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Moradi-Vastegani Z, Hosseininejad M, Barati F, Hoseini F, Koohifayegh F. Long-lasting canine cardiovascular alterations following bromocriptine induced-estrus. Theriogenology 2023; 198:327-331. [PMID: 36638592 DOI: 10.1016/j.theriogenology.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
Bromocriptine (BRM), a dopamine 2 receptor agonist, is a common drug for inducing estrus in dogs. It is also used for the treatment of some endocrine abnormalities and has some cardiovascular consequences in the patients under treatment. The current study aimed to evaluate its effects on the cardiovascular function of dogs during administration and the subsequent induced estrus cycle. Eight non-pregnant female dogs were assigned into control and treatment groups. The control group (n = 3) were dogs that showed proestrus naturally. The treatment group (n = 5) received oral incremental (μg/kg) doses (100 on days 1 and 2, 200 on days 3, 4, and 400 on days 5 until the proestrus expression) of BRM tablets (2.5 mg; Iran-Hormone Co, Iran). The left ventricle function, carotid blood flow indices, and systolic (SAP) and diastolic (DAP) arterial pressure were recorded every two days. The phases of the cycle were determined using a vaginal smear. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI) had a sharp decline following the administration of BRM (P < 0.05). The carotid PSA, EDV, RI, and pulse index were lower during induced estrus compared to the control (p < 0.05). BRM-induced estrus showed a different pattern of changes compared to the normal cycle from day 9 (p < 0.05) onwards. The cardiovascular effects of BRM remained for days after the termination of administration which may interfere with reproductive functions.
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Affiliation(s)
- Zahra Moradi-Vastegani
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 8818634141, Iran
| | - Morteza Hosseininejad
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 8818634141, Iran
| | - Farid Barati
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 8818634141, Iran.
| | - Farzaneh Hoseini
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 8818634141, Iran
| | - Fardin Koohifayegh
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 8818634141, Iran
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Skinner BD, Weaver SRC, Lucas SJE, Lucas RAI. Menstrual phase influences cerebrovascular responsiveness in females but may not affect sex differences. Front Physiol 2023; 13:1035452. [PMID: 36685202 PMCID: PMC9846518 DOI: 10.3389/fphys.2022.1035452] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Background and aims: Sex differences in the rate and occurrence of cerebrovascular diseases (e.g., stroke) indicate a role for female sex hormones (i.e., oestrogen and progesterone) in cerebrovascular function and regulation. However, it remains unclear how cerebrovascular function differs between the sexes, and between distinct phases of the menstrual cycle. This study aimed to compare cerebrovascular-CO2 responsiveness in 1) females during the early follicular (EF), ovulatory (O) and mid-luteal (ML) phases of their menstrual cycle; and 2) males compared to females during phases of lower oestrogen (EF) and higher oestrogen (O). Methods: Eleven females (25 ± 5 years) complete experimental sessions in the EF (n = 11), O (n = 9) and ML (n = 11) phases of the menstrual cycle. Nine males (22 ± 3 years) completed two experimental sessions, approximately 2 weeks apart for comparison to females. Middle and posterior cerebral artery velocity (MCAv, PCAv) was measured at rest, during two stages of hypercapnia (2% and 5% CO2 inhalation) and hypocapnia (voluntary hyperventilation to an end-tidal CO2 of 30 and 24 mmHg). The linear slope of the cerebral blood velocity response to changes in end-tidal CO2 was calculated to measure cerebrovascular-CO2 responsiveness.. Results: In females, MCAv-CO2 responsiveness to hypocapnia was lower during EF (-.78 ± .45 cm/s/mmHg) when compared to the O phase (-1.17 ± .52 cm/s/mmHg; p < .05) and the ML phase (-1.30 ± .82; p < .05). MCAv-CO2 responsiveness to hypercapnia and hypo-to-hypercapnia, and PCAv-CO2 responsiveness across the CO2 range were similar between menstrual phases (p ≥ .20). MCAv-CO2 responsiveness to hypo-to hypercapnia was greater in females compared to males (3.12 ± .91 cm/s/mmHg vs. 2.31 ± .46 cm/s/mmHg; p = .03), irrespective of menstrual phase (EF or O). Conclusion: Females during O and ML phases have an enhanced vasoconstrictive capacity of the MCA compared to the EF phase. Additionally, biological sex differences can influence cerebrovascular-CO2 responsiveness, dependent on the insonated vessel.
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Affiliation(s)
- Bethany D. Skinner
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom,Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham, United Kingdom,*Correspondence: Bethany D. Skinner,
| | - Samuel R. C. Weaver
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom,Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom,Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Rebekah A. I. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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Korad S, Mündel T, Fan JL, Perry BG. Cerebral autoregulation across the menstrual cycle in eumenorrheic women. Physiol Rep 2022; 10:e15287. [PMID: 35524340 PMCID: PMC9076937 DOI: 10.14814/phy2.15287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 12/20/2022] Open
Abstract
There is emerging evidence that ovarian hormones play a significant role in the lower stroke incidence observed in pre‐menopausal women compared with men. However, the role of ovarian hormones in cerebrovascular regulation remains to be elucidated. We examined the blood pressure‐cerebral blood flow relationship (cerebral autoregulation) across the menstrual cycle in eumenorrheic women (n = 12; mean ± SD: age, 31 ± 7 years). Participants completed sit‐to‐stand and Valsalva maneuvers (VM, mouth pressure of 40 mmHg for 15 s) during the early follicular (EF), late follicular (LF), and mid‐luteal (ML) menstrual cycle phases, confirmed by serum measurement of progesterone and 17β‐estradiol. Middle cerebral artery blood velocity (MCAv), arterial blood pressure and partial pressure of end‐tidal carbon dioxide were measured. Cerebral autoregulation was assessed by transfer function analysis during spontaneous blood pressure oscillations, rate of regulation (RoR) during sit‐to‐stand maneuvers, and Tieck’s autoregulatory index during VM phases II and IV (AI‐II and AI‐IV, respectively). Resting mean MCAv (MCAvmean), blood pressure, and cerebral autoregulation were unchanged across the menstrual cycle (all p > 0.12). RoR tended to be different (EF, 0.25 ± 0.06; LF; 0.19 ± 0.04; ML, 0.18 ± 0.12 sec−1; p = 0.07) and demonstrated a negative relationship with 17β‐estradiol (R2 = 0.26, p = 0.02). No changes in AI‐II (EF, 1.95 ± 1.20; LF, 1.67 ± 0.77 and ML, 1.20 ± 0.55) or AI‐IV (EF, 1.35 ± 0.21; LF, 1.27 ± 0.26 and ML, 1.20 ± 0.2) were observed (p = 0.25 and 0.37, respectively). Although, a significant interaction effect (p = 0.02) was observed for the VM MCAvmean response. These data indicate that the menstrual cycle has limited impact on cerebrovascular autoregulation, but individual differences should be considered.
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Affiliation(s)
- Stephanie Korad
- School of Health Sciences, Massey University, Wellington, New Zealand.,School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Toby Mündel
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Jui-Lin Fan
- Department of Physiology, Faculty of Medical and Health Sciences, Manaaki Manawa, The Centre for Heart Research, University of Auckland, Auckland, New Zealand
| | - Blake G Perry
- School of Health Sciences, Massey University, Wellington, New Zealand
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Cote S, Butler R, Michaud V, Lavallee E, Croteau E, Mendrek A, Lepage J, Whittingstall K. The regional effect of serum hormone levels on cerebral blood flow in healthy nonpregnant women. Hum Brain Mapp 2021; 42:5677-5688. [PMID: 34480503 PMCID: PMC8559491 DOI: 10.1002/hbm.25646] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 12/15/2022] Open
Abstract
Sex hormones estrogen (EST) and progesterone (PROG) have received increased attention for their important physiological action outside of reproduction. While studies have shown that EST and PROG have significant impacts on brain function, their impact on the cerebrovascular system in humans remains largely unknown. To address this, we used a multi-modal magnetic resonance imaging (MRI) approach to investigate the link between serum hormones in the follicular phase and luteal phase of the menstrual cycle (MC) with measures of cerebrovascular function (cerebral blood flow [CBF]) and structure (intracranial artery diameter). Fourteen naturally cycling women were recruited and assessed at two-time points of their MC. CBF was derived from pseudo-continuous arterial spin labeling while diameters of the internal carotid and basilar artery was assessed using time of flight magnetic resonance angiography, blood samples were performed after the MRI. Results show that PROG and EST had opposing and spatially distinct effects on CBF: PROG correlated negatively with CBF in anterior brain regions (r = -.86, p < .01), while EST correlations were positive, yet weak and most prominent in posterior areas (r = .78, p < .01). No significant correlations between either hormone or intracranial artery diameter were observed. These results show that EST and PROG have opposing and regionally distinct effects on CBF and that this relationship is likely not due to interactions with large intracranial arteries. Considering that CBF in healthy women appears tightly linked to their current hormonal state, future studies should consider assessing MC-related hormone fluctuations in the design of functional MRI studies in this population.
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Affiliation(s)
- Samantha Cote
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
| | - Russell Butler
- Faculty of Arts and Sciences, Department of Computer ScienceBishop's UniversitySherbrookeQuebecCanada
| | - Vincent Michaud
- Department of Diagnostic RadiologyUniversity of SherbrookeSherbrookeQuebecCanada
| | - Eric Lavallee
- Sherbrooke Molecular Imaging Center (CIMS), Sherbrooke University Hospital Research Center (CR‐CHUS)SherbrookeQuebecCanada
| | - Etienne Croteau
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Sherbrooke Molecular Imaging Center (CIMS), Sherbrooke University Hospital Research Center (CR‐CHUS)SherbrookeQuebecCanada
| | - Adrianna Mendrek
- Faculty of Arts and Sciences, Department of PsychologyBishop's UniversitySherbrookeQuebecCanada
| | - Jean‐Francois Lepage
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Faculty of Medicine and Health Sciences, Department of PediatricsUniversity of SherbrookeSherbrookeQuebecCanada
| | - Kevin Whittingstall
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Department of Diagnostic RadiologyUniversity of SherbrookeSherbrookeQuebecCanada
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Skinner BD, Davies RJ, Weaver SR, Cable NT, Lucas SJE, Lucas RAI. A Systematic Review and Meta-Analysis Examining Whether Changing Ovarian Sex Steroid Hormone Levels Influence Cerebrovascular Function. Front Physiol 2021; 12:687591. [PMID: 34220552 PMCID: PMC8248489 DOI: 10.3389/fphys.2021.687591] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/21/2021] [Indexed: 01/14/2023] Open
Abstract
Sex differences in cerebrovascular disease rates indicate a possible role for ovarian sex steroid hormones in cerebrovascular function. To synthesise and identify knowledge gaps, a systematic review and meta-analysis was conducted to assess how ovarian sex steroid hormone changes across the lifespan affect cerebrovascular function in women. Three databases (EMBASE, MEDLINE and Web of Science) were systematically searched for studies on adult cerebrovascular function and ovarian sex steroid hormones. Forty-five studies met pre-defined inclusion criteria. Studied hormone groups included hormone replacement therapy (HRT; n = 17), pregnancy (n = 12), menstrual cycle (n = 7), menopause (n = 5), oral contraception (n = 2), and ovarian hyperstimulation (n = 2). Outcome measures included pulsatility index (PI), cerebral blood flow/velocity (CBF), resistance index (RI), cerebral autoregulation, and cerebrovascular reactivity. Meta-analysis was carried out on HRT studies. PI significantly decreased [−0.05, 95% CI: (−0.10, −0.01); p = 0.01] in post-menopausal women undergoing HRT compared to post-menopausal women who were not, though there was considerable heterogeneity (I2 = 96.8%). No effects of HRT were seen in CBF (p = 0.24) or RI (p = 0.77). This review indicates that HRT improves PI in post-menopausal women. However, there remains insufficient evidence to determine how changing ovarian sex steroid hormone levels affects cerebrovascular function in women during other hormonal phases (e.g., pregnancy, oral contraception).
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Affiliation(s)
- Bethany D Skinner
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Rebecca J Davies
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel R Weaver
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - N Tim Cable
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Ruediger SL, Koep JL, Keating SE, Pizzey FK, Coombes JS, Bailey TG. Effect of menopause on cerebral artery blood flow velocity and cerebrovascular reactivity: Systematic review and meta-analysis. Maturitas 2021; 148:24-32. [PMID: 34024348 DOI: 10.1016/j.maturitas.2021.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/28/2021] [Accepted: 04/11/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Menopause and its associated decline in oestrogen is linked to chronic conditions like cardiovascular disease and osteoporosis, which may be difficult to disentangle from the effects of ageing. Further, post-menopausal women are at increased risk of cerebrovascular disease, linked to declines in cerebral blood flow (CBF) and cerebrovascular reactivity (CVR), yet the direct understanding of the impact of the menopause on cerebrovascular function is unclear. The aim of this systematic review and meta-analysis was to examine the literature investigating CBF and CVR in pre- compared with post-menopausal women METHODS: Five databases were searched for studies assessing CBF or CVR in pre- and post-menopausal women. Meta-analysis examined the effect of menopausal status on middle cerebral artery velocity (MCAv), and GRADE-assessed evidence certainty RESULTS: Nine studies (n=504) included cerebrovascular outcomes. Six studies (n=239) reported negligible differences in MCAv between pre- and post-menopausal women [2.11cm/s (95% CI: -8.94 to 4.73, p=0.54)], but with a "low" certainty of evidence. MCAv was lower in post-menopausal women in two studies, when MCAv was adjusted for blood pressure. CVR was lower in post- compared with pre-menopausal women in two of three studies, but high-quality evidence is lacking. Across outcomes, study methodology and reporting criteria for menopause were inconsistent CONCLUSIONS: MCAv was similar in post- compared with pre-menopausal women. Methodological differences in characterising menopause and inconsistent reporting of cerebrovascular outcomes make comparisons difficult. Comprehensive assessments of cerebrovascular function of the intra- and extracranial arteries to determine the physiological implications of menopause on CBF with healthy ageing is warranted.
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Affiliation(s)
- Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Jodie L Koep
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Shelley E Keating
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Faith K Pizzey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia
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Gonzales JU, James CR, Yang HS, Jensen D, Atkins L, Al-Khalil K, O'Boyle M. Carotid flow pulsatility is higher in women with greater decrement in gait speed during multi-tasking. Gait Posture 2017; 54:271-276. [PMID: 28371741 DOI: 10.1016/j.gaitpost.2017.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/07/2017] [Accepted: 03/23/2017] [Indexed: 02/02/2023]
Abstract
AIM Central arterial hemodynamics is associated with cognitive impairment. Reductions in gait speed during walking while performing concurrent tasks known as dual-tasking (DT) or multi-tasking (MT) is thought to reflect the cognitive cost that exceeds neural capacity to share resources. We hypothesized that central vascular function would associate with decrements in gait speed during DT or MT. METHODS Gait speed was measured using a motion capture system in 56 women (30-80y) without mild-cognitive impairment. Dual-tasking was considered walking at a fast-pace while balancing a tray. Multi-tasking was the DT condition plus subtracting by serial 7's. Applanation tonometry was used for measurement of aortic stiffness and central pulse pressure. Doppler-ultrasound was used to measure blood flow velocity and β-stiffness index in the common carotid artery. RESULTS The percent change in gait speed was larger for MT than DT (14.1±11.2 vs. 8.7±9.6%, p <0.01). Tertiles were formed based on the percent change in gait speed for each condition. No vascular parameters differed across tertiles for DT. In contrast, carotid flow pulsatility (1.85±0.43 vs. 1.47±0.42, p=0.02) and resistance (0.75±0.07 vs. 0.68±0.07, p=0.01) indices were higher in women with more decrement (third tertile) as compared to women with less decrement (first tertile) in gait speed during MT after adjusting for age, gait speed, and task error. Carotid pulse pressure and β-stiffness did not contribute to these tertile differences. CONCLUSION Elevated carotid flow pulsatility and resistance are characteristics found in healthy women that show lower cognitive capacity to walk and perform multiple concurrent tasks.
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Affiliation(s)
- Joaquin U Gonzales
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA.
| | - C Roger James
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Hyung Suk Yang
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Daniel Jensen
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Lee Atkins
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kareem Al-Khalil
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX, USA
| | - Michael O'Boyle
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX, USA
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Peltonen GL, Harrell JW, Aleckson BP, LaPlante KM, Crain MK, Schrage WG. Cerebral blood flow regulation in women across menstrual phase: differential contribution of cyclooxygenase to basal, hypoxic, and hypercapnic vascular tone. Am J Physiol Regul Integr Comp Physiol 2016; 311:R222-31. [PMID: 27225949 DOI: 10.1152/ajpregu.00106.2016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/24/2016] [Indexed: 11/22/2022]
Abstract
In healthy young women, basal cerebral blood flow (CBF) and cerebrovascular reactivity may change across the menstrual cycle, but mechanisms remain untested. When compared with the early follicular phase of the menstrual cycle, we hypothesized women in late follicular phase would exhibit: 1) greater basal CBF, 2) greater hypercapnic increases in CBF, 3) greater hypoxic increases in CBF, and 4) increased cyclooxygenase (COX) signaling. We measured middle cerebral artery velocity (MCAv, transcranial Doppler ultrasound) in 11 healthy women (23 ± 1 yr) during rest, hypoxia, and hypercapnia. Subjects completed four visits: two during the early follicular (∼day 3) and two during the late follicular (∼day 14) phases of the menstrual cycle, with and without COX inhibition (oral indomethacin). Isocapnic hypoxia elicited an SPO2 = 90% and SPO2 = 80% for 5 min each. Separately, hypercapnia increased end-tidal CO2 10 mmHg above baseline. Cerebral vascular conductance index (CVCi = MCAv/MABP·100, where MABP is mean arterial blood pressure) was calculated and a positive change reflected vasodilation (ΔCVCi). Basal CVCi was greater in the late follicular phase (P < 0.001). Indomethacin decreased basal CVCi (∼37%) and abolished the phase difference (P < 0.001). Hypoxic ΔCVCi was similar between phases and unaffected by indomethacin. Hypercapnic ΔCVCi was similar between phases, and indomethacin decreased hypercapnic ΔCVCi (∼68%; P < 0.001) similarly between phases. In summary, while neither hypercapnic nor hypoxic vasodilation is altered by menstrual phase, increased basal CBF in the late follicular phase is fully explained by a greater contribution of COX. These data provide new mechanistic insight into anterior CBF regulation across menstrual phases and contribute to our understanding of CBF regulation in women.
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Affiliation(s)
- Garrett L Peltonen
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - John W Harrell
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Benjamin P Aleckson
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kaylie M LaPlante
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Meghan K Crain
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - William G Schrage
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
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Peltonen GL, Harrell JW, Rousseau CL, Ernst BS, Marino ML, Crain MK, Schrage WG. Cerebrovascular regulation in men and women: stimulus-specific role of cyclooxygenase. Physiol Rep 2015; 3:3/7/e12451. [PMID: 26149282 PMCID: PMC4552531 DOI: 10.14814/phy2.12451] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Greater cerebral artery vasodilation mediated by cyclooxygenase (COX) in female animals is unexplored in humans. We hypothesized that young, healthy women would exhibit greater basal cerebral blood flow (CBF) and greater vasodilation during hypoxia or hypercapnia compared to men, mediated by a larger contribution of COX. We measured middle cerebral artery velocity (MCAv, transcranial Doppler ultrasound) in 42 adults (24 women, 18 men; 24 ± 1 years) during two visits, in a double-blind, placebo-controlled design (COX inhibition, 100 mg oral indomethacin, Indo). Women were studied early in the follicular phase of the menstrual cycle (days 1–5). Two levels of isocapnic hypoxia (SPO2 = 90% and 80%) were induced for 5-min each. Separately, hypercapnia was induced by increasing end-tidal carbon dioxide (PETCO2) 10 mmHg above baseline. A positive change in MCAv (ΔMCAv) reflected vasodilation. Basal MCAv was greater in women compared to men (P < 0.01) across all conditions. Indo decreased baseline MCAv (P < 0.01) similarly between sexes. Hypoxia increased MCAv (P < 0.01), but ΔMCAv was not different between sexes. Indo did not alter hypoxic vasodilation in either sex. Hypercapnia increased MCAv (P < 0.01), but ΔMCAv was not different between sexes. Indo elicited a large decrease in hypercapnic vasodilation (P < 0.01) that was similar between sexes. During the early follicular phase, women exhibit greater basal CBF than men, but similar vasodilatory responses to hypoxia and hypercapnia. Moreover, COX is not obligatory for hypoxic vasodilation, but plays a vital and similar role in the regulation of basal CBF (∼30%) and hypercapnic response (∼55%) between sexes.
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Affiliation(s)
- Garrett L Peltonen
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - John W Harrell
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Cameron L Rousseau
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Brady S Ernst
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Mariah L Marino
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Meghan K Crain
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - William G Schrage
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
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10
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Raz L. Estrogen and cerebrovascular regulation in menopause. Mol Cell Endocrinol 2014; 389:22-30. [PMID: 24472522 DOI: 10.1016/j.mce.2014.01.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 01/20/2014] [Accepted: 01/20/2014] [Indexed: 12/11/2022]
Abstract
Estrogen (E2), classically viewed as a reproductive steroid hormone, has non-reproductive functions throughout the body including in the brain and vasculature. Studies report diminished neuroprotection with declining E2 levels, corresponding with higher incidence of cerebrovascular and neurological disease. However, the effects of menopausal hormone therapy (MHT) on the cerebral vasculature and brain function remain controversial. This review will focus on evidence of 17β-estradiol actions in the cerebral vasculature, with a particular emphasis on the vasoactive, anti-inflammatory, anti-oxidant, metabolic and molecular properties. Controversies surrounding MHT in relation to cerebrovascular disease and stroke risk will be discussed, particularly the emerging evidence from clinical trials supporting the critical period hypothesis of estrogen protection.
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Affiliation(s)
- Limor Raz
- Department of Neurology, University of New Mexico, Albuquerque, NM, United States.
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Ciccone MM, Scicchitano P, Gesualdo M, Fornarelli F, Pinto V, Farinola G, Lagioia R, Sassara M, Zito A, Federici A, Cicinelli E. Systemic vascular hemodynamic changes due to 17-β-estradiol intranasal administration. J Cardiovasc Pharmacol Ther 2013; 18:354-358. [PMID: 23624711 DOI: 10.1177/1074248413484385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
PURPOSE According to the literature, estradiol has a direct vasodilator action by means of endothelium-derived relaxing factor synthesis. The present study aims to evaluate the acute hemodynamic effects of intranasal 17-β-estradiol on cerebral and lower limb arterial circulation in postmenopausal women. METHODS Sixteen healthy women in natural menopause (mean age: 54 ± 3 years) were investigated for at least 6 months, each receiving 300 µg of intranasal 17-β-estradiol. We evaluated the heart rate, systolic/diastolic blood pressure, peak systolic velocity, end-diastolic velocity, and velocity-time integral (VTI) at the level of internal carotid and posterior tibial arteries, before and after 30, 60, and 180 minutes of drug administration. RESULTS After intranasal 17-β-estradiol administration, the internal carotid artery VTI showed statistically significant (P < .05) variations at all the time intervals after administration of the drug (30, 60, and 180 minutes) when compared with "time zero" (T0, ie, the speed recorded at baseline before drug administration). No significant variation was found at the posterior tibial artery. The systolic/diastolic blood pressure and heart rate did not significantly differ before and after drug administration. CONCLUSIONS The administration of a single intranasal dose of 17-β-estradiol in healthy postmenopausal women increased cerebral perfusions, whereas the effect on peripheral circulation was much more limited.
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Affiliation(s)
- Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
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Ciccone MM, Cicinelli E, Giovanni A, Scicchitano P, Gesualdo M, Zito A, Fornarelli F, Locorotondo M, Cicinelli MV, Di Teo C, Farinola G, Scrutinio D. Ophthalmic artery vasodilation after intranasal estradiol use in postmenopausal women. J Atheroscler Thromb 2012; 19:1061-5. [PMID: 22878703 DOI: 10.5551/jat.13904] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The study aim was to evaluate the acute hemodynamic effects of intranasal 17-beta-estradiol on ophthalmic arterial circulation in postmenopausal women. METHODS Twenty-one healthy women in natural menopause for at least 6 months (mean age: 53.2± 2.9 years) were investigated. Each patient received 300 µg intranasal 17-beta-estradiol. We evaluated the heart rate, systolic and diastolic blood pressure, ophthalmic artery velocity at systolic and diastolic peak and its flow curve integral (FCI) before and 30, 60 and 180 minutes after the administration of the drug. RESULTS At all time points, the ophthalmic artery FCI showed statistically significant variations (p<0.001) of velocity (cm/sec) compared to T0 (speed recorded at baseline before drug administration). Moreover, systolic blood pressure, diastolic blood pressure and heart rate did not significantly differ each other after drug administration. CONCLUSIONS Administration of a single dose of intranasal 17-beta-estradiol to healthy postmenopausal women increases ophthalmic artery perfusion.
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Affiliation(s)
- Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy.
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Joseph JE, Swearingen JE, Corbly CR, Curry TE, Kelly TH. Influence of estradiol on functional brain organization for working memory. Neuroimage 2011; 59:2923-31. [PMID: 21985908 DOI: 10.1016/j.neuroimage.2011.09.067] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 09/03/2011] [Accepted: 09/25/2011] [Indexed: 10/17/2022] Open
Abstract
Working memory is a cognitive function that is affected by aging and disease. To better understand the neural substrates for working memory, the present study examined the influence of estradiol on working memory using functional magnetic resonance imaging. Pre-menopausal women were tested on a verbal n-back task during the early (EF) and late follicular (LF) phases of the menstrual cycle. Although brain activation patterns were similar across the two phases, the most striking pattern that emerged was that estradiol had different associations with the two hemispheres. Increased activation in left frontal circuitry in the LF phase was associated with increased estradiol levels and decrements in working memory performance. In contrast, increased activation in right hemisphere regions in the LF phase was associated with improved task performance. The present study showed that better performance in the LF than the EF phase was associated with a pattern of reduced recruitment of the left-hemisphere and increased recruitment of the right-hemisphere in the LF compared to EF phase. We speculate that estradiol interferes with left-hemisphere working-memory processing in the LF phase, but that recruitment of the right hemisphere can compensate for left-hemisphere interference. This may be related to the proposal that estradiol can reduce cerebral asymmetries by modulating transcallosal communication (Hausmann, 2005).
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Affiliation(s)
- Jane E Joseph
- Department of Anatomy and Neurobiology, College of Medicine, University of Kentucky, Lexington, KY 40506, USA.
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Vascular resistance of central retinal artery is reduced in postmenopausal women after use of estrogen. Menopause 2011; 18:869-72. [DOI: 10.1097/gme.0b013e31820cc60c] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effects of estrogen and progestin on the CO2 sensitivity of hemispheric cerebral blood volume. Menopause 2008; 15:346-51. [PMID: 17975517 DOI: 10.1097/gme.0b013e31813c688d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE High CO2 sensitivity is one of the major characteristics of the cerebrovascular bed. It has been shown to be influenced by many differrent factors (eg, sex hormones). DESIGN The effect of ovariectomy and subsequent female sexual hormone treatment on the steady-state hemispheric cerebral blood volume and CO2 responsiveness of the hemispheric blood vessels was studied on anesthetized, ventilated, normotensive, normoxic rats. Cerebral blood volume was measured with Tomita's photoelectric method with Sandor's modification. RESULTS Steady-state cerebral blood volume values in ovariectomized rats did not differ from those found in control animals. The CO2 responsiveness of hemispheric blood vessels was higher in ovariectomized and progestin-treated, but not estrogen-treated, animals compared with controls. CONCLUSIONS Our results demonstrate that the CO2 sensitivity of the hemispheric vessels is sex hormone dependent. Estrogen and progestin treatment have opposite effects on this cerebral circulatory parameter.
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Acute effect of intranasal estrogen on cerebral and cerebellar perfusion in postmenopausal women. Maturitas 2008; 59:72-82. [DOI: 10.1016/j.maturitas.2007.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Revised: 10/05/2007] [Accepted: 10/09/2007] [Indexed: 11/21/2022]
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Abstract
1. Cerebral vessels express oestrogen receptors (ER) in both the smooth muscle and endothelial cell layers of cerebral blood vessels. Levels of ERalpha are higher in female rats chronically exposed to oestrogen, either endogenous or exogenous. 2. Chronic exposure to oestrogen, either endogenous (normally cycling females) or exogenous (ovariectomized with oestrogen replacement), results in cerebral arteries that are more dilated than arteries from ovariectomized counterparts when studied in vitro. This effect is primarily mediated by an increase in the production of vasodilator factors, including nitric oxide (NO) and prostacylin. In contrast, oestrogen appears to suppress the production of endothelial-derived hyperpolarizing factor. Oestrogen treatment increases cerebrovascular levels of endothelial nitric oxide synthase (eNOS), cyclo-oxygenase (COX)-1 and prostacyclin synthase. In addition, via activation of the phosphatidylinositol 3-kinase/Akt pathway, both acute and chronic oestrogen exposure increases eNOS phosphorylation, increasing NO production. 3. Oestrogen receptors have also been localized to cerebrovascular mitochondria and exposure to oestrogen increases the efficiency of energy production while simultaneously reducing mitochondrial production of reactive oxygen species. Oestrogen increases the production of mitochondrial proteins encoded by both mitochondrial and nuclear DNA, including cytochrome c, subunits I and IV of complex IV and Mn-superoxide dismutase. Oestrogen treatment increases the activity of citrate synthase and complex IV and decreases mitochondrial production of H(2)O(2). 4. Oestrogen also has potent anti-inflammatory effects in the cerebral circulation that may have important implications for the incidence and severity of cerebrovascular disease. Administration of lipopolysaccharide or interleukin-1beta to ovariectomized female rats induces cerebrovascular COX-2 and inducible nitric oxide synthase (iNOS) protein expression and increases prostaglandin E(2) expression. Levels of COX-2 and iNOS expression vary with the stage of the oestrous cycle, and the cerebrovascular inflammatory response is suppressed in ovariectomized animals treated with oestrogen. Interleukin-1beta induction of COX-2 protein is prevented by treatment with a nuclear factor (NF)-kappaB inhibitor, and oestrogen treatment reduces cerebrovascular NF-kappaB activity. 5. Cerebrovascular dysfunction and pathology contribute to the pathogenesis of stroke, brain trauma, oedema and dementias, such as Alzheimer's disease. A better understanding of the action of oestrogen on cerebrovascular function holds promise for the development of new therapeutic entities that could be useful in preventing or treating a wide variety of cerebrovascular diseases.
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Affiliation(s)
- Sue P Duckles
- Department of Pharmacology, School of Medicine, University of California, Irvine, California 92697, USA.
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Krause DN, Duckles SP, Pelligrino DA. Influence of sex steroid hormones on cerebrovascular function. J Appl Physiol (1985) 2006; 101:1252-61. [PMID: 16794020 DOI: 10.1152/japplphysiol.01095.2005] [Citation(s) in RCA: 277] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The cerebral vasculature is a target tissue for sex steroid hormones. Estrogens, androgens, and progestins all influence the function and pathophysiology of the cerebral circulation. Estrogen decreases cerebral vascular tone and increases cerebral blood flow by enhancing endothelial-derived nitric oxide and prostacyclin pathways. Testosterone has opposite effects, increasing cerebral artery tone. Cerebrovascular inflammation is suppressed by estrogen but increased by testosterone and progesterone. Evidence suggests that sex steroids also modulate blood-brain barrier permeability. Estrogen has important protective effects on cerebral endothelial cells by increasing mitochondrial efficiency, decreasing free radical production, promoting cell survival, and stimulating angiogenesis. Although much has been learned regarding hormonal effects on brain blood vessels, most studies involve young, healthy animals. It is becoming apparent that hormonal effects may be modified by aging or disease states such as diabetes. Furthermore, effects of testosterone are complicated because this steroid is also converted to estrogen, systemically and possibly within the vessels themselves. Elucidating the impact of sex steroids on the cerebral vasculature is important for understanding male-female differences in stroke and conditions such as menstrual migraine and preeclampsia-related cerebral edema in pregnancy. Cerebrovascular effects of sex steroids also need to be considered in untangling current controversies regarding consequences of hormone replacement therapies and steroid abuse.
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Affiliation(s)
- Diana N Krause
- Department of Pharmacology, School of Medicine, University of California, Irvine, 92697-4625, USA.
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Krejza J, Swiat M. Letters to the Editors. Climacteric 2006; 9:66; author reply 67. [PMID: 16428127 DOI: 10.1080/13697130500487190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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