Infrared-monitored cold response in the assessment of Raynaud's phenomenon

Clin Exp Dermatol. 2006 Jan;31(1):6-12. doi: 10.1111/j.1365-2230.2005.01995.x.

Abstract

Background: Evaluation of treatments for Raynaud's phenomenon (RP) requires objective response parameters in addition to clinical activity scores. Thermographic monitoring of fingertip re-warming after cold challenge has been widely used but usually requires sophisticated equipment. We have previously shown that fingertip re-warming after cold challenge follows a first-order transient response curve that can be described by a single variable, designated tau.

Objectives: Here, we describe a novel device termed a duosensor, which records the tau value upon cold challenge in an automated manner.

Methods: We determined tau values in healthy probands, patients with primary or secondary RP associated with autoimmune disease and patients with scleroderma-associated RP following cold challenge, to determine assay variability, sensitivity and specificity.

Results: Duosensor-based thermography exhibited low intraindividual variability in healthy probands. As expected, tau values in RP patients were significantly increased compared with controls (8.08 +/- 3.65 min vs. 3.23 +/- 1.65 min). The duosensor-determined tau value yielded a specificity of 94.6% and predictive value of 95.3% for the presence of RP in a retrospective analysis of 139 patients. Furthermore, in a cohort of scleroderma patients with RP, patient self-assessment of RP severity correlated with tau values.

Conclusions: Taken together, the present data suggest that tau value determination provides a suitable outcome measure for clinical studies of novel RP treatments. As the duosensor is a simple stand-alone device requiring no supporting equipment and minimal personnel attention, it should allow RP activity monitoring even in clinical settings with minimal technical infrastructure.

MeSH terms

  • Body Temperature / physiology
  • Cohort Studies
  • Cold Temperature*
  • Fingers / physiopathology*
  • Humans
  • Infrared Rays
  • Plethysmography / instrumentation
  • Plethysmography / methods
  • Predictive Value of Tests
  • Raynaud Disease / diagnosis*
  • Raynaud Disease / physiopathology
  • Regional Blood Flow / physiology
  • Retrospective Studies
  • Scleroderma, Systemic / diagnosis
  • Scleroderma, Systemic / physiopathology
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Thermography / methods