title: Use of Laser Speckle Contrast Imaging to Assess Digital Microvascular Function in Primary Raynaud Phenomenon and Systemic Sclerosis: A Comparison Using the Raynaud Condition Score Diary.
abstract: OBJECTIVE
  Evaluate objective assessment of digital microvascular function using laser speckle contrast imaging (LSCI) in a cross-sectional study of patients with primary Raynaud phenomenon (RP) and systemic sclerosis (SSc), comparing LSCI with both infrared thermography (IRT) and subjective assessment using the Raynaud Condition Score (RCS) diary.
  
  
  METHODS
  Patients with SSc (n = 25) and primary RP (n = 18) underwent simultaneous assessment of digital perfusion using LSCI and IRT with a cold challenge on 2 occasions, 2 weeks apart. The RCS diary was completed between assessments. The relationship between objective and subjective assessments of RP was evaluated. Reproducibility of LSCI/IRT was assessed, along with differences between primary RP and SSc, and the effect of sex.
  
  
  RESULTS
  There was moderate-to-good correlation between LSCI and IRT (Spearman rho 0.58-0.84, p < 0.01), but poor correlation between objective assessments and the RCS diary (p > 0.05 for all analyses). Reproducibility of IRT and LSCI was moderate at baseline (ICC 0.51-0.63) and immediately following cold challenge (ICC 0.56-0.86), but lower during reperfusion (ICC 0.3-0.7). Neither subjective nor objective assessments differentiated between primary RP and SSc. Men reported lower median daily frequency of RP attacks (0.82 vs 1.93, p = 0.03). Perfusion using LSCI/IRT was higher in men for the majority of assessments.
  
  
  CONCLUSIONS
  Objective and subjective methods provide differing information on microvascular function in RP. There is good convergent validity of LSCI with IRT and acceptable reproducibility of both modalities. Neither subjective nor objective assessments could differentiate between primary RP and SSc. Influence of sex on subjective and objective assessment of RP warrants further evaluation.
authors.affiliation: From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath. John.Pauling@rnhrd.nhs.uk.
authors.forename: John D
authors.initials: JD
authors.lastname: Pauling
authors.affiliation: From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath.
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Shipley
authors.affiliation: From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath.
authors.forename: Darren J
authors.initials: DJ
authors.lastname: Hart
authors.affiliation: From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath.
authors.forename: Anita
authors.initials: A
authors.lastname: McGrogan
authors.affiliation: From the Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; and the Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.J.D. Pauling, BMedSci, BMBS, MRCP, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath; J.A. Shipley, BSc, PhD; D.J. Hart, BSc, PhD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases; A. McGrogan, PhD, Department of Pharmacy and Pharmacology, University of Bath; N.J. McHugh, BMBS, FRCP, FRCPath, MD, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, and Department of Pharmacy and Pharmacology, University of Bath.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: McHugh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D011928:Raynaud Disease / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D012595:Scleroderma, Systemic / Q000503:physiopathology*
keywords: IMAGING; OUTCOMES MEASUREMENT; RAYNAUD PHENOMENON; REPRODUCIBILITY; SYSTEMIC SCLEROSIS