On the suitability of laser-Doppler flowmetry for capturing microvascular blood flow dynamics from darkly pigmented skin

Objective: To assess the performance of laser Doppler flowmetry (LDF) in measuring blood perfusion from darkly-pigmented skin, i.e. skin with high melanin concentration. LDF provides for the noninvasive monitoring of microvascular blood flow dynamics. It has been used extensively on light-skinned subjects, i.e. on skin with low melanin concentration, in both the healthy and pathological states. Because the optical properties of human skin might affect the reliability of optically-based diagnostic equipment, the effectiveness of LDF needs to be checked and evaluated on dark skin, too, if this method is to be useful in global healthcare. Approach: Thirteen dark-skinned subjects and ten light-skinned subjects were included in the study. Microvascular blood flow dynamics was measured on both the right and left ankles using LDF with a laser diode of wavelength 780 nm. The characteristics of time-varying blood flow oscillations were investigated by wavelet analysis, nonlinear mode decomposition and wavelet phase coherence. An electrocardiogram (ECG), skin temperature, and respiratory effort were measured simultaneously with the LDF for each subject. Main results: No significant differences were observed between the groups in the mean blood perfusion (p   >  0.1), or wavelet power (p   >  0.6). The instantaneous heart rate (IHR), extracted from the LDF at each of the recording sites, and from the ECG, did not differ significantly between the groups (p   >  0.8). Nor did the wavelet power of the IHR differ (p   >  0.8) between the groups. The only significant difference found between the groups lay in left/right ankle blood flow coherence near the cardiac frequency, attributable to known ethnic physiological differences. Significance: These results indicate that high melanin concentrations in skin exert no significant influence on the ability of LDF to monitor microvascular blood flow dynamics when using a laser diode of wavelength 780 nm. Hence LDF can help in the diagnosis and exploration of the pathogenesis of diseases such as diabetes, hypertension, or malaria in darkly pigmented patients across sub-Saharan Africa. (paper)