The Acute Cardiorespiratory and Cerebrovascular Response to Resistance Exercise

Neurovascular coupling during dynamic upper body resistance exercise in healthy individuals

During unilateral static and rhythmic handgrip exercise, middle cerebral artery blood velocity (MCAv) increases in the contralateral side to the exercising limb. However, whether this neurovascular coupling-mediated increase in contralateral MCAv is apparent against a background of fluctuating perfusion pressure produced by dynamic resistance exercise (RE) is unclear. We examined the cerebral haemodynamic response to unilateral dynamic RE in 30 healthy individuals (female = 16, mean ± SD: age, 26 ± 6 years; height, 175 ± 10 cm; weight, 74 ± 15 kg; body mass index, 24 ± 5 kg m-2). Participants completed four sets of 10 paced repetitions (15 repetitions min-1) of unilateral bicep curl exercise at 60% of the predicted one-repetition maximum (7 ± 3 kg). Beat-to-beat blood pressure, bilateral MCAv and end-tidal carbon dioxide were measured throughout. One-way ANOVA was used to analyse cardiovascular variables and two-way ANOVA to analyse dependent cerebrovascular variables (side × sets, 2 × 5). A linear mixed model analysis was also performed to investigate the effects of end-tidal carbon dioxide and mean arterial blood pressure on MCAv. In comparison to baseline, within-exercise mean arterial blood pressure increased (P < 0.001) across the sets, whereas bilateral MCAv decreased (P < 0.001). However, no significant interaction effect was observed for any dependent variables (all P > 0.787). The linear mixed model revealed that end-tidal carbon dioxide had the greatest effect on MCAv (estimate = 1.019, t = 8.490, P < 0.001). No differences were seen in contralateral and ipsilateral MCAv during dynamic RE, suggesting that neurovascular coupling contributions during dynamic RE might be masked by other regulators, such as blood pressure.

The effects of habitual resistance exercise training on cerebrovascular responses to lower body dynamic resistance exercise: A cross-sectional study

Dynamic resistance exercise (RE) produces sinusoidal fluctuations in blood pressure with simultaneous fluctuations in middle cerebral artery blood velocity (MCAv). Some evidence indicates that RE may alter cerebrovascular function. This study aimed to examine the effects of habitual RE training on the within-RE cerebrovascular responses. RE-trained (n = 15, Female = 4) and healthy untrained individuals (n = 15, Female = 12) completed four sets of 10 paced repetitions (15 repetitions per minute) of unilateral leg extension exercise at 60% of predicted 1 repetition maximum. Beat-to-beat blood pressure, MCAv and end-tidal carbon dioxide were measured throughout. Zenith, nadir and zenith-to-nadir difference in mean arterial blood pressure (MAP) and mean MCAv (MCAvmean) for each repetition were averaged across each set. Two-way ANOVA was used to analyse dependent variables (training × sets), Bonferroni corrected t-tests were used for post hoc pairwise comparisons. Group age (26 ± 7 trained vs. 25 ± 6 years untrained, P = 0.683) and weight (78 ± 15 vs. 71 ± 15 kg, P = 0.683) were not different. During exercise average MAP was greater for the RE-trained group in sets 2, 3 and 4 (e.g., set 4: 101 ± 11 vs. 92 ± 7 mmHg for RE trained and untrained, respectively, post hoc tests all P = < 0.012). Zenith MAP and zenith-to-nadir MAP difference demonstrated a training effect (P < 0.039). Average MCAvmean and MCAvmean zenith-to-nadir difference was not different between groups (interaction effect P = 0.166 and P = 0.459, respectively). Despite RE-trained individuals demonstrating greater fluctuations in MAP during RE compared to untrained, there were no differences in MCAvmean. Regular RE may lead to vascular adaptations that stabilise MCAv during RE.

Cerebrovascular adaptations to habitual resistance exercise with aging

Resistance training (RT) is associated with improved metabolism, bone density, muscular strength, and lower risk of osteoporosis, sarcopenia, and cardiovascular disease. Although RT imparts many physiological benefits, cerebrovascular adaptations to chronic RT are not well defined. Participation in RT is associated with greater resting peripheral arterial diameters, improved endothelial function, and general cardiovascular health, whereas simultaneously linked to reductions in central arterial compliance. Rapid blood pressure fluctuations during resistance exercise, combined with reduced arterial compliance, could lead to cerebral microvasculature damage and subsequent cerebral hypoperfusion. Reductions in cerebral blood flow (CBF) accompany normal aging, where chronic reductions in CBF are associated with changes in brain structure and function, and increased risk of neurodegeneration. It remains unclear whether reductions in arterial compliance with RT relate to subclinical cerebrovascular pathology, or if such adaptations require interpretation in the context of RT specifically. The purpose of this narrative review is to synthesize literature pertaining to cerebrovascular adaptations to RT at different stages of the life span. This review also aims to identify gaps in the current understanding of the long-term impacts of RT on cerebral hemodynamics and provide a mechanistic rationale for these adaptations as they relate to aging, cerebral vasculature, and overall brain health.

Cerebral oxygenation and perfusion kinetics monitoring of military aircrew at high G using novel fNIRS wearable system

Introduction

Real-time physiological episode (PE) detection and management in aircrew operating high-performance aircraft (HPA) is crucial for the US Military. This paper addresses the unique challenges posed by high acceleration (G-force) in HPA aircrew and explores the potential of a novel wearable functional near-infrared spectroscopy (fNIRS) system, named NIRSense Aerie, to continuously monitor cerebral oxygenation during high G-force exposure.

Methods

The NIRSense Aerie system is a flight-optimized, wearable fNIRS device designed to monitor tissue oxygenation 13-20 mm below the skin's surface. The system includes an optical frontend adhered to the forehead, an electronics module behind the earcup of aircrew helmets, and a custom adhesive for secure attachment. The fNIRS optical layout incorporates near-distance, middle-distance, and far-distance infrared emitters, a photodetector, and an accelerometer for motion measurements. Data processing involves the modified Beer-Lambert law for computing relative chromophore concentration changes. A human evaluation of the NIRSense Aerie was conducted on six subjects exposed to G-forces up to +9 Gz in an Aerospace Environmental Protection Laboratory centrifuge. fNIRS data, pulse oximetry, and electrocardiography (HR) were collected to analyze cerebral and superficial tissue oxygenation kinetics during G-loading and recovery.

Results

The NIRSense Aerie successfully captured cerebral deoxygenation responses during high G-force exposure, demonstrating its potential for continuous monitoring in challenging operational environments. Pulse oximetry was compromised during G-loading, emphasizing the system's advantage in uninterrupted cerebrovascular monitoring. Significant changes in oxygenation metrics were observed across G-loading levels, with distinct responses in Deoxy-Hb and Oxy-Hb concentrations. HR increased during G-loading, reflecting physiological stress and the anti-G straining maneuver.

Discussion

The NIRSense Aerie shows promise for real-time monitoring of aircrew physiological responses during high G-force exposure. Despite challenges, the system provides valuable insights into cerebral oxygenation kinetics. Future developments aim for miniaturization and optimization for enhanced aircrew comfort and wearability. This technology has potential for improving anti-G straining maneuver learning and retention through real-time cerebral oxygenation feedback during centrifuge training.

A New Algorithm for Estimating a Noiseless, Evenly Sampled, Heart Rate Modulating Signal

Heart rate variability (HRV) is commonly intended as the variation in the heart rate (HR), and it is evaluated in the time and frequency domains with various well-known methods. In the present paper, the heart rate is considered as a time domain signal, at first as an abstract model in which the HR is the instantaneous frequency of an otherwise periodic signal, such as with an electrocardiogram (ECG). In this model, the ECG is assumed to be a frequency modulated signal, or carrier signal, where HRV or HRV(t) is the time-domain signal which is frequency modulating the carrier ECG signal around its average frequency. Hence, an algorithm able to frequency demodulate the ECG signal to extract the signal HRV(t) is described, with possibly enough time resolution to analyse fast time-domain variations in the instantaneous HR. After exhaustive testing of the method on simulated frequency modulated sinusoidal signals, the new procedure is eventually applied on actual ECG tracings for preliminary nonclinical testing. The purpose of the work is to use this algorithm as a tool and a more reliable method for the assessment of heart rate before any further clinical or physiological analysis.

Dynamic resistance exercise-induced pressor response does not alter hypercapnia-induced cerebral vasodilation in young adults

Excessive arterial pressure elevation induced by resistance exercise (RE) attenuates peripheral vasodilatory function, but its effect on cerebrovascular function is unknown. We aimed to evaluate the effect of different pressor responses to RE on hypercapnia-induced vasodilation of the internal carotid artery (ICA), an index of cerebrovascular function. To manipulate pressor responses to RE, 15 healthy young adults (11M/4F) performed two RE: high intensity with low repetitions (HL) and low intensity with high repetitions (LH) dynamic knee extension. ICA dilation, induced by 3 min of hypercapnia, was measured before and 10 min after RE using Doppler ultrasound. HL exercise elicited a greater pressor response than LH exercise. In relaxation phases of RE, ICA blood velocity increased in both HL and LH trials. However, ICA shear rate did not significantly increase in either trial (P = 0.06). Consequently, neither exercise altered post-exercise hypercapnia-induced ICA dilation (HL, 3.9 ± 1.9% to 5.1 ± 1.7%; LH, 4.6 ± 1.4% to 4.8 ± 1.8%; P > 0.05 for all). When viewed individually, the changes in ICA shear rate were positively correlated with changes in end-tidal partial pressure of carbon dioxide (P_ETCO₂) (r = 0.46, P < 0.01) than with mean arterial pressure (r = 0.32, P = 0.02). These findings suggest that the effects of RE-induced pressor response on cerebrovascular function may be different from peripheral arteries. An increase in P_ETCO₂ during the relaxation phase may play a more crucial role than elevated pressure in increasing cerebral shear during dynamic RE.

The effect of aging on carotid artery wall mechanics during maximal resistance exercise

INTRODUCTION

Age-related stiffening of the large elastic arteries (e.g., common carotid artery [CCA]) may impair wall dynamics (i.e., strain) and amplify transmission of pulsatile blood flow into the brain with large increases in pressure that occur during maximal resistance exercise (RE). The purpose of this study was to compare CCA arterial wall dynamics, central hemodynamics, and cerebral blood velocity responses during maximal RE between young and older adults.

METHODS

Thirty-one young (YA; 26 ± 5 yrs; 23.8 ± 3.3 kg/m²) and 25 older adults (OA; 60 ± 6 yrs; 30.0 ± 5.5 kg/m²) performed a unilateral maximal isokinetic knee flexion/extension exercise protocol (i.e., maximal RE). All measures were recorded at baseline and during the last 10 s of maximal RE. Common carotid artery strain, CCA strain time to peak, and CCA strain rate (i.e., variables of arterial wall dynamics) were analyzed using 2D speckle tracking software from circumferential ultrasound images. Transcranial Doppler was used to measure right middle cerebral artery (MCA) blood velocity. Non-invasive arterial blood pressure measurements were obtained using finger photoplethysmography.

RESULTS

Older adults had greater reductions in CCA strain time to peak from baseline to maximal RE (345 ± 39 to 242 ± 52 ms) than YA (308 ± 35 to 247 ± 42 ms; interaction effect, p < 0.01). MCA velocity was similar between YA and OA during maximal RE (p = 0.48), despite a greater arterial pressor response in OA (p < 0.01).

CONCLUSION

These data suggest cerebral blood velocity responds similarly during maximal RE among OA compared to YA, despite subtle age-related differences in the pressor and extracranial vascular response during maximal RE.

On the use and misuse of cerebral hemodynamics terminology using Transcranial Doppler ultrasound: a call for standardization

Cerebral hemodynamics (e.g., cerebral blood flow) can be measured and quantified using many different methods, with Transcranial Doppler ultrasound (TCD) being one of the most commonly utilized approaches. In human physiology, the terminology used to describe metrics of cerebral hemodynamics are inconsistent, and in some instances technically inaccurate; this is especially true when evaluating, reporting, and interpreting measures from TCD. Therefore, this perspectives article presents recommended terminology when reporting cerebral hemodynamic data. We discuss the current use and misuse of the terminology in the context of using TCD to measure and quantify cerebral hemodynamics and present our rationale and consensus on the terminology that we recommend moving forward. For example, one recommendation is to discontinue use of the term "cerebral blood flow velocity" in favor of "cerebral blood velocity" with precise indication of the vessel of interest. We also recommend clarity when differentiating between discrete cerebrovascular regulatory mechanisms, namely cerebral autoregulation, neurovascular coupling, and cerebrovascular reactivity. This will be a useful guide for investigators in the field of cerebral hemodynamics research.

Time course recovery of cerebral blood velocity metrics post aerobic exercise: A systematic review

Currently, the standard approach for restricting exercise prior to cerebrovascular data collection varies widely between 6-24 hours. This universally employed practice is a conservative approach to safeguard physiological alterations that could potentially confound one's study design. Therefore, the purpose of this systematic review was to amalgamate the literature that examines the extent and duration cerebrovascular function is impacted following aerobic exercise measured via transcranial Doppler ultrasound. Further, an exploratory aim was to scrutinize and discuss common biases/limitations in the previous studies to help guide future investigations. Search strategies were developed and imported into PubMed, SPORTDiscus, and Medline databases. A total of 595 records were screened and 35 articles met the inclusion criteria in this review, which included assessments of basic cerebrovascular metrics (n=35), dynamic cerebral autoregulation (dCA; n=9), neurovascular coupling (NVC; n=2); and/or cerebrovascular reactivity (CVR-CO₂; n=1) following acute bouts of aerobic exercise. Across all studies, it was found NVC was impacted for 1-hour, basic cerebrovascular parameters and CVR-CO₂ parameters 2-hours, and dCA metrics 6-hours post-exercise. Therefore, future studies can provide participants with these evidence-based time restrictions, regarding the minimum time to abstain from exercise prior to data collection. However, it should be noted, other physiological mechanisms could still be altered (e.g., metabolic, hormonal, and/or autonomic influences), despite cerebrovascular function returning to baseline levels. Thus, future investigations should seek to control for as many physiological influences when employing cerebrovascular assessments, immediately following these time restraints. The main limitations/biases were lack of female participants, cardiorespiratory fitness, and consideration for vessel diameter.

Directional sensitivity of the cerebral pressure-flow relationship in young healthy individuals trained in endurance and resistance exercise

NEW FINDINGS

What is the central question of this study? Does habitual exercise modality affect the directionality of the cerebral pressure-flow relationship? What is the main finding and its importance? These data suggest the hysteresis-like pattern of dynamic cerebral autoregulation appears present in long-term sedentary and endurance-trained individuals, but absent in resistance-trained individuals. This is the first study to expand knowledge on the directional sensitivity of the cerebral pressure-flow relationship to trained populations.

ABSTRACT

Evidence suggests the cerebrovasculature may be more efficient at dampening cerebral blood flow (CBF) variations when mean arterial pressure (MAP) transiently increases, compared to when it decreases. Despite divergent MAP and CBF responses to acute endurance and resistance training, the long-term impact of habitual exercise modality on the directionality of dynamic cerebral autoregulation (dCA) is currently unknown. Thirty-six young healthy participants [sedentary (n = 12), endurance-trained (n = 12) and resistance-trained (n = 12)] undertook a 5-min repeated squat-stand protocol at two forced MAP oscillation frequencies (0.05 Hz and 0.10 Hz). Middle cerebral artery mean blood velocity (MCAv) and MAP were continuously monitored. We calculated absolute (ΔMCAv_T /ΔMAP_T ) and relative (%MCAv_T /%MAP_T ) changes in MCAv and MAP with respect to the transition time intervals of both variables to compute a time-adjusted ratio in each MAP direction, averaged over the 5-min repeated squat-stand protocols. At 0.10 Hz repeated squat-stands, ΔMCAv_T /ΔMAP_T and %MCAv_T /%MAP_T were lower when MAP increased compared with when MAP decreased for sedentary (ΔMCAv_T /ΔMAP_T : p = 0.032; %MCAv_T /%MAP_T : p = 0.040) and endurance-trained individuals (ΔMCAv_T /ΔMAP_T : p = 0.012; %MCAv_T /%MAP_T : p = 0.007), but not in the resistance-trained (ΔMCAv_T /ΔMAP_T : p = 0.512; %MCAv_T /%MAP_T : p = 0.666). At 0.05 Hz repeated squat-stands, time-adjusted ratios were similar for all groups (all p>0.605). These findings suggest exercise training modality does influence the directionality of the cerebral pressure-flow relationship and support the presence of a hysteresis-like pattern during 0.10 Hz repeated squat-stands in sedentary and endurance-trained participants, but not in resistance-trained individuals. In future studies, assessment of elite endurance and resistance training habits may further elucidate modality-dependent discrepancies on directional dCA measurements. This article is protected by copyright. All rights reserved.

A Systematic Review of the Impact of Physical Exercise-Induced Increased Resting Cerebral Blood Flow on Cognitive Functions

Brain perfusion declines with aging. Physical exercise represents a low-cost accessible form of intervention to increase cerebral blood flow; however, it remains unclear if exercise-induced amelioration of brain perfusion has any impact on cognition. We aimed to provide a state-of-the art review on this subject. A comprehensive search of the PubMed (MEDLINE) database was performed. On the basis of the inclusion and exclusion criteria, 14 studies were included in the analysis. Eleven of the studies conducted well-controlled exercise programs that lasted 12–19 weeks for 10–40 participants and two studies were conducted in much larger groups of subjects for more than 5 years, but the exercise loads were indirectly measured, and three of them were focused on acute exercise. Literature review does not show a direct link between exercise-induced augmentation of brain perfusion and better cognitive functioning. However, in none of the reviewed studies was such an association the primary study endpoint. Carefully designed clinical studies with focus on cognitive and perfusion variables are needed to provide a response to the question whether exercise-induced cerebral perfusion augmentation is of clinical importance.

Effect of breath-hold on the responses of arterial blood pressure and cerebral blood velocity to isometric exercise

PURPOSE

The present study examined the effect of breath-hold without a Valsalva maneuver during isometric exercise on arterial blood pressure (ABP) and cerebral blood flow (CBF).

METHODS

Twenty healthy adults (15 men and five women) randomly performed only breath-hold without a Valsalva maneuver (BH), and an isometric handgrip exercise for 30 s at 40% of individual maximal voluntary contraction with continuous breathing (IHG) and with breath-hold without the Valsalva maneuver (IHG-BH). Mean ABP (MAP) and blood velocity in the middle (MCA V_mean) and posterior cerebral arteries (PCA V_mean) were continuously measured throughout each protocol.

RESULTS

MAP was elevated during the IHG-BH compared with IHG (P < 0.001) and BH (P = 0.001). Similarly, both MCA V_mean and PCA V_mean were higher during IHG-BH compared with IHG and BH (all P < 0.001). Moreover, the relative change in MAP from the baseline was correlated with that in both cerebral blood velocities during the BH (MCA V_mean: r = 0.739, P < 0.001 and PCA V_mean: r = 0.570, P = 0.009) and IHG-BH (MCA V_mean: r = 0.755, P < 0.001 and PCA V_mean: r = 0.617, P = 0.003) condition, but not the IHG condition (P = 0.154 and P = 0.306).

CONCLUSION

These results indicate that during isometric exercise, a breath-hold enhances an exercise-induced increase in MAP and, consequently, MCA V_mean and PCA V_mean.