Reproducibility of cerebral blood volume measurements by near infrared spectroscopy in 16 healthy elderly subjects.

Near infrared spectroscopy (NIRS) is a non-invasive method to monitor cerebral haemodynamics. Used either alone or in combination with other non-invasive methods such as transcranial Doppler sonography, this technique is well suited for use in cerebrovascular research in ageing. Reproducibility of NIRS, however, has only been determined in neonates and adults. We applied controlled desaturation (the O(2)-method) to measure the cerebral blood volume (CBV) with NIRS in 16 healthy subjects aged 65 to 88. This method uses deoxygenated haemoglobin (the concentration of which is manipulated by desaturation) as an intravascular tracer for NIRS. We determined repeatability (between tests interval: 2 min), short-term reproducibility (intervals of 20 and 40 min) and long-term reproducibility (interval > 2 weeks). We found a coefficient of variation (CV) of 12.5% for repeatability and a CV of 11.7% for short-term reproducibility. The CV for long-term reproducibility was 15%. We conclude that NIRS can reproducibly measure CBV in subjects aged 65 and older, using the O(2)-method. In this group of healthy subjects, this method was well tolerated.

L-carnitine and creatine in Friedreich's ataxia. A randomized, placebo-controlled crossover trial.

Impaired oxidative phosphorylation is a crucial factor in the pathogenesis of Friedreich's ataxia (FA). L-carnitine and creatine are natural compounds that can enhance cellular energy transduction. We performed a placebo-controlled triple-phase crossover trial of L-carnitine (3 g/d) and creatine (6.75 g/d) in 16 patients with genetically confirmed FA. Primary outcome measures were mitochondrial ATP production measured as phosphocreatine recovery by 31Phosphorus magnetic resonance spectroscopy, neurological deficits assessed by the international co-operative ataxia rating scale and cardiac hypertrophy in echocardiography. After 4 months on L-carnitine phosphocreatine recovery was improved compared to baseline (p<0.03, t-test) but comparison to placebo and creatine effects did not reach significance (p=0.06, F-test). Ataxia rating scale and echocardiographic parameters remained unchanged. Creatine had no effect in FA patients. L-carnitine is a promising substance for the treatment of FA patients, and larger trials are warranted.

Muscle oxygen consumption, determined by NIRS, in relation to external force and EMG.

Local oxygen consumption in a muscle (VO(2)) can be determined by near infrared spectroscopy (NIRS). In principle it should be possible to use this measure to validate musculoskeletal models. However, the relationship between VO(2) and external force, or between VO(2) and surface EMG, as a measure for muscle activity, is hardly known. The aim of this study was: (1) to evaluate the characteristics of the relationship between VO(2) and external moments and (2) to determine whether differences exist between the EMG-moment relationship and the VO(2)-moment relationship. Subjects (n=5) were asked to perform isometric contractions exerting combinations of elbow flexion and pro/supination moments at force levels up to 70% of their maximum. Simultaneous surface-EMG and NIRS measurements were performed on the m. biceps breve (BB) and the m. brachioradialis (BR). A linear relationship was found between EMG and VO(2). For the BB VO(2) and EMG were linearly related to both the flexion moment and the pro/supination moment. However, for the BR only a linear relationship with flexion moment was found. As expected, based on the findings above, the relationship between VO(2) and elbow flexion moment can be described by a linear equation, under the conditions of this study (isometric, and force levels up to 70%). These findings suggest that load sharing is independent of force level and that next to EMG, VO(2) can be used for the validation of musculoskeletal models.