Effect of sympathetic nerve stimulation on cerebral blood flow and on large cerebral arteries of dogs

CBF regulation in hypertension and Alzheimer's disease

PURPOSE

To review the recent developments on the effect of chronic high mean arterial blood pressure (MAP) on cerebral blood flow (CBF) autoregulation and supporting the notion that CBF autoregulation impairment has connection with chronic cerebral diseases. Method: A narrative review of all the relevant papers known to the authors was conducted. Results: Our understanding of the connection between cerebral perfusion impairment and chronic high MAP and cerebral disease is rapidly evolving, from cerebral perfusion impairment being the result of cerebral diseases to being the cause of cerebral diseases. We now better understand the intertwined impact of hypertension and Alzheimer's disease (AD) on cerebrovascular sensory elements and recognize cerebrovascular elements that are more vulnerable to these diseases. Conclusion: We conclude with the suggestion that the sensory elements pathology plays important roles in intertwined mechanisms of chronic high MAP and AD that impact cerebral perfusion.

Parasympathetic reflex vasodilation in the cerebral hemodynamics of rats

We investigated the role of parasympathetic reflex vasodilation in the regulation of the cerebral hemodynamics, and whether GABAA receptors modulate the response. We examined the effects of activation of the parasympathetic fibers through trigeminal afferent inputs on blood flow in the internal carotid artery (ICABF) and the cerebral blood vessels (rCBF) in parietal cortex in urethane-anesthetized rats. Electrical stimulation of the central cut end of the lingual nerve (LN) elicited intensity- and frequency-dependent increases in ICABF that were independent of changes in external carotid artery blood flow. Increases in ICABF were elicited by LN stimulation regardless of the presence or absence of sympathetic innervation. The ICABF increases evoked by LN stimulation were almost abolished by the intravenous administration of hexamethonium (10 mg kg(-1)) and were reduced significantly by atropine administration (0.1 mg kg(-1)). Although the LN stimulation alone had no significant effect on rCBF, LN stimulation in combination with a blocker of the GABAA receptor pentylenetetrazole increased the rCBF markedly. This increase in rCBF was reduced significantly by the administration of hexamethonium and atropine. These observations indicate that the increases in both ICABF and rCBF are evoked by parasympathetic activation via the trigeminal-mediated reflex. The rCBF increase evoked by LN stimulation is thought to be limited by the GABAA receptors in the central nervous system. These results suggest that the parasympathetic reflex vasodilation and its modulation mediated by GABA receptors within synaptic transmission in the brainstem are involved in the regulation of the cerebral hemodynamics during trigeminal afferent inputs.

Methamphetamine causes sustained depression in cerebral blood flow

The use prevalence of the highly addictive psychostimulant methamphetamine (MA) has been steadily increasing over the past decade. MA abuse has been associated with both transient and permanent alterations in cerebral blood flow (CBF), hemorrhage, cerebrovascular accidents and death. To understand MA-induced changes in CBF, we exposed C56BL/6 mice to an acute bolus of MA (5mg/kg MA, delivered IP). This elicited a biphasic CBF response, characterized by an initial transient increase (~ 5 minutes) followed by a prolonged decrease (~ 30 minutes) of approximately 25% relative to baseline CBF--as measured by laser Doppler flowmetry over the somatosensory cortex. To assess if this was due to catecholamine derived vasoconstriction, phentolamine, an α-adrenergic antagonist was administered prior to MA treatment. This reduced the initial increase in CBF but failed to prevent the subsequent, sustained decrease in CBF. Consistent with prior reports, MA caused a transient increase in mean arterial blood pressure, body temperature and respiratory rate. Elevated respiratory rate resulted in hypocapnia. When respiratory rate was controlled by artificially ventilating mice, blood PaCO(2) levels after MA exposure remained unchanged from physiologic levels, and the MA-induced decrease in CBF was abolished. In vivo two-photon imaging of cerebral blood vessels revealed sustained MA-induced vasoconstriction of pial arterioles, consistent with laser Doppler flowmetry data. These findings show that even a single, acute exposure to MA can result in profound changes in CBF, with potentially deleterious consequences for brain function.

Decreased upright cerebral blood flow and cerebral autoregulation in normocapnic postural tachycardia syndrome

Postural tachycardia syndrome (POTS), a chronic form of orthostatic intolerance, has signs and symptoms of lightheadedness, loss of vision, headache, fatigue, and neurocognitive deficits consistent with reductions in cerebrovascular perfusion. We hypothesized that young, normocapnic POTS patients exhibit abnormal cerebral autoregulation (CA) that results in decreased static and dynamic cerebral blood flow (CBF) autoregulation. All subjects had continuous recordings of mean arterial pressure (MAP) and CBF velocity (CBFV) using transcranial Doppler sonography in both the supine supine position and during a 70 degrees head-up tilt. During tilt, POTS patients (n = 9) demonstrated a higher heart rate than controls (n = 7) (109 +/- 6 vs. 80 +/- 2 beats/min, P < 0.05), whereas controls demonstrated a higher MAP than POTS (87 +/- 2 vs. 77 +/- 3 mmHg, P < 0.05). Also during tilt, mean CBFV decreased 19.5 +/- 2.6% in POTS patients versus 10.3 +/- 2.0% in controls (P < 0.05). We then used a transfer function analysis of MAP and CFBV in the frequency domain to quantify these changes. The low-frequency (LF; 0.04-0.15 Hz) component of CBFV variability increased during tilt in POTS patients (supine: 3 +/- 0.9 vs. tilt: 9 +/- 2, P < 0.02). In POTS patients, there was an increase in LF and high-frequency coherence between MAP and CBFV, an increase in LF gain, and a lack of significant change in phase. Static CA may be less effective in POTS patients compared with controls, since immediately after tilt CBFV decreased more in POTS patients and was highly oscillatory and autoregulation did not restore CBFV to baseline values until the subjects became supine. Dynamic CA may be less effective in POTS patients because MAP and CBFV during tilt became almost perfectly synchronous. We conclude that dynamic and static autoregulation of CBF are less effective in POTS patients compared with control subjects during orthostatic challenge.

Effects of etomidate administration on cerebral collateral flow

OBJECTIVE

Augmentation of blood flow to collateral-dependent tissue (CDT) as a result of selective vasodilation of collateral vessels has been shown to occur with various stimuli after middle cerebral artery occlusion. Etomidate, a carboxylated imidazole derivative, is a nonbarbiturate anesthetic that is used clinically both as an anesthetic and as a neuroprotective agent. The effect etomidate has on collateral cerebral vessels is unknown. The purpose of our studies was to test whether etomidate selectively augmented cerebral blood flow (CBF) to CDT during ischemia as an additional mechanism of neuroprotection.

METHODS

A left craniotomy was performed in each of 14 dogs, with the animals under halothane anesthesia. A branch of the middle cerebral artery was occluded and cannulated distally for determination of CDT using a "shadow flow" technique. CBF and vascular pressures were measured and used to calculate vascular resistance. An etomidate infusion (0.1 mg/kg of body weight/min administered intravenously) was started, and CBF and vascular pressures were measured at 10 and 40 minutes. Hypotension was then induced, and CBF and pressures were again measured.

RESULTS

CBF was significantly reduced in all regions of the brain, including CDT, when etomidate was infused. CDT showed a 53.7% reduction in flow, whereas normal CBF was reduced by at least 63.4%. During hypotension, blood flow to CDT was reduced by an additional 42.7%, whereas normal cerebrum was reduced by at least 22.7%. Vascular resistance was increased in all vessels during etomidate infusion.

CONCLUSION

The neuroprotective effects of etomidate do not seem to be through the augmentation of collateral or global CBF.

Pre- and postischemic effects of the NMDA receptor antagonist dizocilpine maleate (MK-801) on collateral cerebral blood flow

The authors studied the effects of pre- and postischemic administration of dizocilpine maleate (MK-801) on collateral and regional cerebral blood flow (CBF). The ischemic penumbra appears to benefit most from the neuroprotective effects of MK-801. The precise mechanism by which MK-801 provides this neuroprotection remains controversial. Alterations in CBF have been demonstrated with MK-801 administration, but whether the response is an increase or decrease in flow has remained unclear. A left-sided craniectomy was performed in 20 dogs. A branch of the middle cerebral artery (MCA) was cannulated and collateral blood supply-dependent tissue (CDT) was identified using the "shadow flow" technique. Regional CBF was measured using radiolabeled microspheres. Six dogs received MK-801 (1 mg/kg administered intravenously) before they underwent MCA branch occlusion; the remaining 14 dogs received MK-801 after they underwent MCA occlusion. Cerebral blood flow and vascular pressures were measured 30 and 60 minutes after MK-801 administration. In animals that received MK-801 before MCA occlusion, CBF did not change significantly from baseline values before or after occlusion. In contrast, in animals that received MK-801 after MCA occlusion, CBF was significantly reduced in all regions of the brain, including the CDT. Collateral blood supply-dependent tissue showed a 51.7% reduction in flow, whereas normal CBF was reduced by 29.7%. The MK-801 induced cerebral vasoconstriction in both groups. The neuroprotective effects of MK-801 do not appear to be caused by the augmentation of collateral or global cerebral circulation and, in fact, may block the glutamate-mediated vasodilation that occurs during ischemia.

Effects of serotonin on cerebral circulation after middle cerebral artery occlusion

Serotonin (5-HT) produces constriction of peripheral collateral blood vessels. Using an animal model, the authors tested the hypothesis that 5-HT constricts collateral vessels in the cerebrum. A branch of the middle cerebral artery (MCA) was occluded proximally and cannulated distally in anesthetized dogs. Blood flow to the area at risk for infarction was detected by perfusing the cannulated MCA branch with microsphere-free blood during systemic injection of radioactive microspheres (shadow flow technique). Blood flow to collateral-dependent and normal cerebrum was measured during intravenous infusion of 5-HT (10 and 40 mg/kg/minute). Serotonin produced a dose-related reduction of blood flow to collateral-dependent cerebrum, increased collateral vessel resistance in large cerebral arteries and collateral vessels, and decreased cerebral artery perfusion pressure. In contrast, blood flow to normal cerebrum was not altered because a decrease in small vessel resistance effectively compensated for a decrease in MCA perfusion pressure. These findings indicate that 5-HT produces constriction of collateral vessels in the cerebrum. This response is clearly different from normal small cerebral vessels, which dilate during 5-HT infusion.

Functional 5-HT receptor subtypes in the isolated canine common carotid artery

The vascular responses to 5-hydroxytrypamine (5-HT), 5-carboxamidotryptamine (5-CT, a selective 5-HT1-like receptor agonist), alpha-methyl-5-HT (alpha-M-5-HT, a relatively selective 5-HT2 receptor agonist), noradrenaline (NA), and KCl were examined in isolated, cannulated, and perfused canine common carotid arterial preparations. They caused strong vasoconstrictions. The rank order of vasoconstrictive potency was 5-HT > alpha-M-5-HT > or = NA > 5-CT >> KCl. The 5-HT-induced vasoconstriction was significantly depressed by methysergide (a 5-HT1 and 5-HT2 receptor antagonist), ketanserin (a selective 5-HT2 receptor antagonist), and spiperone (a selective 5-HT2 receptor antagonist). The 5-CT- and alpha-M-5-HT-induced vasoconstrictions were also significantly inhibited by methysergide, spiperone, and ketanserin. The NA-induced vasoconstriction was readily inhibited by bunazosin (an alpha-adrenoceptor antagonist) and ketanserin but not significantly inhibited by spiperone and methysergide. KCl has a weak potency for producing a vasoconstriction of the canine common carotid artery. A relatively large dose of diltiazem (a calcium channel-blocker) did not modify 5-HT-induced vasoconstrictions.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrophysiology of cerebral blood vessels

In spite of the relatively large amount of in vitro and in vivo data indicating that, in a number of ways, cerebral arteries are pharmacologically different from peripheral arteries, the mechanisms responsible for these differences are far from clear. An understanding of these mechanisms is particularly important for a rational approach to the treatment of disorders of the cerebral circulation including migraine, hypertension and the responses of cerebral vessels to subarachnoid haemorrhage. This review outlines electrophysiological data which are available from cerebrovascular smooth muscle cells, including the possibility that inwardly-rectifying potassium channels, active at potentials close to the resting membrane potential, are intimately involved in the changes in smooth muscle tone which couple blood flow to regional changes in nerve cell activity. The membrane potential changes in response to perivascular nerve stimulation, noradrenaline, 5-hydroxytryptamine and endothelium-derived hyperpolarizing factor are also described, together with the underlying membrane mechanisms and their relationship to smooth muscle contraction and relaxation.

Epinephrine in cardiopulmonary resuscitation

This review assesses the role of epinephrine in cardiopulmonary resuscitation from the perspective of mechanisms of action, cardiac and cerebral effects, and use in human beings. We reviewed the literature from 1966 onward, using a Medline Search of the National Library of Medicine with the key words: "heart arrest," "resuscitation," and "epinephrine." Pertinent articles that represented original research were critically appraised by at least two authors. We concluded that the Advanced Cardiac Life Support recommended dose of epinephrine (1 mg or 0.007 to 0.014 mg/kg) has little scientific basis. Evidence from animal studies demonstrates that doses of 0.1 to 0.2 mg/kg are required to significantly improve myocardial and cerebral blood flow and resuscitation rates. Limited human data confirm the dose-dependent vasopressor response to epinephrine and the potential for improved immediate survival with higher doses. We suggest that randomized controlled human trials are needed to document the usefulness of higher doses of epinephrine in cardiopulmonary resuscitation.

Trigeminovascular fibers increase blood flow in cortical gray matter by axon reflex-like mechanisms during acute severe hypertension or seizures

Cerebral blood flow was measured and compared in 10 symmetrical brain regions following unilateral trigeminal ganglionectomy (n = 13), sham operation (n = 6), or trigeminal root section (rhizotomy) (n = 8) in cats. Multiple determinations were obtained in anesthetized and paralyzed animals using radiolabeled microspheres during (i) normocapnia-normotension, (ii) hypercapnia (5% CO2/95% room air), (iii) angiotensin-induced acute severe hypertension (190 greater than mean arterial blood pressure less than 210 mmHg), or (iv) bicuculline-induced seizures. Flow was symmetrical in all brain regions at rest and during increases induced by hypercapnia in the three groups. During severe hypertension or seizures, marked elevations developed bilaterally (approximately 93% and approximately 130%, respectively). In ganglionectomized animals, increases due to hypertension or seizures were attenuated by 28-32% on the denervated side within cortical gray matter regions corresponding to the anterior, middle, and posterior cerebral arteries. Flow was symmetrical within all brain regions in sham-operated animals and in the rhizotomy group, despite comparable increases in regional cerebral blood flow induced by angiotensin. Hence, the trigeminal nerve mediates blood flow adaptations during severe hypertension and seizures. Furthermore, since trigeminal cell bodies and peripheral axons are destroyed or degenerate following ganglionectomy but not following rhizotomy, local "axon reflex-like" mechanisms mediate these increases in cerebral blood flow.

Effect of serotonin on blood flow to the choroid plexus

The choroid plexus contains a very high density of serotonin receptors and serotonin has been reported to influence the rate of formation of cerebrospinal fluid. The goal of this study was to examine effects of serotonin (5-hydroxytryptamine) on blood flow to the choroid plexus. Blood flow to the choroid plexus was measured in anesthetized cynomolgus monkeys and dogs using radioactive microspheres. Under control conditions, blood flow to choroid plexus was approximately 4 times greater than blood flow to the cerebrum in monkeys and approximately 7 times greater than blood flow to the cerebrum in dogs. Infusion of serotonin (40 micrograms.kg-1.min-1) into the left atrium increased blood flow to choroid plexus by 101 +/- 26% (mean +/- S.E.M.) in monkeys and by 201 +/- 45% in dogs. Serotonin did not affect cerebral blood flow. These findings suggest that serotonin may play an important role in regulation of blood flow to the choroid plexus.

Local glucose utilization of the brain and pineal gland during stimulation of the cervical sympathetic trunk

The quantitative autoradiographic 2-[14C]deoxyglucose method was employed to map the metabolic activity of the superior cervical ganglion and the entire brain during unilateral electrical stimulation of the cervical sympathetic trunk in the urethane-anesthetized rat. Stimulation of the cervical sympathetic trunk increased glucose utilization in the ipsilateral superior cervical ganglion (+95%) but did not produce side-to-side differences in glucose utilization in any of the brain structures examined in this study. Compared to the control nonstimulated animals, the rate of glucose metabolism in the pineal gland was increased 71% following stimulation of the cervical sympathetic trunk. The pineal gland was the only brain region out of 87 structures examined in which glucose utilization was increased by electrical stimulation of its sympathetic innervation.

Importance of bilateral sympathetic innervation on cerebral blood flow autoregulation in the thalamus

Effects of bilateral sympathetic innervation on the regulation of cerebral blood flow to the thalamus were examined in spontaneously hypertensive rats (SHR). The superior cervical ganglion was removed on one side or bilaterally, and blood flow in the thalamus was repeatedly measured with a hydrogen clearance technique during a stepwise increase in arterial pressure. Regional blood flow in the thalamus was unchanged following acute ganglionectomy: 55 +/- 6 ml/100 g/min in the intact rats and 56 +/- 4 in the denervated rats. Sympathectomy on one side neither had effects on the pressure-flow relationship nor on the blood pressure levels of upper limits of autoregulation in the ipsilateral thalamus. In contrast, bilateral sympathetic denervation impaired the autoregulatory function in the thalamus and the upper limits were significantly lower than those in intact rats: 206 +/- 8 vs 226 +/- 10 mm Hg, respectively (P less than 0.02). It is concluded that overlapping innervation of sympathetic nerves has an important role in regulation of blood flow to the thalamus during an acute rise in arterial pressure in SHR.

Enhancement of vasoconstrictor and attenuation of vasodilator effects of 5-hydroxytryptamine by the calcium channel blockers nimodipine and nifedipine in the pig

As calcium (Ca2+) channel blockers are effective against the vasoconstrictor responses to 5-hydroxytryptamine (5-HT) in vitro, and a favourable response is claimed for these drugs in migraine prophylaxis, we studied the interaction between nimodipine or nifedipine, and 5-HT for effects on carotid haemodynamics in the anaesthetized pig. Intracarotid infusions of nimodipine (0.25 microgram X kg-1 X min-1), nifedipine (0.75 microgram X kg-1 X min-1) or 5-HT (2.0 micrograms X kg-1 X min-1) caused a redistribution of carotid blood flow in favour of the nutrient (capillary) fraction at the expense of the non-nutrient (arteriovenous anastomoses; AVA) fraction. Compared to those of 5-HT, the effects of the Ca2+ channel blockers on cranial AVAs were much weaker and the increase in the capillary fraction was observed mainly in the skeletal muscles, rather than in the skin and ears as with 5-HT. When 5-HT was infused in the presence of nimodipine or nifedipine, the amine-induced vasoconstrictor responses in the total carotid vascular bed and its AVA fraction were either not attenuated or were increased while the vasodilator responses were reduced. We conclude that: in contrast to what was found in vitro, the 5-HT-induced vasoconstriction in vivo, involving either '5-HT1-like' (AVAs) or 5-HT2 (arterioles) receptors, was not antagonized by nimodipine or nifedipine; the attenuation of the 5-HT-induced dermal vasodilatation by the two Ca2+ channel blockers is most likely to be the result of a 'steal' due to the profound vasodilatation in the skeletal muscle region; and the comparatively mild reduction in AVA conductance caused by the Ca2+ channel blockers may be one of the reasons for their inability to abort acute attacks of migraine. The increase in nutrient blood flow is of potential benefit, but whether this property of the Ca2+ channel blockers is linked to their usefulness in migraine prophylaxis remains to be ascertained.

Effects of fluid-percussion brain injury on regional cerebral blood flow and pial arteriolar diameter

The effects of two levels of fluid-percussion brain injury on cerebral blood flow (CBF) and pial arteriolar diameter were investigated in cats. Regional CBF was measured using the radioactive microsphere technique. Experimental brain injury resulted in changes in arterial blood pressure, CBF, and pial arteriolar diameter that were related to the severity of the injury. Low-level injury (1.88 +/- 0.11 atm, mean +/- standard error of the mean) resulted in a slight transient increase in CBF which had returned to preinjury levels by 30 minutes. High-level injury (2.68 +/- 0.19 atm) resulted in larger, statistically significant (p less than 0.01) increases in whole-brain CBF, decreases in cerebrovascular resistance, and increases in pial arteriolar diameter 1 minute postinjury. One hour after injury, CBF had returned to preinjury levels while cerebral perfusion pressure was significantly (p less than 0.01) reduced. There was no evidence of reduced CBF in any region studied. Pial arterioles dilated during the posttraumatic hypertensive period and then returned to control diameters within 1 hour after injury. Changes in the diameter of pial arterioles were significantly correlated with posttraumatic changes in CBF.

Regional cerebral blood volume and hematocrit measured in normal human volunteers by single-photon emission computed tomography

Single-photon emission computed tomography (SPECT) was used for the measurement of regional cerebral blood volume (CBV) and hematocrit (Hct) in normal healthy human volunteers (mean age 30 +/- 8 years). Regional cerebral red blood cell (RBC) volume and plasma volume were determined separately and their responses to carbon dioxide were investigated. Ten right-handed healthy volunteers were the subjects studied. SPECT scans were performed following intravenous injection of the RBC tracer (99mTc-labeled RBC) and plasma tracer (99mTc-labeled human serum albumin) with an interval of 48 h. Regional cerebral Hct was calculated as the regional ratio between RBC and plasma volumes and then was used for calculating CBV. Mean regional CBV in the resting state was 4.81 +/- 0.37 ml/100 g brain, significantly greater in the left hemisphere compared with the right by 3.8% (p less than 0.01). Mean regional RBC volumes (1.50 +/- 0.09 ml/100 g brain) were less than mean regional plasma volumes (3.34 +/- 0.28 ml/100 g brain), and mean regional cerebral Hcts were 31.3 +/- 1.8%, which was 75.9 +/- 2.1% of the large-vessel Hct. During 5% CO2 inhalation, increases in plasma volume (2.48 +/- 0.82%/mmHg PaCO2) were significantly greater than for RBC volume (1.46 +/- 0.48%/mmHg PaCO2). Consequently, the cerebral-to-large-vessel Hct ratio was reduced to 72.4 +/- 2.2%. Results emphasize the importance of cerebral Hct for the measurement of CBV and indicate that regional cerebral Hcts are not constant when shifted from one physiological state to another.

5-Carboxamide tryptamine, a compound with high affinity for 5-hydroxytryptamine1 binding sites, dilates arterioles and constricts arteriovenous anastomoses

The effects of 5-carboxamide tryptamine, which activates non-5-hydroxytryptamine2-'atypical' receptors for 5-hydroxytryptamine (5-HT) in the dog saphenous vein, was studied on the complete distribution of cardiac output and common carotid blood flow in anaesthetized pigs. The drug was infused for 10 min at the rate of 0.025, 0.1 and 0.4 micrograms kg-1 min-1 either intravenously (cardiac output distribution) or intra-arterially (carotid distribution). 5-Carboxamide tryptamine decreased arterial blood pressure due to a reduction of cardiac output. This reduction was confined to its arteriovenous anastomotic component; the component used for the tissue perfusion (nutrient part) in fact increased. Similar changes were observed in the carotid blood flow distribution. Vasodilation was observed in several tissues, but the skin, ears and stomach responded most prominently. The effects of 5-carboxamide tryptamine on the carotid distribution were not significantly modified by cyproheptadine (1 mg kg-1). It is concluded that, like 5-HT, 5-carboxamide tryptamine constricts arteriovenous anastomoses and dilates arterioles by activating non-5-HT2-'atypical' receptors. These 'atypical' 5-HT receptors appear to be of the 5-HT1 type since both 5-carboxamide tryptamine and BEA 1654, a new piperazine derivative, produced similar vascular effects in the carotid bed of the pig and also showed a high and selective affinity for the 5-HT1 binding sites.

Redistribution of carotid artery blood flow by 5-HT: effects of the 5-HT2 receptor antagonists ketanserin and Wal 1307

The study concerned effects of ketanserin and a new 5-HT2 receptor antagonist, Wal 1307, on the responses to 5-hydroxytryptamine (5-HT) in the porcine common carotid vascular bed. More than 80% of the total carotid blood flow (208 +/- 18 ml; n = 12) bypassed the tissues via arteriovenous anastomoses. Intracarotid infusions of 5-HT (2 micrograms X kg-1 X min-1) reduced the total carotid blood flow by about 50% and arteriovenous anastomotic flow by 85% but extracerebral tissue (nutrient) blood flow more than tripled. The cerebral component did not change. Thus, 5-HT appears to constrict large conducting arteries and arteriovenous anastomoses but dilates arterioles. Ketanserin and Wal 1307 did not affect carotid blood flow distribution but completely blocked the amine-induced reduction of total carotid blood flow. The constriction of arteriovenous anastomoses was only slightly reduced but the 5-HT-induced arteriolar, vasodilation was enhanced. We conclude that vasoconstriction in the main trunk of the carotid artery and, to a smaller degree, in the arteriovenous anastomoses and arterioles, is mediated by mediated by 5-HT2 receptors. The major part of the constriction of arteriovenous anastomoses and arteriolar dilation elicited by 5-HT is, however, not mediated by 5-HT2 receptors. It is argued that these 'atypical' 5-HT receptors may be related to 5-HT1 binding sites.

Effects of methysergide and 5-hydroxytryptamine on carotid blood flow distribution in pigs: further evidence for the presence of atypical 5-HT receptors

The effects of acute (50-350 micrograms kg-1, i.v.) and subacute (350 micrograms kg-1 orally per day for six days) administration of methysergide, and of intra-arterial infusions of 0.5 and 2.0 micrograms kg-1 min-1 5-hydroxytryptamine (5-HT) on the distribution of carotid blood flow into the capillary (nutrient) and arterio-venous anastomotic (AVA) fractions were studied in anaesthetized pigs. The acute, but not the subacute, administration of methysergide caused a moderate reduction of carotid blood flow. This reduction, noticed only in the AVA fraction, was due to a constriction of the arterio-venous anastomoses (AVAs). Both doses of 5-HT reduced total carotid blood flow but its nutrient fraction--particularly that distributed to the skin and ears--increased substantially. The AVA fraction was greatly diminished. After treatment with methysergide, 5-HT no longer reduced the total carotid blood flow, but increased it. Despite this reversal the constriction of AVAs by the amine was only slightly diminished. On the other hand, the vasodilatation of the nutrient channels was enhanced. The results of the interaction between methysergide and 5-HT provide further evidence for the presence of 'atypical' 5-HT receptors (probably corresponding to 5-HT1 binding sites) mediating AVA contraction and nutrient vasodilatation. The 5-HT2 receptors mediate vasoconstriction and are located in the large conducting arteries and possibly, in smaller numbers, in the AVAs and arterioles.

The role of sympathetic efferent activity in the regulation of brain temperature

The role of nasal heat exchange in the control of brain temperature has been studied in cats, pigs, ducks and rabbits during acute experiments under general anaesthesia. Nasal air flow at physiological rates caused hypothalamic temperature to fall at between 0.2 and 0.5 degrees C/min in cats, pigs and ducks, which all have arterial rete systems that can cool blood flowing to the brain, but not in rabbits, which lack an arterial rete. Bilateral stimulation of cervical sympathetic trunks reduced or abolished the brain cooling effect of nasal air flow in cats, pigs and ducks. After a period of airflow during which brain cooling was reduced by sympathetic stimulation, the end of stimulation was sometimes followed by marked and rapid brain cooling, indicating re-perfusion through ischaemic cooled tissues. Cervical sympathetic stimulation caused a reduction in resistance to nasal airflow in all species studied, by inducing vasoconstriction and shrinkage of the nasal mucosa. In species with well-developed arterial retia, the effect of cervical sympathetic stimulation in regulating nasal cooling of the brain is probably mediated by controlling blood flow through the nasal mucosa. Although this vascular control also occurs in rabbits, they cannot selectively cool the brain and sympathetic stimulation has no effect on rabbit brain temperature.

Redistribution by 5-hydroxytryptamine of carotid arterial blood at the expense of arteriovenous anastomotic blood flow

1. The effects of 5-hydroxytryptamine by intravenous (1, 5 and 10 mug kg(-1) min(-1) in cats) and intracarotid (0.5 and 2 mug kg(-1) min(-1) in pigs) routes were studied on the complete distribution of common carotid artery blood flow, measured with radioactive microspheres (15 mum). In addition, the amine was also infused (0.75-3 mug kg(-1) min(-1)) into the carotid artery of cats to observe its influence on the shunting of microspheres in the jugular venous blood.2. The basal total common carotid blood flow was distributed ipsilaterally mainly to extracerebral tissues and only little blood entered the brain. As shown by the presence of microspheres in the lungs after injection into the carotid artery (52% in cats; 82% in pigs), a major fraction of the carotid blood by-passed the capillary bed through arteriovenous anastomoses in the head (non-nutrient fraction).3. 5-Hydroxytryptamine redistributed the blood in favour of the nutrient compartment at the expense of arteriovenous anastomotic fraction. In cats, tissue blood flow did not significantly change but, in the pig, blood flow to all tissues, particularly to skin and ears, was substantially increased despite a reduction in total carotid blood flow. This reduction was entirely due to a change in the non-nutrient fraction.4. Intracarotid infusion of 5-hydroxytryptamine in vagosympathectomized intact or spinal cats decreased the number of microspheres appearing in the jugular venous blood, again indicating a reduction in arteriovenous anastomotic flow due to a constriction of these non-nutrient vessels.5. Cyproheptadine (1 mg kg(-1)) completely reversed the effect of 5-hydroxytryptamine on the total carotid blood flow. However, the vasoconstriction of arteriovenous anastomoses was only partially attenuated and the vasodilatatory response was either unchanged (muscle) or even enhanced (skin, ear and bones).6. It is suggested that 5-hydroxytryptamine causes vasoconstriction of the large arteries via D-receptors which are only partly involved in the constriction of arteriovenous anastomoses. A part of the vasoconstriction in these non-nutrient vessels and the vasodilatation in extracerebral tissues are mediated by atypical 5-hydroxytryptamine receptors that are yet to be fully characterized.

Effects of cervical sympathetic stimulation on cerebral and ocular blood flows during hemorrhagic hypotension and moderate hypoxia

The effect of cervical sympathetic stimulation upon regional blood flows was investigated in albino rabbits during graded hemorrhagic hypotension and mild to moderate hypoxic hypoxia. Regional blood flows were determined using labelled microspheres. Cerebral blood flow (CBF) decreased in response to progressive hypotension and increased considerably during hypoxia (100-200%). Unilateral sympathetic stimulation did not change the ipsilateral cerebral flow responses under either condition. There was a greater tendency to autoregulate down to lower blood pressures in deep than in superficial cerebral structures. During hypoxia cortical gray matter blood flow increased relatively more than did white matter blood flow. Blood flow in different parts of the eye decreased during hypotension and tended to increase during hypoxia. Unilateral sympathetic stimulation reduced flow rates on the stimulated side (10-50% of control side) under both conditions. The vasoconstrictory effect upon retinal blood flow tended, however, to be less during hypoxia. Dural blood flow showed a poor autoregulation and also no consistent vasodilatory response upon hypoxia. Sympathetic stimulation had a very marked effect. The results suggest that the cervical sympathetic nerves do not have any appreciable effect upon cerebral circulation during profound hypotensive and moderate hypoxic states. Dural and most ocular blood flows seem, however, to be clearly affected by sympathetic stimulation even under these extreme conditions.

Effects of sympathetic stimulation on cerebral and ocular blood flow. Modification by hypertension, hypercapnia, acetazolamide, PGI2 and papaverine

The effect of unilateral, electrical stimulation of the cervical sympathetic chain in rabbits anesthetized with pentobarbital sodium and vasodilated by hypercapnia, acetazolamide, papaverine or PGI2 was investigated to determine to what extent the sympathetic nerves to the brain and the eye cause vasoconstriction and prevent overperfusion in previously vasodilated animals. Evans blue was given as a tracer for protein leakage. Blood flow determinations were made with the labelled microsphere method during normotension and acute arterial hypertension. Hypertension was induced by ligation of the thoracic aorta and in some animals metaraminol or angiotensin was also used. Acetazolamide caused a two to threefold increase in cerebral blood flow (CBF) and hypercapnia resulted in a fivefold increase. CBF was not markedly affected by papaverine or PGI2. In the choroid plexus, the ciliary body and choroid, papaverine and hypercapnia caused significant blood flow increases on the control side. Sympathetic stimulation induced a 12% blood flow reduction in the brain in normotensive, hypercapnic animals. Marked effects of sympathetic stimulation at normotension were obtained under all conditions in the eye. In the hypertensive state the CBF reduction during sympathetic stimulation was moderate, but highly significant in hypercapnic or papaverine-treated animals as well as in controls. Leakage of Evans blue was more frequently seen on the nonstimulated side of the brain. In the eye there was leakage only on the control side except in PGI2-treated animals where 2 rabbits had bilateral leakage. The effect of sympathetic stimulation on the blood flow in the cerebrum and cerebellum in vasodilated animals seems to be small or absent if the blood pressure is normal. In the eye pronounced vasoconstriction occurs under these conditions. In acute arterial hypertension sympathetic stimulation protects both the cerebral and ocular barriers even under conditions of marked vasodilation.

Validity of cerebral blood flow measurements obtained with quantitative tracer techniques

A great number of results for the cerebral blood flow obtained in the animal with quantitative tracer techniques have been collected from the literature. They are exposed in order to compare both normal flow values in different laboratory species, and the characteristics, accuracy and sensitivity of each technique. A dramatic overall dispersion of flow values is observed, allowing neither the flow level particular to each species to be estimated, nor the average value provided by a given technique to be found. The physiological and technological causes of such a dispersion are discussed. Several techniques seem to have limitations which even alter the interpretation of their results, and especially the origin of the local or regional blood flow results. Other techniques may be criticized from the quantitative standpoint, but give more reliable results.

Autoregulation of cerebral blood flow after experimental fluid percussion injury of the brain

To test the hypothesis that concussive brain injury autoregulation of cerebral blood flow (CBF), 24 cats were subjected to hemorrhagic hypotension in 10-mm Hg increments while measurements were made of arterial and intracranial pressure, CBF, and arterial blood gases. Eight cats served as controls, while eight were subjected to mild fluid percussion injury of the brain (1.5 to 2.2 atmospheres) and eight to severe injury (2.8 to 4.8 atmospheres). Injury produced only transient changes in arterial and intracranial pressure, and no change in resting CBF. Impairment of autoregulation was found in injured animals, more pronounced in the severe-injury group. This could not be explained on the basis of intracranial hypertension, hypoxemia, hypercarbia, or brain damage localized to the area of the blood flow electrodes. It is, therefore, concluded that concussive brain injury produces a generalized loss of autoregulation for at least several hours following injury.

Control of breathing during acute hemorrhage in anesthetized cats

We studied in anesthetized cats the ventilatory response to acute blood loss under hyperoxic iso-capnic conditions. From a blood pressure, of approximately 150 down to approximately 70 mm Hg ventilation increased on the average by 2.5 times. The ventilatory response was characterized by two phases: there was an initial phase (down to a PB approximately 100 mm Hg) of increase in frequency due to an excitatory effect on bulbo-pontine respiratory timing which was estimated from the duration of breaths following occlusion of the airways at the end expiratory volume. This effect was mainly due to the withdrawal of inhibitory afferents from the baroreceptors of the aortic arch. To this phase corresponded the phase of vasomotor compensation. Subsequently there was a phase of excitatory effect on the respiratory output which was estimated from the rate of change of the pressure developed in the airways during occluded breaths. This effect was mainly due to afferents from carotid sinuses; a minor role was due to the decrease in inhibitory afferents from carotid baroreceptors while the greater part was likely to be due to the hypoxic stimulation of glomus cells due to reduced blood flow. Following vagotomy above the superior laryngeal and sinus denervation the excitatory effect on respiratory timing and output were reduced to about 30% of that observed in intact cats.

Functional activity of the noradrenergic innervation of large cerebral arteries

1 The role of the sympathetic innervation of cerebral arteries remains controversial. Therefore, the functional activity of the adrenergic innervation of the rabbit basilar artery was characterized and compared to that of a peripheral artery, the ear artery. 2 Both the ear artery and basilar artery have similar endogenous noradrenaline (NA) contents but accumulation of [3H]-NA was considerably greater in the basilar artery. 3 Studies of tritium efflux after loading with [3H]-NA demonstrated a considerable non-neuronal component since neither guanethidine nor tetrodotoxin completely blocked tritium efflux during nerve stimulation. Pretreatment with blockers of uptake2 did not eliminate this problem. 4 Comparison of methods for estimating the functional activity of adrenergic nerves showed that, for the vessels studied, NA content and [3H]-NA accumulation gave markedly different answers. Fractional release of [3H]-NA did not correspond to fractional release of endogenous NA. 5 Adrenergic nerves innervating cerebral arteries are shown to have a high activity relative to a peripheral artery. While cerebrovascular sympathetic innervation may not play an important role in normal circumstances, its influence may be seen in pathological conditions.

Is there an active mechanism limiting the influence of the sympathetic system on the cerebral vascular bed? Evidence for vasomotor escape from sympathetic stimulation in the rabbit

The influence of the cervical sympathetic chain on cerebral circulation in the rabbit was studied by means of 3 complementary techniques. Two dynamic techniques involving chronically implanted probes were used: blood flow in the caudate nucleus (CN) was measured by thermal clearance; tissue PO2 and PCO2 in the same structure were measured by mass spectrometry. Other variables measured continuously and simultaneously included arterial blood pressure (BP), PaO2 and PaCO2. The third technique was a tissue sampling method based on the Fick principle and using 14C1 ethanol as tracer. Blood flow in 7 regions was measured at stable BP, PaO2 and PaCO2. Stimulation of the sympathetic chain at 15 Hz induced mean maximal decreases in CN blood flow of 23.9% (thermal clearance) and 24.4% (ethanol technique). Mean decrease of PO2 in the CN at 15 Hz was 16.6%. Significant falls in blood flow were observed with the ethanol technique in all 7 structures measured. During prolonged stimulation (greater than 1 min) CN blood flow and PO2 were found to escape towards the baseline level, which was sometimes even exceeded during the stimulation (blood flow). Stimulation frequency had only a very moderate influence on the rate of escape, and no evidence of a metabolic mechanism was found, although injection of barbiturate decreased the escape. These results are discussed with respect to the conflicting evidence on the effects of sympathetic stimulation in the brain, and to possible mechanisms for the escape phenomenon.

Role of large arteries in regulation of cerebral blood flow in dogs

Previous studies have demonstrated a significant pressure gradient from carotid artery to pial or middle cerebral arteries. This pressure gradient suggests that large cerebral arteries contribute to cerebral resistance. We have tested the hypothesis that large cerebral arteries contribute to regulation of cerebral blood flow during changes in blood gases and arterial pressure. Microspheres were used to measure brain blood flow in anesthetized dogs. Resistance of large cerebral arteries was estimated by determining the pressure gradient between common carotid and wedged vertebral artery catheters. Systemic hypercapnia and hypoxia dilated large cerebral arteries, and hypocapnia constricted large cerebral arteries. Resistance of large arteries was 0.6+/-0.1 (mean +/- SE) mm Hg per ml/min per 100 g during normocapnia. During hypercapnia and hypoxia, large artery resistance decreased significantly to 0.2 +/- 0.03 and 0.3 +/- 0.05, respectively. During hypocapnia large artery resistance increased significantly to 1.0 +/- 0.1. In other experiments, we found that large cerebral arteries participate in auto-regulatory responses to hemorrhagic hypotension. When arterial pressure was reduced from 110 to 58 mm Hg, autoregulation maintained cerebral blood flow constant, and resistance of large cerebral arteries decreased significantly from 1.0 +/- 0.2 to 0.6 +/- 0.1 mm Hg per ml/min per 100 g. In absolute terms, we calculated that 20-45% of the change in total cerebral resistance during these interventions was accounted for by changes in large artery resistance. These studies indicate that large cerebral arteries, as well as arterioles, participate actively in regulation of cerebral blood flow during changes in arterial blood gases and during autoregulatory responses to hemorrhagic hypotension.

Influence of the cerebrovascular sympathetic innervation on regional flow, autoregulation, and blood-brain barrier function

Experiments have been done on rats, rabbits and baboons to elucidate the role of the cranial sympathetic nerves originating in the superior cervical ganglia in the regulation of local cerebral blood flow, including its autoregulation, and in blood-brain barrier functions. Flow was measured by the [14C] ethanol technique, thermoclearance, and xenon-133 clearance. Blood-brain barrier functions were studied by the extravasation of an Evan's blue-albumin complex and by calculation of brain uptake index for two compounds (noradrenaline and inulin). Electrical stimulation of the sympathetic nerves reduces regional flow to a degree that is related to the amount of local perivascular innervation. The breakthrough of autoregulation during induced systemic hypertension is prevented by bilateral stimulation of the superior cervical ganglia. Acute sympathectomy markedly enhances the vascular penetration both at normotension (tested by brain uptake index for noradrenaline and inulin) and rapidly induced hypertension (evidenced by extravasation of Evans' blue). This extravasation of Evans' blud during acute hypertension can be counteracted by sympathetic nerve stimulation. The results give further support for the view that the cranial sympathetic nerves afford an efficient control of the cerebrovascular bed.