Here we present a combination of laser Doppler perfusion imaging (LDPI) and laser Doppler perfusion monitoring (LDPM) to measure spinal cord local blood flows and oxygen saturation (SO2), as well as a standardized procedure for introducing spinal cord trauma on rat.
Laser Doppler flowmetry (LDF) is a noninvasive method for blood flow (BF) measurement, which makes it preferable for measuring microcirculatory alterations of the spinal cord. In this article, our goal was to use both Laser Doppler imaging and monitoring to analyze the change of BF after spinal cord injury. Both the laser Doppler image scanner and the probe/monitor were being employed to obtain each readout. The data of LDPI provided a local distribution of BF, which gave an overview of perfusion around the injury site and made it accessible for comparative analysis of BF among different locations. By intensely measuring the probing area over a period of time, a combined probe was used to simultaneously measure the BF and oxygen saturation of the spinal cord, showing overall spinal cord perfusion and oxygen supply. LDF itself has a few limitations, such as relative flux, sensitivity to movement, and biological zero signal. However, the technology has been applied in clinical and experimental study due to its simple setup and rapid measurement of BF.
The tissue of the spinal cord is highly vascularized and extremely sensitive to hypoxia induced by spinal cord injury (SCI). Our previous studies showed that blood flow of the spinal cord was significantly decreased after concussion injury1,2, which might be related to the deficit of motor function. Recent studies have shown that the integrity of blood vessels following SCI is well-correlated with the improvement of sensory motor function3. It has been reported that improved vascularity might rescue white matter, indirectly leading to improved function4. Therefore, the maintenance of post-injury spinal cord perfusion appeared to be of primary importance for preserving viability and functionality.
The effects of various treatments on perfusion after SCI have been examined by numerous investigators using a variety of techniques in experimental models of SCI5,6,7. Laser Doppler, as a well-established technique, was undoubtedly a useful method for quantifying perfusion in several animal and human studies8,9,10,11. The technique is based on measuring the Doppler shift12 induced by moving red blood cells to the illuminating light. Since the commercialization of the technique in the early 1980s, great progress has been made in laser technology, fiber optics and signal processing for measuring perfusion by laser Doppler instruments13, which made LDF into a reliable technology.
In the current study, both methods of laser Doppler measurement were applied to evaluate blood flow (BF) in the spinal cords of concussive rats. Due to the noninvasive nature of the technology and its simple setup, our protocol provides a sensitive, rapid and reliable method for BF measurements of the spinal cord. More importantly, this method allows longitudinal study of BF post concussive SCI without animal sacrifice at each time point.
Due to the ability to assess the BF of the tissue and fast changes of perfusion during stimulation, it is possible to apply this protocol to evaluate cerebral BF14,15 as well as measure other tissues such as liver16,17, skin18,19, and bowel20. In a rat model of transient occlusion of the middle cerebral artery, the laser Doppler readings were used to ensure proper reduction of the BF rate to levels that are expected in the ischemic penumbra14. In rats which have undergone critical limb ischemia (CLI) induction, laser Doppler scanning was applied to observe hind limb BF before and after the CLI procedure and during different periods after treatment21. Additionally, the bioavailability and metabolic clearance of some drugs depended on hepatic BF, which was detected by LDF16. Therefore, LDF could be widely used in experimental model, pharmacodynamic, and pharmacokinetic evaluation.
Animal protocols involving experimental animals followed guidelines established by the National Institutes of Health (NIH) and were approved by the Animal Care and Use Committee of Capital Medical University.
The procedures of introducing SCI and measuring BF of spinal cord using laser Doppler equipment described below were used in a published study1.
1. Preparation for the Surgery
2. Preparation of Rat for Surgery
3. Laminectomy and the Concussion to the Spinal Cord
NOTE: To perform laminectomy only for the sham group, follow steps 3.1 to 3.6.
4. Laser Doppler Scanning
5. Laser Doppler Monitoring
6. Sutures and Post-Operation Care
LDPI was used to measure BF in the spinal cord, which was quantified along the rostral-caudal axis of the spinal cord by extracting linear profiles (Figure 4). Figure 5A and Figure 5B represent the flux imaging of the spinal cord of the sham group and SCI group, respectively. Figure 5C and Figure 5D represent the altering BF along the rostral-caudal axis of the spinal cord of sham group and SCI group, respectively. A comparison of Figure 5A and Figure 5B demonstrated that SCI induced reduction of BF, and BF of the epicenter was lower than rostral cord and caudal cord.
LDPM showed the time-domain LD signal and SO2 and Figure 6 illustrated the acquiring and processing of the LDPM data. After the data were recorded, an 8 min stretch of continuous Region of Interest (ROI) data was selected, which was then filtered by a built-in filter to minimize any non-biological signals. Subsequently, the ROI was statistically analyzed and the results were exported in a raw data format. Figure 7 recorded the periodic variation of BF and SO2 over time in the sham group and SCI group. As shown in Figure 7A, the spinal cord BF of the SCI group significantly decreased compared with the sham group. Simultaneously, the SO2 of the spinal cord was remarkably lower after spinal cord concussion (Figure 7B), which was consistent with the change of BF after injury. To reduce disturbance, measurements were taken repeatedly and the data were normalized.
Figure 1. Laminectomy and the concussion to the spine. (A) Disconnect the junction between T10 and T11. (B) Insert the forceps to break the pedicle. (C) Break the lamina and expose the spinal cord. (schematic sketch of the anatomy) (D) Stabilize the spine on the experiment table. (E) Initial impact using the software and check the data. Please click here to view a larger version of this figure.
Figure 2. Step by step setup for laser Doppler scanning. (A) General setup for scanning. (B) Setup interface for image scan parameters. (C) Setup interface for video and distance. (D) Setup interface for repeat scan. Please click here to view a larger version of this figure.
Figure 3. Step by step setup for laser Doppler monitoring. (A) Start a new experiment. (B) Select channel display. (C) Input subject details. (D) To start data recording. Please click here to view a larger version of this figure.
Figure 4. Process of laser Doppler perfusion imaging. (A) 8 continuous scans derived by scanning rats in the sham group. (B) The average image of the continuous scans. (C, D) Region of Interest (ROI) was selected based on the infrared image to extract the intensity profile along the central axis of the spine. The inset box shows the profiling result of the ROI. The color bar indicated perfusion units measured by laser Doppler scanner where blue represents the lowest value and red represents the highest value. The instrument detected the relative value of perfusion, namely "flux". Please click here to view a larger version of this figure.
Figure 5. BF of the spinal cord was detected using laser Doppler perfusion imaging. (A, B) A 5 mm ROI was drawn on the flux map along the axis of the spine from the rostral to the caudal cord. (C, D) The intensity profile of each ROI along a line centered on the spinal cord axis was extracted for quantification.
Figure 6. Process of laser Doppler perfusion monitoring. (A) The recording of raw data where the time marker indicated the starting point. (B) Selection of an 8 min ROI. (C) The selected data were then filtered by a built-in filter. (D) Statistical analysis of ROI. (E) Export of the raw data. Please click here to view a larger version of this figure.
Figure 7. Spinal cord perfusion was evaluated by laser Doppler perfusion monitoring. (A) A 15 s sample of the raw blood flow output from both sham group and SCI group. (B) A 15 s sample of the raw oxygen saturation output from both sham group and SCI group. The laser Doppler probe was positioned 2 mm rostrally to the middle point at the level just above the surface of the spinal cord to the right side of the central vein. Please click here to view a larger version of this figure.
A few details should be noticed when performing this protocol. Firstly, the process of anesthesia and surgery should be carried out as quickly and elegantly as possible to minimize the introduced stress to the animal. To reduce disturbance to the results, keep the animal in a relatively peaceful and stable state. Secondly, more attention should be paid to bleeding during the measurement using laser Doppler equipment, since blood could potentially interfere with the reading. Finally, during the data recording, animals should be kept in a temperature controlled environment to avoiding inconsistent results caused by temperature variance.
There are several important factors researchers should consider when using laser Doppler scanning. As mentioned in protocol, the distance of the scan should be kept consistent throughout the experiment for comparable results. For small areas, we suggest high resolution with multiple scans to produce reliable data of the BF. Additionally, we recommend putting a sterile gauze with the marked direction of the animal covering the surgical area with a small window only exposing the spine to further minimize background.
Probe positioning is the critical consideration in adapting and implementing the monitoring protocol. The probe should be perpendicular to the measured surface and excessive pressure should be avoided. To achieve this goal, the rat spine should be straightened and leveled by underlaying the animal with Styrofoam if necessary, and the probe should be positioned using the apparatus and the coordinates to make sure measurements are taken from roughly the same area.
As discussed in our previous article1, there are some limitations to this technology, such as the disability of calibration with absolute flow and sensitivity to movement artifact24. Another well-noticed limitation is the biological zero signal – that is, the presence of signal without BF25,26. To minimize the influence of these limitations to the results, measurements should be taken repeatedly and normalization is recommended to reduce disturbance.
Other techniques such as radioactive microsphere technique and Doppler ultrasound technique have been developed for BF measurement. However, the former is not in real time since a radioactive substance must be injected into the blood and the tissue needs to be excised for the measurement27. As for the technology of contrast enhanced ultrasound imaging, although it is non-invasive like LDF, contrast agent (microbubbles) must be injected intravenously and catheterization of the jugular or femoral is necessary for consistent microbubble infusion28. Compared with these techniques, LDF is capable of non-invasively measuring the microcirculatory flux of the tissue.
LDF signals consist of different features of both time and frequency. To capture these features, methods of wavelet analysis and fourier analysis have been applied to reveal periodic frequency fluctuations29,30. These oscillations manifested the influence of heart beat, respiration, intrinsic myogenic activity of the vascular smooth muscle, neurogenic activity on the vessel wall, and endothelial related metabolic activity31,32. In clinical applications and fundamental research, LDF can not only obtain the signals of BF, but also the evaluation of microvascular BF can provide a platform from which to investigate microvascular impairment and, more generally, the pathogenesis of microvascular disease.
In the current study, both methods of LDF were applied to evaluate BF in the spinal cord. The data of LDPI provided a geographic distribution of BF, which gave an overview of perfusion around the area and made it possible to perform comparative analysis of BF in different locations. By intensely measuring the probing area over time, the data derived from LD monitoring provided a more detailed description of the local blood flow, allowing in-depth analyses, such as spectrum and wavelet analysis, to gain a deeper understanding of the BF in the area, which is a promising future research topic.
The authors have nothing to disclose.
The authors have no acknowledgements.
Laser Doppler Line Scanner | Moor Instruments | moorLDLS2 | |
Laser Doppler Monitor | Moor Instruments | moorVMS-LDF | |
Probe for Monitor | Moor Instruments | VP3 | Blunt needle end delivery probe |
Impactor | Precision Systems and Instrumentation | IH-0400 | |
Phenobarbital sodium | Sigma-Aldrich | P3761 | |
Buprenorphine | Sigma-Aldrich | B-908 | |
Syringe | Becton Dickinson Medica (s) Pte.Ltd | 300841 | |
Surgical suture needles with thread | Shanghai Pudong Jinhuan Medical Products Co., Ltd | 18T0329 (batch number) /4-0 | |
Scalpel | Operation instrument factory of Shanghai Medical Instrument Co., Ltd. | J11030 4# | |
Scalpel blade | Operation instrument factory of Shanghai Medical Instrument Co., Ltd. | J12130 20# | |
Ophthalmic forceps | Operation instrument factory of Shanghai Medical Instrument Co., Ltd. | JD1040 | |
Hemostatic forceps | Operation instrument factory of Shanghai Medical Instrument Co., Ltd. | J31050 | |
Benzyl penicillin sodium | North China Pharmaceutical Co., Ltd | F6072116 (batch number) | |
75% alcohol | Dezhou Anjie Gaoke disinfection products Co., Ltd | 150421R (batch number) | |
Iodine | Shandong Lierkang Medical Technology Co., Ltd | 20170102 (batch number) | |
Rat | Laboratory Animal Center, The Academy of Millitery Medical Sciences | Sprague-Dawly (rat strain) |