Background/Purpose: Our group has previously described the sublingual frenulum abnormalities in systemic sclerosis (SSc, scleroderma).   The goal of this project was to assess microvascular abnormalities in SSc by comparing perfusion of the frenulum using laser speckle contrast imaging (LSCI) in patients with SSc and healthy controls (HC). As we have observed sublingual microvascular abnormalities in SSc patients using a different technique (i.e., video-microscopy) we compared the inter-day variability of LSCI and video-microscopy of the sublingual mucosa by the Glycocheck Measurement device and software analysis in the HC.

Methods: Ten patients fulfilling 2013 ACR/EULAR classification criteria for SSc and 17 HC were recruited from the University of Utah SSc clinic and local community. Baseline perfusion (in arbitrary flux units [fu]) of the frenulum was assessed using LSCI in patients with SSc during a clinical visit and HC. Video-microscopy was assessed in 7 HC, and microvascular health was determined by penetration of red blood cells into the microvessel wall barrier region (perfused barrier region, PBR) using the Glycocheck Measurement device and software. To determine inter-day variability, HC subjects completed LSCI and video-microscopy on an additional day. All subjects were at least 2 hours without any exercise, caffeine, or food. 

Results: The mean age of the SSc population was 55.1 (SD 13.7) years. Median SSc disease duration from first non-Raynaud symptom was 9.9 years (SD 9.9). When LSCI was applied to the frenulum, the perfusion index was 2308 fu (1810-3203).  The perfusion index correlated negatively with disease duration, -0.64 (p < 0.05), but the was not significantly different from the healthy control population (2794 fu; 1368-5292). The mean age of the healthy control population was 35.9 (SD 6.25). In the healthy control population the coefficient of variation for the LSCI was 37.8±29.1% vs. coefficient of variation for Glycocheck PBR score is 5.0±2.3% (p=0.011). 

Conclusion: This feasibility study suggests perfusion of the sublingual frenulum can be assessed by both LSCI and videomicroscopy. Although we have previously shown a decrement in microvascular health in SSc compare with HC using videomicroscopy, there were no differences between SSc and HC using LSCI. Considering the differences in measurement variability, proper perfusion measurement of the sublingual frenulum microvasculature may be assessed more accurately by use of videomicroscopy

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/laser-speckled-imaging-and-videomicroscopy-assessment-of-sublingual-perfusion-in-systemic-sclerosis-and-healthy-controls/