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ABSTRACT: Walking can help improve the recovery after stroke. The present study used skin-surface laser-Doppler flowmetry (LDF) measurements and beat-to-beat waveform analysis with the aim of discriminating the microcirculatory blood flow (MBF) characteristics in stroke subjects subdivided into two groups according to their walking ability. Five-minute LDF measurements were performed in the following groups: Group A (cannot walk independently; n = 17), Group B (can walk independently; n = 11), and Group C (healthy controls; n = 17). The pulse width (PW) and foot delay time (FDT) and their coefficients of variation (PWCV and FDTCV, respectively) were calculated for the beat-to-beat LDF waveform. The FDT in Group A and the blood-pressure-normalized PW in Group C were significantly longer than the corresponding values in the other groups, and PWCV and FDTCV were significantly larger in Group C than in Group A. To our knowledge this is the first study demonstrating the feasibility of using a beat-to-beat LDF waveform index to discriminate between stroke subjects with different walking abilities and between stroke and normal subjects. It provides a noninvasive and real-time method for discriminating MBF characteristics, and thus could aid the development of an index for the early detection of stroke or for evaluating the recovery condition in stroke patients.
Clinical hemorheology and microcirculation 01/2013; · 3.40 Impact Factor
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ABSTRACT: Stroke induces abnormal microcirculatory blood flow perfusion resistance in cerebral vascular beds, which may in turn alter the arterial pulse transmission. This study aimed to determine if the frequency-domain harmonic index for the blood-pressure waveform is useful in monitoring the microcirculatory blood flow perfusion response in cerebral vascular beds of stroke patients following acupuncture stimulation.
Bilateral radial arterial blood-pressure waveform and laser-Doppler flowmetry signals were obtained noninvasively before and after acupuncture in 17 stroke patients. The amplitude proportion (Cn) for all the acquired pulses and the coefficient of variance (CVn) for harmonics 1-10 were calculated to evaluate the blood-pressure harmonic variability.
The laser-Doppler flowmetry parameters showed that the cerebral microvascular blood flow supply could be improved following acupuncture. For the blood pressure waveform harmonic index, there were significant increases in C5 and C6 and decreases in CV5 and CV7 on the stroke-affected side, but no significant changes on the contralateral side.
Cn values might reflect changes in arterial pulse transmission, and the blood-pressure-harmonic-variability response might be partly attributable to cardiovascular regulatory activities caused by acupuncture-induced changes in the cerebral microvascular blood flow perfusion. The present findings of blood pressure waveform harmonic analysis may be useful to the development of a noninvasive and real-time technique for evaluating treatment efficacy in stroke patients.
Biorheology 01/2013; 50(1):69-81. · 1.93 Impact Factor
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ABSTRACT: We aimed to elucidate the frequency-specific microcirculatory blood-flow (MBF) effect induced by weak vibration stimulation (VS) in healthy human subjects.
VS was implemented by a rod (connected to a DC motor) hitting a water-filled bag. VS was applied to the left palm at frequencies near to the heart rate (HR) (n=35; Group A) and 50% higher than the HR (n=20; Group B), and laser-Doppler-flowmetry measurements were made on the back of the left hand (Site 1). A control group without applying VS was also used (n=21).
The mean MBF (MMBF), pulsatile MBF, and pulse width at Site 1 only increased significantly in Group A, and the coefficient of variance of the MMBF sequence increased significantly at Site 1 in Groups A and B.
These results illustrate the VS-induced changes in the regulatory activities of arteriolar openings, and improvement of the MBF near the VS application site in Group A. The improvement in MBF depended on whether the VS frequency was near to, or higher than the HR. The present findings may be pertinent to amelioration of disease induced by an abnormal MBF.
Biorheology 01/2012; 49(1):15-25. · 1.93 Impact Factor
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ABSTRACT: Cold stimulation (CS) accompanied by vasoconstriction can increase the stiffness of the arterial system. The vascular responses during CS have been studied using photoplethysmography (PPG), but most have focused on time-domain waveform indexes. Focusing on the radial arterial blood pressure (BPW) and the finger PPG waveforms, we aimed to determine if harmonic index could help to noninvasively characterize the changes in arterial pulse transmission following mild CS.
Trials were measured on male healthy volunteers (n=29); mild CS was applied by placing a bag filled with 2000 cc of water at a temperature of 19-21°C around the right lower arm. For each experiment, we recorded a 3-min baseline-data sequence, applied local mild CS and recorded a 3-min effect sequence, and then recorded another 3-min effect sequence immediately after stopping CS. BPW and PPG spectra were used to calculate the amplitude proportion (C(n)) and phase angle (P(n)) for each harmonic (for n=1-10) from averages of all the pulses during the measurement period.
Several harmonic indexes were prominently increased following CS, including C(4)-C(10) and P(3)-P(10) for the BPW and C(5)-C(10) and P(3) and P(4) for PPG waveforms.
It was demonstrated that the application of mild CS significantly changes several harmonic-analysis indexes of the BPW and the PPG waveforms. By providing detailed information about the pulse transmission of each frequency component, harmonic analysis may improve the ability to detect arterial elastic properties induced by CS, other forms of external stimulation, or pathological factors. It may be pertinent to the development of medical devices for application in telemedicine.
Photomedicine and laser surgery 12/2011; 30(2):77-84. · 1.76 Impact Factor
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ABSTRACT: This study aimed to assess the skin-surface microcirculatory effects of oral administration of Liuwei Dihuang (LW) formula by analyzing the frequency content of laser-Doppler skin blood-flow signals at important acupoints.
Laser-Doppler signals were measured in male healthy volunteers in two groups of experiments: the LW experiment (n=42; aged (27.8±3.8) years) and the control experiment (n=28; aged (27.3±3.4) years). Each experiment involved a 20-minute baseline-data sequence and three following sets of effects data: recorded on the same day after oral administration of 250 mL water (28 degrees centigrade) accompanied with 5 g of LW formula (herbal extract granules), and recorded on the second day after taking other two doses of LW formula.
During the second day, the increases in the mean and pulsatile components of the flux signal were the most prominent, and the relative energy contribution at 0.02 to 0.06 Hz was significantly decreased at Taixi (KI3). There were no any other significant changes in these parameters at other measurement sites.
The redistribution of skin-surface microcirculatory blood flow following oral LW administration observed here can be attributed to different changes in sympathetic neural activities and thus the different perfusion resistance through the arteriolar openings of the peripheral vascular beds at different measurement sites. The developed noninvasive and real-time monitoring technique could form part of an evidence-based method for studying the physiological effects and the underlying mechanisms of traditional Chinese medicine herbs.
Journal of Chinese Integrative Medicine 10/2011; 9(10):1101-9.
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ABSTRACT: The aim of this study was to determine the effects of acupuncture stimulation (AS) in stroke patients by analyzing the pulsatile waveform and frequency content of skin blood-flow signals recorded simultaneously on the bilateral skin surface of the head. Laser Doppler flowmetry (LDF) signals were obtained in 18 stroke patients. Each assessment involved a 20-min baseline recording, a 20-min AS, and a further 20-min recording. Significant bilateral differences in LDF parameters were noted following AS, with an increased pulsatile component of the microcirculatory blood flow (MBF), decreased blood-flow resistance, and decreased MBF variability in the vascular beds on the stroke-affected side. Spectral analysis revealed that the vasodilation on the stroke-affected side could be partly attributed to decreased sympathetic neural activity. This is the first study to demonstrate the feasibility of evaluating the cerebral MBF conditions induced by AS in stroke patients by noninvasive LDF measurement. The present skull-intact measurement setup could aid the development of noninvasive detection techniques for determining bilateral differences in the cerebral MBF, and could thus become useful for the efficacy evaluation of treatment techniques for stroke. It might also promote understanding of the mechanisms underlying the responses and possible treatment efficacy of AS as applied to stroke patients.
Microvascular Research 03/2011; 81(3):289-94. · 2.83 Impact Factor
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ABSTRACT: Beat-to-beat cardiovascular variability analysis provides important information on the autonomic control. Bilateral radial arterial blood pressure waveforms (BPW) in stroke patients were compared to explore the efficacy of frequency-domain variability index in evaluating bilateral differences in the cerebral blood-flow condition.
Five-minute BPW signals were obtained in 22 stroke patients (Group S) and 21 healthy volunteers (control Group C). Amplitude proportions of the acquired pulses and their coefficient of variance (CVn) were calculated for 1st-10th harmonics to evaluate the blood pressure harmonic variability (BPHV).
In Group S, CV1-CV7 were significantly larger on the stroke side than on the contralateral side. CV1, CV3-CV5 and CV7 were significantly larger on the stroke side in Group S than on either side in Group C.
We first demonstrate the feasibility of using BPHV index to noninvasively detect the bilateral difference in cerebral vascular resistance in stroke patients. Two main indexes could be developed based on the present results: (1) bilateral differences in BPHV in stroke patients; (2) BPHV differences between normal and stroke subjects. It might have meaning in developing an easy-to-perform, noninvasive and continuous monitoring technique to improve the early detection and disease progress monitoring for stroke.
Biorheology 01/2011; 48(3-4):219-28. · 1.93 Impact Factor
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ABSTRACT: We aimed to assess the effects of acupuncture by analyzing the frequency content of skin blood-flow signals simultaneously recorded at the Hegu acupoint and two nearby nonacupoints following acupuncture stimulation (AS). Laser Doppler flowmetry (LDF) signals were measured in male healthy volunteers in two groups of experiments: needling the Hegu acupoint (n = 13) and needling a nearby nonacupoint (control experiment; n = 10). Each experiment involved recording a 20 min baseline-data sequence and two sets of effects data recorded 0-20 and 50-70 min after stopping AS. Wavelet transform with Morlet mother wavelet was applied to the measured LDF signals. Needling the Hegu acupoint significantly increased the blood flow, significantly decreased the relative energy contribution at 0.02-0.06 Hz and significantly increased the relative energy contribution at 0.4-1.6 Hz at Hegu, but induced no significant changes at the nonacupoints. Also, needling a nearby nonacupoint had no effect in any band at any site. This is the first time that spectral analysis has been used to investigate the microcirculatory blood-flow responses induced by AS, and has revealed possible differences in sympathetic nerve activities between needling the Hegu acupoint and its nearby nonacupoint. One possible weakness of the present design is that different De-Qi feelings following AS could lead to nonblind experimental setup, which may bias the comparison between needling Hegu and its nearby nonacupoint. Our results suggest that the described noninvasive method can be used to evaluate sympathetic control of peripheral vascular activity, which might be useful for studying the therapeutic effects of AS.
Evidence-based Complementary and Alternative Medicine 01/2011; 2011:435928. · 4.77 Impact Factor
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ABSTRACT: Analyzing the beat-to-beat cardiovascular variability (e.g., heart-rate variability analysis) provides important information regarding circulatory autonomic control. The present study aimed to use laser Doppler flowmetry (LDF) and beat-to-beat analysis to elucidate changes in the microcirculatory blood flow (MBF) and variations (MBFV) therein induced by local heating stimulation.
For each experiment, we applied nonpainful local heating and recorded a 20-min heating effect, which was segmented into four measurements separated by 5 min as M1-M4. DCflux (average LDF flux) was calculated for each pulse, and the coefficient of variance of DCflux (DCCV) was then calculated to evaluate the beat-to-beat MBFV.
In the linear regression analysis of the M2-M4 data sequence, the slope between relative changes (compared with M1 values) in DCCV and DCflux, and those between the proceeding DCCV and the subsequent DCflux, were negative (R(2) > 0.40 for all; p < 0.05).
This is the first study to reveal a possible time-domain relationship between changes in MBF and MBFV parameters. Our results suggest that MBFV evaluated from the beat-to-beat LDF waveform is useful for monitoring the microcirculatory regulatory activities of arteriolar openings, and might therefore be particularly meaningful when evaluating treatment techniques or drugs aimed at improving microcirculatory perfusion.
Photomedicine and laser surgery 12/2010; 28(6):785-92. · 1.76 Impact Factor
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ABSTRACT: In the present study, laser Doppler measurement was used to quantitatively investigate the microcirculatory effects of contact pressure stimulation (PS) underneath the Hoku acupoint and its nearby nonacupoint, to improve the understanding of the mechanisms underlying acupressure therapy. A control group (no PS applied) and three experimental groups with different applied PS (group A, 60 mmHg on the Hoku acupoint; group B, 60 mmHg on a nearby nonacupoint; group C, 50 mmHg on a nearby nonacupoint) were studied. Each experiment involved recording data of a 20 min baseline and two periods of effects after stopping PS. The relative energy contribution (REC) in five frequency bands, as revealed by Morlet wavelet transformation, was calculated. At the pressed site, the average value of the laser Doppler flux signal was increased only in group A, and coefficient of variance of the amplitude sequence was only significantly decreased during measurement (M1: 0 to 20 min) in group B. The RECs of the myogenic-related band were significantly increased in groups A and C, whereas there were no significant changes found in group B. The improved microcirculatory blood-flow perfusion at Hoku may partly explain why acupressure can exert better therapeutic effects than PS applied to other sites. The laser Doppler spectra responses illustrated that the induced pressure-induced vasodilation can be attributed mainly to the myogenic response. Laser Doppler measurement and analysis therefore represent a noninvasive method of examining the microcirculatory efficacy of acupressure therapy.
Physiological Measurement 06/2010; 31(6):829-41. · 1.68 Impact Factor
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Biorheology 01/2010; 47(5):333. · 1.93 Impact Factor
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ABSTRACT: Moxibustion is a commonly used treatment in traditional Chinese medicine (TCM) that involves the application of local heating (LH) at acupoints.
We used laser Doppler flowmetry (LDF) and spectrum analysis to investigate differences in the microcirculatory responses to the application of homogeneous LH at Hoku and two nearby nonacupoints.
Thirty-four trials were performed on 10 male healthy volunteers. For each experiment, we recorded a 20-minute baseline data sequence, then applied LH by an infrared-radiation lamp and recorded another 20-minute heating-effect sequence. The relative energy contributions (RECs) for LDF periodic oscillations in five characteristic frequency regions from 0.0095 to 1.6 Hz (segmented into FR1-FR5) were calculated by wavelet analysis.
The flux increased significantly following LH. Decreases in RECs of FR2 and FR3, increases in RECs of FR1 and FR5, and the flux increase following LH were all largest at Hoku.
Our results suggest that the application of LH to acupoints induces larger therapeutic effects. This might partly account for the physiological mechanism of moxibustion, and could contribute to optimizing the microcirculatory improvement by applying LH treatments. Frequency-band analysis appears to be a promising tool for studying microcirculatory responses induced by various TCM treatments.
Photomedicine and laser surgery 09/2009; 27(6):855-61. · 1.76 Impact Factor
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ABSTRACT: We used laser Doppler flowmetry (LDF) and spectrum analysis to investigate the microcirculatory responses to pressure stimulation (PS) of the skin surface. A control group without PS applied, and four groups with different PS (20, 60, 100 and 160 mmHg in groups PS(20), PS(60), PS(100) and PS(160), respectively) were formed from seven volunteers. Each experiment involved recording a 20 min baseline and two effect data recorded at 0-20 and 50-70 min after stopping PS. The relative energy contribution (REC) in five frequency bands revealed by Morlet-wavelet transformation was calculated. At the pressed site, the dc component of the flux signal in the second effect increased significantly only in group PS(60) compared with the control values. The REC was significantly increased in a myogenic-related band in groups PS(60), PS(100) and PS(160), and was significantly decreased in a nerve-related band only in group PS(160). Different PS magnitudes compress vessels to different extents. The proposed vessel-pressing model-which is supported by the results of spectral analysis of flux signals-might help to elucidate the underlying mechanism. The study results indicate that an improved perfusion was sustained for the longest time when applying 60 mmHg PS. This might aid the development of techniques for improving skin microcirculatory perfusion.
Physiological Measurement 11/2008; 29(12):1421-34. · 1.68 Impact Factor
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Hsin Hsiu,,
Wei-Chen Hsu,,
Chia Liang Hsu,,
Shih-Min Huang,,
Ming-Yie Jan,,
Wei-Kung Wang,,
Yuh-Ying Lin Wang,
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ABSTRACT: We aimed to characterize the frequency spectra of skin blood flow signals simultaneously recorded at Hoku, an important acupoint in oriental medicine, and two nearby nonacupoints to understand the underlying physiological mechanism of acupuncture points. ECG and laser Doppler flowmetry signals were measured simultaneously. A four-level Haar wavelet transform was applied to the measured 20-minute LDF signals, and periodic oscillations with five characteristic frequency peaks were obtained within the following frequency bands: 0.0095–0.021, 0.021–0.052, 0.052–0.145, 0.145–0.6, and 0.6–1.6 Hz (defined as FR1–FR5), respectively. The power in FR3 was significantly larger at Hoku than at the two nonacupoints. Spectral analysis of the flux signal revealed that one of the major microcirculatory differences between acupoints and nonacupoints was in the different myogenic responses of their vascular beds. This information may aid the development of a method to noninvasively study the microcirculatory characteristics of the acupoint.
Engineering in Medicine and Biology Society, 2008. EMBS 2008. 30th Annual International Conference of the IEEE; 09/2008
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ABSTRACT: We aimed to assess the effects of acupuncture by analyzing the alternating current (AC) component of skin blood-flow signals (around the heartbeat frequency) simultaneously recorded at the Hoku acupoint, which is an important acupoint in oriental medicine, and two nearby non-acupoints following acupuncture stimulation (AS). Laser Doppler flowmetry signals were measured in 28 experiments on nine volunteers. Each experiment involved the recording of a 20-min control-data sequence and two sets of effects data recorded 0-20 min and 50-70 min after the AS had been stopped. The direct current (DC) and AC components (DCflux and ACflux, respectively), pulse width (PW), and foot delay time (FDT) of the flux signal were calculated. The DCflux, ACflux, PW, and FDT were all significantly increased only at Hoku following AS. Regression analysis between the DCflux and ACflux revealed that the slope was largest (>1) at Hoku among the measurement sites. Our results indicated that both the DCflux and ACflux in the microcirculatory perfusion were increased by stimulation at the Hoku acupoint, with the change being greatest for the latter. Parameters calculated from the pulsatile flux waveform, such as the PW and FDT, could contribute to noninvasive evaluations of the sympathetic neural activities and of the improvement in perfusion following AS.
Lasers in Medical Science 09/2008; 24(4):553-60. · 2.00 Impact Factor
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ABSTRACT: We aimed to characterize the frequency spectra of skin blood flow signals recorded at Hoku, an important acupuncture point (acupoint) in oriental medicine. Electrocardiogram (ECG) and laser Doppler flowmetry signals were measured simultaneously in 31 trials on seven volunteers aged 21-27 years. A four-level Haar wavelet transform was applied to the measured 20 min laser Doppler flowmetry (LDF) signals, and periodic oscillations with five characteristic frequency peaks were obtained within the following frequency bands: 0.0095-0.021 Hz, 0.021-0.052 Hz, 0.052-0.145 Hz, 0.145-0.6 Hz, and 0.6-1.6 Hz (defined as FR1-FR5), respectively. The relative energy contribution in FR3 was significantly larger at Hoku than at the two non-acupoints. Linear regression analysis revealed that the relative energy contribution in FR3 at Hoku significantly increased with the pulse pressure (R(2) = 0.48; P < 0.01 by F-test). Spectral analysis of the flux signal revealed that one of the major microcirculatory differences between acupoints and non-acupoints was in the different myogenic responses of their vascular beds. This information may aid the development of a method for the non-invasive study of the microcirculatory characteristics of the acupoint.
Lasers in Medical Science 05/2008; 24(3):353-8. · 2.00 Impact Factor
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ABSTRACT: The present study used laser Doppler flowmetry (LDF) to investigate the connection between skin microcirculatory flow and the length of the RR interval (LRR). Local heating was performed on healthy volunteers to further elucidate its effect on LDF index. ECG and LDF signals were measured in 102 trials on seven volunteers. Each experiment involved a 5 min control and a 5 min heating-effect sequence. Each laser Doppler flux pulse was categorized into four groups according to its LRR compared with the 5 min average LRR. Synchronized averaging analysis was applied to the four groups of pulses to obtain their averaged waveforms, from which four flux parameters were calculated. The ac component of the flux increased significantly with increasing LRR, and the differences therein between the groups with LRR more than 4% smaller and more than 4% larger than the average LRR increased from 15.8% during the control period to 23.9% during the heating period. Understanding of the different flux responses between the control and local-heating experiments may aid the development of a new index, which helps to avoid LDF's main drawback of providing only qualitative measurement.
Physiological Measurement 03/2008; 29(2):245-54. · 1.68 Impact Factor
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ABSTRACT: We aimed to characterize the frequency spectra of skin blood flow signals simultaneously recorded at Hoku, an important acupoint in oriental medicine, and two nearby nonacupoints to understand the underlying physiological mechanism of acupuncture points. ECG and laser Doppler flowmetry signals were measured simultaneously. A four-level Haar wavelet transform was applied to the measured 20-minute LDF signals, and periodic oscillations with five characteristic frequency peaks were obtained within the following frequency bands: 0.0095-0.021, 0.021-0.052, 0.052-0.145, 0.145-0.6, and 0.6-1.6 Hz (defined as FR1-FR5), respectively. The power in FR3 was significantly larger at Hoku than at the two nonacupoints. Spectral analysis of the flux signal revealed that one of the major microcirculatory differences between acupoints and nonacupoints was in the different myogenic responses of their vascular beds. This information may aid the development of a method to noninvasively study the microcirculatory characteristics of the acupoint.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2008; 2008:1084-6.
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ABSTRACT: We aim to analyze the frequency content of skin blood flow signals recorded on Hoku following acupuncture stimulation (AS). Each experiment involved recording a 20-minute control-data sequence and two effects data recorded 0-20 and 50-70 minutes after stopping AS, respectively. 4-level Haar-wavelet transform was performed on the measured LDF signals, and periodic oscillations with five characteristic frequency peaks were obtained within the frequency interval: 0.0095-0.021, 0.021-0.052, 0.052-0.145, 0.145-0.6, and 0.6-1.6 Hz, respectively. Band proportion and DC component of the flux signal were calculated to elucidate the effects following AS. At Hoku, the DCflux was significantly increased, the band proportion of the 1st and the 2nd frequency band were significantly decreased, and that of the 5th band was significantly increased following AS. Our results facilitate a non-invasive method to evaluate sympathetic control of peripheral vascular activity between the acupoint and non-acupoints, which may be important for studying the therapeutic effects of AS.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2008; 2008:2916-9.
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ABSTRACT: Acupuncture points (acupoints) form part of the meridian system that constitutes the most fundamental concept in oriental medicine, but their physiological basis has not been clarified. In this study we employed laser Doppler flowmetry (LDF) to extract the microcirculatory characteristics of acupoints and their surrounding tissues, and we interpreted the results from the viewpoint of microcirculatory physiology. Three groups of measurements were performed focusing on the following two important acupoints in oriental medicine in healthy volunteers (n = 13 for group A and n = 9 for groups B and C, respectively): Hoh-Ku (Li4, on the hand) and Ching-Ku (B64, on the foot). The two groups of measurements around Hoh-Ku (Groups A and B) were so designed as to examine the effect of the direction of the nonacupoint away from the acupoint, whereas comparison between the Hoh-Ku and the Ching-Ku measurements was to verify whether the phenomenon was consistent in the upper and the lower extremities. We found that the mean LDF signals were significantly larger at the acupoints than in their surrounding tissues (all p < 0.05), which indicates a larger blood supply into the microvascular beds of acupoints. The results indicate that the physical properties of the vascular structure of acupoints may affect the perfusion resistance, and thereby modulate the microcirculatory perfusion in accordance with tissue needs. This finding facilitates the localization of acupoints, helps in identifying the connection between microcirculatory physiology and responses to acupoint stimulation, and introduces an objective research method for understanding the mechanisms that underlie oriental medicine.
Physiological Measurement 11/2007; 28(10):N77-86. · 1.68 Impact Factor
