Synergetic interpretation of patterned vasomotor activity in microvascular perfusion: discrete effects of myogenic and neurogenic vasoconstriction as well as arterial and venous pressure fluctuations.

Synergetic concepts allow to identify emergent coordination phenomena between interacting physiological systems, for example between the cutaneous microcirculation, the sympathetic nervous system and the cardiac and pulmonary systems. The temporal patterns (oscillations of various frequencies) that are found in the data obtained with laser-Doppler anemometers (LDA; e.g. Periflux 2 used in the study) can be investigated by simultaneous recording of photoplethysmographic data obtained in the identical region of interest, as well as in cutaneous regions treated with vasoparalytic procedures which permit to record the dynamics of the arterial system. These strategies were applied to studies in the cutaneous microcirculation (volar side of the index fingers) as well as to mucosal microcirculation (maxillar gingiva) in healthy subjects and in patients suffering from autonomic dysfunction (cutaneous microcirculation) or gingivitis. By this procedure, it could be corroborated that - contrary to popular notions - the temporal fluctuations in the LDA records do not necessarily reflect myogenic vasomotion, but can have multiple causes. In a confirming recent study [Schmid-Schönbein et al., J Auton Nerv Syst, 57, 136-140, 1996], we have demonstrated that the LDA fluctuations under conditions of normal ambient temperature and hand position most likely reflect neurogenic vasoconstriction. Under exceptional conditions, different patterns emerge. Prolonged exposure to ambient temperature (18 degrees C) leads to marked vasoconstriction, with occasional vasodilator escape ('miniature hunting reaction'). Normal subjects under gravitational load and in warm environment (28 degrees C ambient) silence their neurogenetic vasoconstriction reactions, which allows sinusoidal vasomotion to dominate. A similar phenomenon is seen in neuropathic patients at 21-24 degrees C (presumably due to structural defects). Fluctuations in LDA signal taken from the healthy gingiva are entrained to arterial, those taken from inflamed gingiva to respiratory activity. The theory and practice of nonlinear analysis is discussed, and data compression procedures allowing to portray characteristic temporal patterns for future diagnostic procedures are presented.