Validation of normalized pulse volume in the outer ear as a simple measure of sympathetic activity using warm and cold pressor tests: towards applications in ambulatory monitoring.
The pulsatile ac component (DeltaI) superimposed on the transmitted dc components (I: tissue plus blood) are obtained from a near-infrared finger photoplethysmogram using a wavelength of 810 nm. Only the dc component is given in an ischaemic circulatory state (I(t): tissue only). Based on Lambert-Beer's law, normalized pulse volume (NPV; =DeltaI/I) and blood volume [BV; =ln(I(t)/I)] have recently been advocated as quantitative measures. In this study, the NPV-BV relationship was examined using the finger occlusion method during rest and mental arithmetic in 16 female undergraduates. Finger vascular tone during stress was evaluated by the distance of the linear and parallel NPV-BV regression lines (D(NB)) between rest and stress conditions. A reference standard was provided by the linear regression lines of compliance index (CI=NPV/pulse pressure) and BV to the transmural pressure. The estimates at 40 mmHg of transmural pressure, as an arbitrarily chosen reference point, were calculated (CI40 and BV40). D(NB) correlated well with them (r=0.81 and 0.94, respectively). The multiple regression with mean blood pressure indicated that the combination of D(NB) and the reactivities in heart period could explain approximately 50% of valiance in pressor response. In conclusion, D(NB) is easily obtainable from the NPV-BV function and seems to be more specific and valid than NPV as an index of finger sympathetic tone, since it adjusts the mechanical effect of arterial distending pressure.