Studying Erythromelalgia Using Doppler Flowmetry Perfusion Signals and Wavelet Analysis—An Exploratory Study

Luis Monteiro Rodrigues, Joana Caetano, Sergio Faloni Andrade, Clemente Rocha, José Delgado Alves, Hugo Alexandre Ferreira

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1 Citation (Scopus)

Abstract

Erythromelalgia (EM) is a rare disease, which is still poorly characterized. In the present paper, we compared the hand perfusion of one female EM patient, under challenges, with a healthy control group. Using a laser Doppler flowmeter (LDF) with an integrated thermal probe, measurements were taken in both hands at rest (Phase I) and after two separate challenges—post-occlusive hyperemia (PORH) in one arm (A) and reduction of skin temperature (cooling) with ice in one hand (B) (Phase II). The final measurement periods corresponded to recovery (Phases III and IV). The control group involved ten healthy women (27.3 ± 7.9 years old). A second set of measurements was taken in the EM patient one month after beginning a new therapeutic approach with beta-blockers (6.25 mg carvedilol twice daily). Z-scores of the patient’s LDF and temperature fluctuations compared to the control group were assessed using the Wavelet transform (WT) analysis. Here, fluctuations with |Z| > 1.96 were considered significantly different from healthy values, whereas positive or negative Z values indicated higher or lower deviations from the control mean values. Cooling elicited more measurable changes in LDF and temperature fluctuations, especially in higher frequency components (cardiac, respiratory, and myogenic), whereas PORH notably evoked changes in lower frequency components (myogenic, autonomic, and endothelial). No significant Z-score deviations were observed in the second measurement, which might signify a stabilization of the patient’s distal perfusion following the new therapeutic approach. This analysis involving one EM patient, while clearly exploratory, has shown significant deviations in WT-derived physiological components’ values in comparison with the healthy group, confirming the interest in using cold temperature as a challenger. The apparent agreement achieved with the clinical evaluation opens the possibility of expanding this approach to other patients and pathologies in vascular medicine.

Original languageEnglish
Article number3327
JournalBiomedicines
Volume11
Issue number12
DOIs
Publication statusPublished - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Funding

This research was financed by national funds through FCT—Foundation for Science and Technology, I.P. (Portugal), under the [UIDB/04567/2020] and [UIDP/04567/2020] programs. All imaging instrumentation was provided by ALIES-COFAC.

FundersFunder number
ALIES-COFAC
Fundação para a Ciência e a TecnologiaUIDP/04567/2020, UIDB/04567/2020

    Keywords

    • erythromelalgia
    • laser doppler flowmetry
    • skin perfusion
    • wavelet analysis

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