Facilitating laser Doppler measurements of cutaneous adrenergic vasoconstriction: a comparison of methods

Detecting vasoconstriction in the skin of the human forearm is often difficult because cutaneous perfusion is usually low, even in the absence of vasoconstrictive agents. However, flow through "vasoconstricted" skin can be detected by increasing the background skin blood flow. The aim of the current study was to evaluate local warming and postocclusive reactive hyperemia as techniques for increasing background flow to facilitate laser Doppler measurements of cutaneous vasoconstriction in the forearm. Noradrenaline introduced by iontophoresis into the forearm of healthy volunteers initially reduced the peak hyperemic response (mean decrease in hyperemia 21 +/- 7%, p <0.01), compared with a saline control. However, vasoconstriction was unrelated to the dose of noradrenaline and was not detectable when the test was repeated, possibly because the peak of the normal hyperemic response decreased with repeated occlusions. When the forearm was warmed to 42 degreesC, noradrenaline introduced by iontophoresis produced dose-dependent vasoconstriction relative to saline control sites and skin not having undergone iontophoresis (greatest mean decrease 64 +/- 7%, p <0.001). Therefore, local warming is recommended over reactive hyperemia for facilitating laser Doppler recordings of cutaneous vasoconstriction in the human forearm.