coronary angiography to myocardial perfusion imaging and quantification. Evaluation of the clinical role of these creative new possibilities warrants investigation.
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Affiliation(s)
- Josef Machac
- Department of Radiology, Mount Sinai School of Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.
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Peltonen LM, Pyörnilä A. Local action of exogenous nitric oxide (NO) on the skin blood flow of rock pigeons (Columba livia) is affected by acclimation and skin site. J Exp Biol 2004; 207:2611-9. [PMID: 15201293 DOI: 10.1242/jeb.01051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
SUMMARY
We studied the blood flow over dorsal and abdominal, non-brooding patch skin of two groups of pigeons: one group was thermally acclimated to cold(winter-acclimatized, WAC) while the other group was acclimated to a mesic environment (thermally non-challenged, NOC). Two bilateral patches at the measurement sites were treated simultaneously with a gel containing sodium nitrate and ascorbic acid, to generate nitric oxide (NO), and a vehicle gel. Blood flow was measured by laser Doppler velocimetry. Changes induced by these treatments were calculated against basic blood flow values for the corresponding patch. The results showed that the basic blood flow over the abdominal skin patches at room temperature was higher than over the dorsal skin in both acclimation states, but comparison revealed a sustainably higher level of basic skin blood flow in the WAC pigeons. The local response to exogenous NO was non-uniform over the two skin areas measured, and a specific vasodilatory action on the abdominal microvessels was recorded in the NOC pigeons. Abdominal vasodilatation in the WAC pigeons seemed to involve other mechanisms as well as local NO-dependent ones, among which the role of cold-induced vasodilatation (CIVD) is discussed here. Interestingly, the dorsal skin seemed to be less responsive to the action of NO, irrespective of the acclimation state.
Our results show that acclimation state and skin site affect the action of exogenous NO on local skin blood flow, and we suggest that the differences reflect acclimation-induced changes in the vascularity of the skin and in its sensitivity to thermal stimuli and that the roles of the abdominal and dorsal skin are different with respect to environmental changes.
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Affiliation(s)
- Liisa M Peltonen
- Department of Basic Veterinary Sciences, Physiology, 00014 University of Helsinki, PO Box 66, FIN 00014 Helsinki, Finland.
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Regnard J, Beji M, Jallat-Daloz I. Airway inflammation affects airway and distal circulatory control. Arch Physiol Biochem 2003; 111:347-51. [PMID: 15764072 DOI: 10.3109/13813450312331337577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- J Regnard
- Physiologie-Explorations Fonctionelles, Faculte de Medicine, Centre Hospitalier Universitaire, Besancon, France.
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Janský L, Vávra V, Janský P, Kunc P, Knı́žková I, Jandová D, Slováček K. Skin temperature changes in humans induced by local peripheral cooling. J Therm Biol 2003. [DOI: 10.1016/s0306-4565(03)00028-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Patients with Raynaud's phenomenon have abnormal digital vasoconstriction in response to cold. The pathogenesis remains unknown but may involve a local neurovascular defect leading to vasoconstriction. Diagnosis of primary Raynaud's phenomenon is based on typical symptomatology coupled with normal physical examination, normal laboratory studies and lack of observable pathology by nail fold capillaroscopy. Secondary Raynaud's phenomenon is known to occur associated with several connective tissue diseases, vascular injury due to repeated vibrational trauma, and other causes which produce demonstrable vascular and microcirculatory damage. Treatment of Raynaud's symptoms is conservative and aimed at prevention of attacks. Patients are advised to remain warm and, if possible, to live in warm climates. We suggest that an ergogenic (thermogenic) steroid, 7-oxo-DHEA (3-acetoxyandrost-5-ene-7,17-dione), which is available without prescription as the trademarked 7-keto DHEA, may be very helpful in prevention of primary Raynaud's attacks by increasing the basal metabolic rate and inhibiting vasospasm.
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Affiliation(s)
- Garret Ihler
- Department of Medical Biochemistry and Medical Genetics, Texas A&M College of Medicine, College Station 77843, USA.
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German?? G, Lintas F, Truini A, Ragazzo M, Iannetti GD, Sperduti L, Cruccu G. Differences in Response to Pain Stimuli Differentiation between Normotensive and Hypertensive Patients. High Blood Press Cardiovasc Prev 2003. [DOI: 10.2165/00151642-200310020-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Eils E, Nolte S, Tewes M, Thorwesten L, Völker K, Rosenbaum D. Modified pressure distribution patterns in walking following reduction of plantar sensation. J Biomech 2002; 35:1307-13. [PMID: 12231276 DOI: 10.1016/s0021-9290(02)00168-9] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the present study was to investigate the influence of reduced plantar sensation on pressure distribution patterns during gait of 40 healthy subjects (25.3+/-3.3 yr, 70.8+/-10.6 kg and 176.5+/-7.8 cm) with no history of sensory disorders. Plantar sensation in the subjects was reduced by using an ice immersion approach, and reduced sensitivity was tested with Semmes-Weinstein monofilaments. All subjects performed six trials of barefoot walking over a pressure distribution platform under normal as well as iced conditions. Plantar cutaneous sensation was significantly reduced after the cooling procedure (p<0.0001). Pressure distribution analysis showed substantially modified plantar pressure distribution patterns during the roll-over process (ROP) under iced conditions. Analysis of peak pressures revealed significant reductions under the toes and under the heel (p<0.001). The contact time and the relative impulse for the whole foot did not change significantly between the two conditions. For the different areas, a significant load shift from the heel and toes towards the central and lateral forefoot and the lateral midfoot was observed. The results indicate the strong influence of reduced afferent information of the sole of the foot on the ROP in walking.
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Affiliation(s)
- Eric Eils
- Funktionsbereich Bewegungsanalytik (Movement Analysis Lab), Klinik und Poliklinik für Allgemeine Orthopädie, University Hospital Münster, Domagkstr. 3, Münster, Germany.
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Aso Y, Fujiwara Y, Tayama K, Inukai T, Takemura Y. Elevation of von Willebrand factor in plasma in diabetic patients with neuropathic foot ulceration. Diabet Med 2002; 19:19-26. [PMID: 11869299 DOI: 10.1046/j.1464-5491.2002.00608.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS The present study examines the relationship between markers of endothelial dysfunction and diabetic neuropathy or consequent neuropathic foot ulceration in patients with Type 2 diabetes mellitus. METHODS We studied 65 Type 2 diabetic patients including 25 diabetic patients without neuropathy, 27 with neuropathy but no history of foot ulceration, and 13 with neuropathic ulceration. Plasma concentrations of von Willebrand factor (vWF) and soluble thrombomodulin (TM), measures of endothelial dysfunction, were determined by enzyme immunoassays. We performed various tests quantifying aspects of diabetic neuropathy including vibration perception threshold (VPT; for sensory neuropathy), coefficient of variation of R-R intervals (CVR-R; for cardiac autonomic neuropathy), and cold-induced vasodilation in the great toe for peripheral sympathetic neuropathy. RESULTS CVR-R and cold-induced vasodilation were significantly diminished in patients with neuropathic foot ulceration compared with patients with neuropathy but no history of foot ulceration. Plasma vWF concentrations were positively correlated with VPT and cold-induced vasodilation test, and were inversely correlated with CVR-R. Multivariate analysis disclosed that VPT and percentage vasodilation were independent factors for plasma vWF. Plasma vWF was significantly elevated in patients with foot ulceration compared with patients without neuropathy or those with neuropathy but not foot ulceration. However, plasma TM concentrations did not differ between the three groups. CONCLUSIONS Diabetic patients with neuropathic foot ulceration had severe impairment of cardiac autonomic and peripheral sympathetic nerves. Elevation of vWF in plasma was associated with neuropathic foot ulceration, linking endothelial dysfunction to foot ulceration.
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Affiliation(s)
- Y Aso
- Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Saitama, Japan.
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