Sympathetically induced spontaneous fluctuations of the photoplethysmographic signal

Abstract
The photoplethysmographic signal shows very low-frequency (VLF) spontaneous fluctuations that have been shown to be mediated by the sympathetic nervous system. In the current study, the photoplethysmographic signal was simultaneously measured in the two index fingers and the two second toes of 54 healthy male subjects. For each photoplethysmographic pulse, two parameters were derived: the pulse amplitude and its baseline, which are related to the arterial wall compliance and to the arterial blood volume, respectively. The baseline and the amplitude VLF fluctuations showed high right-left correlation both for hands (mean±SD 0.94±0.05 and 0.92±0.07, respectively) and for feet (0.90±0.08 and 0.89±0.07, respectively) that only slightly depended on the subject's age. Lower correlation was found between the hand and the foot (0.73±0.12 and 0.72±0.12 for the baseline and the amplitude, respectively). For each hand and foot the baseline and the amplitude VLF fluctuations were also correlated, with the baseline fluctuations lagging the amplitude fluctuations by 3–20 pulses. The amplitude-baseline correlation and the standard deviation of the amplitude or the baseline divided by its mean significantly decreased with age. The VLF fluctuations of the photoplethysmographic parameters and the correlation coefficients between them provide better understanding of the autonomic nervous regulation of the blood circulation.