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Clough RH, Panerai RB, Ladthavorlaphatt K, Robinson TG, Minhas JS. The complexity of cerebral blood flow regulation: the interaction of posture and vasomotor reactivity. J Appl Physiol (1985) 2024; 137:892-902. [PMID: 39143908 DOI: 10.1152/japplphysiol.00851.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 08/09/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024] Open
Abstract
Arterial carbon dioxide ([Formula: see text]) and posture influence the middle (MCAv) and posterior (PCAv) cerebral artery blood velocities, but there is paucity of data about their interaction and need for an integrated model of their effects, including dynamic cerebral autoregulation (dCA). In 22 participants (11 males, age 30.2 ± 14.3 yr), blood pressure (BP, Finometer), dominant MCAv and nondominant PCAv (transcranial Doppler ultrasound), end-tidal CO2 (EtCO2, capnography), and heart rate (HR, ECG) were recorded continuously. Two recordings (R) were taken when the participant was supine (R1, R2), two taken when the participant was sitting (R3, R4), and two taken when the participant was standing (R5, R6). R1, R3, and R5 consisted of 3 min of 5% CO2 through a mask and R2, R4, and R6 consisted of 3 min of paced hyperventilation. The effects of [Formula: see text] were expressed with a logistic curve model (LCM) for each parameter. dCA was expressed by the autoregulation index (ARI), derived by transfer function analysis. Standing shifted LCM to the left for MCAv (P < 0.001), PCAv (P < 0.001), BP (P = 0.03), and ARI (P = 0.001); downward for MCAv and PCAv (both P < 0.001), and upward for HR (P < 0.001). For BP, LCM was shifted downward by sitting and standing (P = 0.024). For ARI, the hypercapnic range of LCM was shifted upward during standing (P < 0.001). A more complete mapping of the combined effects of posture and arterial CO2 on the cerebral circulation and peripheral variables can be obtained with the LCM over a broad physiological range of EtCO2 values.NEW & NOTEWORTHY Data from supine, sitting, and standing postures were measured. Modeling the data with logistic curves to express the effects of CO2 reactivity on middle cerebral artery blood velocity (MCAv), posterior cerebral artery blood velocity (PCAv), heart rate, blood pressure (BP), and the autoregulation index (ARI), provided a more comprehensive approach to study the interaction of arterial CO2 with posture than in previous studies. Above all, shifts of the logistic curve model with changes in posture have shown interactions with [Formula: see text] that have not been previously demonstrated.
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Affiliation(s)
- Rebecca H Clough
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Ronney B Panerai
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Kannaphob Ladthavorlaphatt
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- Medical Diagnostics Unit, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Thompson G Robinson
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Jatinder S Minhas
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
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Bari V, Gelpi F, Cairo B, Anguissola M, Acerbi E, Squillace M, De Maria B, Bertoldo EG, Fiolo V, Callus E, De Vincentiis C, Bedogni F, Ranucci M, Porta A. Impact of surgical aortic valve replacement and transcatheter aortic valve implantation on cardiovascular and cerebrovascular controls: A pilot study. Physiol Rep 2024; 12:e70028. [PMID: 39227321 PMCID: PMC11371460 DOI: 10.14814/phy2.70028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/23/2024] [Accepted: 08/23/2024] [Indexed: 09/05/2024] Open
Abstract
Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are options in severe aortic valve stenosis (AVS). Cardiovascular (CV) and cerebrovascular (CBV) control markers, derived from variability of heart period, systolic arterial pressure, mean cerebral blood velocity and mean arterial pressure, were acquired in 19 AVS patients (age: 76.8 ± 3.1 yrs, eight males) scheduled for SAVR and in 19 AVS patients (age: 79.9 + 6.5 yrs, 11 males) scheduled for TAVI before (PRE) and after intervention (POST, <7 days). Left ventricular function was preserved in both groups. Patients were studied at supine resting (REST) and during active standing (STAND). We found that: (i) both SAVR and TAVI groups featured a weak pre-procedure CV control; (ii) TAVI ensured better CV control; (iii) cerebral autoregulation was working in PRE in both SAVR and TAVI groups; (iv) SAVR and TAVI had no impact on the CBV control; (v) regardless of group, CV and CBV control markers were not influenced by STAND in POST. Even though the post-procedure preservation of both CV and CBV controls in TAVI group might lead to privilege this procedure in patients at higher risk, the missing response to STAND suggests that this advantage could be insignificant.
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Affiliation(s)
- Vlasta Bari
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
- Department of Cardiothoracic, Vascular Anesthesia and Intensive CareIRCCS Policlinico San DonatoMilanItaly
| | - Francesca Gelpi
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | - Beatrice Cairo
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | - Martina Anguissola
- Department of Cardiothoracic, Vascular Anesthesia and Intensive CareIRCCS Policlinico San DonatoMilanItaly
| | - Elena Acerbi
- Department of Clinical and Interventional CardiologyIRCCS Policlinico San DonatoMilanItaly
| | - Mattia Squillace
- Department of Clinical and Interventional CardiologyIRCCS Policlinico San DonatoMilanItaly
| | | | | | - Valentina Fiolo
- Clinical Psychology ServiceIRCCS Policlinico San DonatoMilanItaly
| | - Edward Callus
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
- Clinical Psychology ServiceIRCCS Policlinico San DonatoMilanItaly
| | | | - Francesco Bedogni
- Department of Clinical and Interventional CardiologyIRCCS Policlinico San DonatoMilanItaly
| | - Marco Ranucci
- Department of Cardiothoracic, Vascular Anesthesia and Intensive CareIRCCS Policlinico San DonatoMilanItaly
| | - Alberto Porta
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
- Department of Cardiothoracic, Vascular Anesthesia and Intensive CareIRCCS Policlinico San DonatoMilanItaly
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Burkart JJ, Johnson NE, Burma JS, Neill MG, Smirl JD. Does exercise modality and posture influence cerebrovascular and cardiovascular systems similarly? Appl Physiol Nutr Metab 2024. [PMID: 39088845 DOI: 10.1139/apnm-2024-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
Cerebral hemodynamics have been quantified during exercise via transcranial Doppler ultrasound, as it has high-sensitivity to movement artifacts and displays temporal superiority. Currently, limited research exists regarding how different exercise modalities and postural changes impact the cerebrovasculature across the cardiac cycle. Ten participants (4 females and 6 males) ages 20-29 completed three exercise tests (treadmill, supine, and upright cycling) to volitional fatigue. Physiological data collected included middle cerebral artery velocity (MCAv), blood pressure (BP), heart rate, and respiratory parameters. Normalized data were analyzed for variance and effect sizes were calculated to examine differences between physiological measures across the three exercise modalities. Systolic MCAv was greater during treadmill compared to supine and upright cycling (p < 0.001, (large) effect size), and greater during upright versus supine cycling (p < 0.017, (large)). Diastolic MCAv was lower during treadmill versus cycling exercise only at 60% maximal effort (p < 0.005, (moderate)) and no differences were observed between upright and supine cycling. No main effect was found for mean and diastolic BP (p > 0.05, (negligible)). Systolic BP was lower during treadmill versus supine cycling at 40% and 60% intensity (p < 0.05, (moderate-large)) and greater during supine versus upright at only 60% intensity (p < 0.003, (moderate)). The above differences were not explained by partial pressure of end-tidal carbon dioxide levels (main effect: p = 0.432). The current study demonstrates the cerebrovascular and cardiovascular systems respond heterogeneously to different exercise modalities and aspects of the cardiac cycle. As physiological data were largely similar between tests, differences associated with posture and modality are likely contributors.
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Affiliation(s)
- Joshua J Burkart
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Nathan E Johnson
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Joel S Burma
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Matthew G Neill
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Jonathan D Smirl
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
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Labrecque L, Roy MA, Soleimani Dehnavi S, Taghizadeh M, Smirl JD, Brassard P. Directional sensitivity of the cerebral pressure-flow relationship during forced oscillations induced by oscillatory lower body negative pressure. J Cereb Blood Flow Metab 2024:271678X241247633. [PMID: 38613236 DOI: 10.1177/0271678x241247633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
A directional sensitivity of the cerebral pressure-flow relationship has been described using repeated squat-stands. Oscillatory lower body negative pressure (OLBNP) is a reproducible method to characterize dynamic cerebral autoregulation (dCA). It could represent a safer method to examine the directional sensitivity of the cerebral pressure-flow relationship within clinical populations and/or during pharmaceutical administration. Therefore, examining the cerebral pressure-flow directional sensitivity during an OLBNP-induced cyclic physiological stress is crucial. We calculated changes in middle cerebral artery mean blood velocity (MCAv) per alterations to mean arterial pressure (MAP) to compute ratios adjusted for time intervals (ΔMCAvT/ΔMAPT) with respect to the minimum-to-maximum MCAv and MAP, for each OLBNP transition (0 to -90 Torr), during 0.05 Hz and 0.10 Hz OLBNP. We then compared averaged ΔMCAvT/ΔMAPT during OLBNP-induced MAP increases (INC) (ΔMCAvT/Δ MAP T INC ) and decreases (DEC) (ΔMCAvT/Δ MAP T DEC ). Nineteen healthy participants [9 females; 30 ± 6 years] were included. There were no differences in ΔMCAvT/ΔMAPT between INC and DEC at 0.05 Hz. ΔMCAvT/Δ MAP T INC (1.06 ± 0.35 vs. 1.33 ± 0.60 cm⋅s-1/mmHg; p = 0.0076) was lower than ΔMCAvT/Δ MAP T DEC at 0.10 Hz. These results support OLBNP as a model to evaluate the directional sensitivity of the cerebral pressure-flow relationship.
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Affiliation(s)
- Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Marc-Antoine Roy
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Shahrzad Soleimani Dehnavi
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Mahmoudreza Taghizadeh
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Jonathan D Smirl
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Chen H, Cui L, Chen S, Liu R, Pan X, Zhou F, Xing Y. Comparable dynamic cerebral autoregulation and neurovascular coupling of the posterior cerebral artery between healthy men and women. CNS Neurosci Ther 2024; 30:e14584. [PMID: 38421125 PMCID: PMC10851316 DOI: 10.1111/cns.14584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024] Open
Abstract
AIMS Most studies focus on dynamic cerebral autoregulation (dCA) in the middle cerebral artery (MCA), and few studies investigated neurovascular coupling (NVC) and dCA in the posterior cerebral artery (PCA). We investigated NVC and dCA of the PCA in healthy volunteers to identify sex differences. METHODS Thirty men and 30 age-matched women completed dCA and NCV assessments. The cerebral blood flow velocity (CBFV) and mean arterial pressure were evaluated using transcranial Doppler ultrasound and a servo-controlled plethysmograph, respectively. The dCA parameters were analyzed using transfer function analysis. The NCV was evaluated by eyes-open and eyes-closed (24 s each) periodically based on voice prompts. The eyes-open visual stimulation comprised silent reading of Beijing-related tourist information. RESULTS The PCA gain was lower than that of the MCA in all frequency ranges (all p < 0.05). Phase was consistent across the cerebrovascular territories. The cerebrovascular conductance index (CVCi) and mean CBFV (MV) of the PCA were significantly higher during the eyes-open than eyes-closed period (CVCi: 0.50 ± 0.12 vs. 0.38 ± 0.10; MV: 42.89 ± 8.49 vs. 32.98 ± 7.25, both p < 0.001). The PCA dCA and NVC were similar between the sexes. CONCLUSION We assessed two major mechanisms that maintain cerebral hemodynamic stability in healthy men and women. The visual stimulation-evoked CBFV of the PCA was significantly increased compared to that during rest, confirming the activation of NVC. Men and women have similar functions in PCA dCA and NCV.
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Affiliation(s)
- Hongxiu Chen
- Department of Vascular UltrasonographyXuanwu Hospital, Capital Medical UniversityBeijingChina
- Beijing Diagnostic Center of Vascular UltrasoundBeijingChina
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
| | - Liuping Cui
- Department of Vascular UltrasonographyXuanwu Hospital, Capital Medical UniversityBeijingChina
- Beijing Diagnostic Center of Vascular UltrasoundBeijingChina
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
| | - Songwei Chen
- Department of Vascular UltrasonographyXuanwu Hospital, Capital Medical UniversityBeijingChina
- Beijing Diagnostic Center of Vascular UltrasoundBeijingChina
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
| | - Ran Liu
- Department of Vascular UltrasonographyXuanwu Hospital, Capital Medical UniversityBeijingChina
- Beijing Diagnostic Center of Vascular UltrasoundBeijingChina
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
| | - Xijuan Pan
- Department of Vascular UltrasonographyXuanwu Hospital, Capital Medical UniversityBeijingChina
- Beijing Diagnostic Center of Vascular UltrasoundBeijingChina
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
| | - Fubo Zhou
- Department of Vascular UltrasonographyXuanwu Hospital, Capital Medical UniversityBeijingChina
- Beijing Diagnostic Center of Vascular UltrasoundBeijingChina
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
| | - Yingqi Xing
- Department of Vascular UltrasonographyXuanwu Hospital, Capital Medical UniversityBeijingChina
- Beijing Diagnostic Center of Vascular UltrasoundBeijingChina
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
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Manferdelli G, Narang BJ, Bourdillon N, Giardini G, Debevec T, Millet GP. Impaired cerebrovascular CO 2 reactivity at high altitude in prematurely born adults. J Physiol 2023. [PMID: 38116893 DOI: 10.1113/jp285048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023] Open
Abstract
Premature birth impairs cardiac and ventilatory responses to both hypoxia and hypercapnia, but little is known about cerebrovascular responses. Both at sea level and after 2 days at high altitude (3375 m), 16 young preterm-born (gestational age, 29 ± 1 weeks) and 15 age-matched term-born (40 ± 0 weeks) adults were exposed to two consecutive 4 min bouts of hyperoxic hypercapnic conditions (3% CO2 -97% O2 ; 6% CO2 -94% O2 ), followed by two periods of voluntary hyperventilation-induced hypocapnia. We measured middle cerebral artery blood velocity, end-tidal CO2 , pulmonary ventilation, beat-by-beat mean arterial pressure and arterialized capillary blood gases. Baseline middle cerebral artery blood velocity increased at high altitude compared with sea level in term-born (+24 ± 39%, P = 0.036), but not in preterm-born (-4 ± 27%, P = 0.278) adults. The end-tidal CO2 , pulmonary ventilation and mean arterial pressure were similar between groups at sea level and high altitude. Hypocapnic cerebrovascular reactivity was higher at high altitude compared with sea level in term-born adults (+173 ± 326%, P = 0.026) but not in preterm-born adults (-21 ± 107%, P = 0.572). Hypercapnic reactivity was altered at altitude only in preterm-born adults (+125 ± 144%, P < 0.001). Collectively, at high altitude, term-born participants showed higher hypocapnic (P = 0.012) and lower hypercapnic (P = 0.020) CO2 reactivity compared with their preterm-born peers. In conclusion, exposure to high altitude revealed different cerebrovascular responses in preterm- compared with term-born adults, despite similar ventilatory responses. These findings suggest a blunted cerebrovascular response at high altitude in preterm-born adults, which might predispose these individuals to an increased risk of high-altitude illnesses. KEY POINTS: Cerebral haemodynamics and cerebrovascular reactivity in normoxia are known to be similar between term-born and prematurely born adults. In contrast, acute exposure to high altitude unveiled different cerebrovascular responses to hypoxia, hypercapnia and hypocapnia. In particular, cerebral vasodilatation was impaired in prematurely born adults, leading to an exaggerated cerebral vasoconstriction. Cardiovascular and ventilatory responses to both hypo- and hypercapnia at sea level and at high altitude were similar between control subjects and prematurely born adults. Other mechanisms might therefore underlie the observed blunted cerebral vasodilatory responses in preterm-born adults at high altitude.
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Affiliation(s)
| | - Benjamin J Narang
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Nicolas Bourdillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Guido Giardini
- Mountain Medicine and Neurology Centre, Valle D'Aosta Regional Hospital, Aosta, Italy
| | - Tadej Debevec
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Freeberg KA, Craighead DH, Heinbockel TC, Rossman MJ, Jackman RA, Jankowski LR, Ludwig KR, Chonchol M, Bailey EF, Seals DR. Time-efficient, high-resistance inspiratory muscle strength training increases cerebrovascular reactivity in midlife and older adults. Am J Physiol Heart Circ Physiol 2023; 325:H1059-H1068. [PMID: 37682232 PMCID: PMC10908405 DOI: 10.1152/ajpheart.00351.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023]
Abstract
Aging is associated with increased risk for cognitive decline and dementia due in part to increases in systolic blood pressure (SBP) and cerebrovascular dysfunction. High-resistance inspiratory muscle strength training (IMST) is a time-efficient, intensive respiratory training protocol (30 resisted inspirations/day) that lowers SBP and improves peripheral vascular function in midlife/older adults with above-normal SBP. However, whether, and by what mechanisms, IMST can improve cerebrovascular function is unknown. We hypothesized that IMST would increase cerebrovascular reactivity to hypercapnia (CVR to CO2), which would coincide with changes to the plasma milieu that improve brain endothelial cell function and enhance cognitive performance (NIH Toolbox). We conducted a 6-wk double-blind, randomized, controlled clinical trial investigating high-resistance IMST [75% maximal inspiratory pressure (PImax); 6×/wk; 4 females, 5 males] vs. low-resistance sham training (15% PImax; 6×/wk; 2 females, 5 males) in midlife/older adults (age 50-79 yr) with initial above-normal SBP. Human brain endothelial cells (HBECs) were exposed to participant plasma and assessed for acetylcholine-stimulated nitric oxide (NO) production. CVR to CO2 increased after high-resistance IMST (pre: 1.38 ± 0.66 cm/s/mmHg; post: 2.31 ± 1.02 cm/s/mmHg, P = 0.020). Acetylcholine-stimulated NO production increased in HBECs exposed to plasma from after vs. before the IMST intervention [pre: 1.49 ± 0.33; post: 1.73 ± 0.35 arbitrary units (AU); P < 0.001]. Episodic memory increased modestly after the IMST intervention (pre: 95 ± 13; post: 103 ± 17 AU; P = 0.045). Cerebrovascular and cognitive function were unchanged in the sham control group. High-resistance IMST may be a promising strategy to improve cerebrovascular and cognitive function in midlife/older adults with above-normal SBP, a population at risk for future cognitive decline and dementia.NEW & NOTEWORTHY Midlife/older adults with above-normal blood pressure are at increased risk of developing cognitive decline and dementia. Our findings suggest that high-resistance inspiratory muscle strength training (IMST), a novel, time-efficient (5-10 min/day) form of physical training, may increase cerebrovascular reactivity to CO2 and episodic memory in midlife/older adults with initial above-normal blood pressure.
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Affiliation(s)
- Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Thomas C Heinbockel
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Rachel A Jackman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Lindsey R Jankowski
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Katelyn R Ludwig
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - E Fiona Bailey
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona, United States
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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Wowdzia JB, Hazell TJ, Berg ERV, Labrecque L, Brassard P, Davenport MH. Maternal and Fetal Cardiovascular Responses to Acute High-Intensity Interval and Moderate-Intensity Continuous Training Exercise During Pregnancy: A Randomized Crossover Trial. Sports Med 2023; 53:1819-1833. [PMID: 37213048 DOI: 10.1007/s40279-023-01858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE We aimed to compare maternal and fetal cardiovascular responses to an acute bout of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) during pregnancy. METHODS Fifteen women with a singleton pregnancy (27.3 ± 3.5 weeks of gestation, 33 ± 4 years of age) were recruited. Following a peak fitness test, participants engaged in a session of HIIT (10 × 1-min intervals ≥ 90% maximum heart rate [HRmax]) interspersed with 1 min of active recovery) and MICT (30 min at 64-76% HRmax) 48 h apart in random order. Maternal HR, blood pressure, middle (MCAv), and posterior cerebral artery blood velocity (PCAv), as well as respiratory measures were monitored continuously throughout HIIT/MICT. Fetal heart rate, as well as umbilical systolic/diastolic (S/D) ratio, resistive index (RI), and pulsatility index (PI) were assessed immediately before and after exercise. RESULTS Average maternal heart rate was higher for HIIT (82 ± 5% HRmax) compared with MICT (74 ± 4% HRmax; p < 0.001). During the HIIT session, participants achieved a peak heart rate of 96 ± 5% HRmax (range of 87-105% HRmax). Maternal cerebral blood velocities increased with exercise but was not different between HIIT and MICT for MCAv (p = 0.340) and PCAv (p = 0.142). Fetal heart rate increased during exercise (p = 0.244) but was not different between sessions (HIIT: Δ + 14 ± 7 bpm; MICT: Δ + 10 ± 10 bpm). Metrics of umbilical blood flow decreased with exercise and were not different between exercise sessions (PI: p = 0.707; S/D ratio: p = 0.671; RI: p = 0.792). Fetal bradycardia was not observed, and S/D ratio, RI, and PI remained within normal ranges both before and immediately after all exercise sessions. CONCLUSIONS An acute bout of HIIT exercise consisting of repeated 1-min near-maximal to maximal exertions, as well as MICT exercise is well tolerated by both mother and fetus. CLINICAL TRIAL REGISTRATION NCT05369247.
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Affiliation(s)
- Jenna B Wowdzia
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, 1-052 Li Ka Shing Centre for Health Research Innovation, 8602-112 St NW, Edmonton, AB T6G, Canada
| | - Tom J Hazell
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Emily R Vanden Berg
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, 1-052 Li Ka Shing Centre for Health Research Innovation, 8602-112 St NW, Edmonton, AB T6G, Canada
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Universite Laval, Quebec, QC, Canada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, QC, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Universite Laval, Quebec, QC, Canada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, QC, Canada
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, 1-052 Li Ka Shing Centre for Health Research Innovation, 8602-112 St NW, Edmonton, AB T6G, Canada.
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9
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Kamiya I, Kim C, Kageyama A, Sakamoto A. Lateral position does not cause an interhemicerebral difference of cerebral hemodynamic in healthy adult volunteers. Physiol Rep 2023; 11:e15685. [PMID: 37144602 PMCID: PMC10161209 DOI: 10.14814/phy2.15685] [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: 09/30/2022] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
Cerebral perfusion is maintained at a consistent value irrespective of changes in systemic blood pressure or disease-induced changes in general physical condition. This regulatory mechanism is effective despite postural changes, working even during changes in posture, such as those from sitting to standing or from the head-down to the head-up position. However, no study has addressed changes in perfusion separately in the left and right cerebral hemispheres, and there has been no specific investigation of the effect of the lateral decubitus position on perfusion in each hemisphere. Surgery, particularly respiratory surgery, is often performed with the patient in the lateral decubitus position, and since intraoperative anesthesia may also have an effect, it is important to ascertain the effect of the lateral decubitus position on perfusion in the left and right cerebral hemispheres in the absence of anesthesia. The effects of the lateral decubitus position on heart rate, blood pressure, and hemodynamic in the left and right cerebral hemispheres assessed by regional saturation of oxygen measured by near-infrared spectroscopy were investigated in healthy adult volunteers. Although the lateral decubitus position causes systemic circulatory changes, it may not cause any difference in hemodynamic between the left and right cerebral hemispheres.
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Affiliation(s)
- Ichiro Kamiya
- Department of Anesthesiology, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan
| | - Chol Kim
- Department of Anesthesiology, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan
| | - Atsuko Kageyama
- Department of Anesthesiology, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan
| | - Atsuhiro Sakamoto
- Department of Anesthesiology and Pain Medicine, Nippon Medical School, Tokyo, Japan
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10
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Cowdrick KR, Urner T, Sathialingam E, Fang Z, Quadri A, Turrentine K, Yup Lee S, Buckley EM. Agreement in cerebrovascular reactivity assessed with diffuse correlation spectroscopy across experimental paradigms improves with short separation regression. NEUROPHOTONICS 2023; 10:025002. [PMID: 37034012 PMCID: PMC10079775 DOI: 10.1117/1.nph.10.2.025002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Significance Cerebrovascular reactivity (CVR), i.e., the ability of cerebral vasculature to dilate or constrict in response to vasoactive stimuli, is a biomarker of vascular health. Exogenous administration of inhaled carbon dioxide, i.e., hypercapnia (HC), remains the "gold-standard" intervention to assess CVR. More tolerable paradigms that enable CVR quantification when HC is difficult/contraindicated have been proposed. However, because these paradigms feature mechanistic differences in action, an assessment of agreement of these more tolerable paradigms to HC is needed. Aim We aim to determine the agreement of CVR assessed during HC, breath-hold (BH), and resting state (RS) paradigms. Approach Healthy adults were subject to HC, BH, and RS paradigms. End tidal carbon dioxide (EtCO2) and cerebral blood flow (CBF, assessed with diffuse correlation spectroscopy) were monitored continuously. CVR (%/mmHg) was quantified via linear regression of CBF versus EtCO2 or via a general linear model (GLM) that was used to minimize the influence of systemic and extracerebral signal contributions. Results Strong agreement ( CCC ≥ 0.69 ; R ≥ 0.76 ) among CVR paradigms was demonstrated when utilizing a GLM to regress out systemic/extracerebral signal contributions. Linear regression alone showed poor agreement across paradigms ( CCC ≤ 0.35 ; R ≤ 0.45 ). Conclusions More tolerable experimental paradigms coupled with regression of systemic/extracerebral signal contributions may offer a viable alternative to HC for assessing CVR.
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Affiliation(s)
- Kyle R. Cowdrick
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Tara Urner
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Eashani Sathialingam
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Zhou Fang
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Ayesha Quadri
- Children’s Healthcare of Atlanta and Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
- Morehouse School of Medicine, Atlanta, Georgia, United States
| | - Katherine Turrentine
- Children’s Healthcare of Atlanta and Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
| | - Seung Yup Lee
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Kennesaw State University, Department of Electrical and Computer Engineering, Marietta, Georgia, United States
| | - Erin M. Buckley
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Children’s Healthcare of Atlanta and Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
- Children’s Healthcare of Atlanta, Children’s Research Scholar, Atlanta, Georgia, United States
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11
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Washio T, Hissen SL, Takeda R, Manabe K, Akins JD, Sanchez B, D'Souza AW, Nelson DB, Khan S, Tomlinson AR, Babb TG, Fu Q. Effects of posture changes on dynamic cerebral autoregulation during early pregnancy in women with obesity and/or sleep apnea. Clin Auton Res 2023; 33:121-131. [PMID: 37115467 PMCID: PMC11384342 DOI: 10.1007/s10286-023-00939-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023]
Abstract
The incidence of syncope during orthostasis increases in early human pregnancy, which may be associated with cerebral blood flow (CBF) dysregulation in the upright posture. In addition, obesity and/or sleep apnea per se may influence CBF regulation due to their detrimental impacts on cerebrovascular function. However, it is unknown whether early pregnant women with obesity and/or sleep apnea could have impaired CBF regulation in the supine position and whether this impairment would be further exacerbated in the upright posture. Dynamic cerebral autoregulation (CA) was evaluated using transfer function analysis in 33 women during early pregnancy (13 with obesity, 8 with sleep apnea, 12 with normal weight) and 15 age-matched nonpregnant women during supine rest. Pregnant women also underwent a graded head-up tilt (30° and 60° for 6 min each). We found that pregnant women with obesity or sleep apnea had a higher transfer function low-frequency gain compared with nonpregnant women in the supine position (P = 0.026 and 0.009, respectively) but not normal-weight pregnant women (P = 0.945). Conversely, the transfer function low-frequency phase in all pregnancy groups decreased during head-up tilt (P = 0.001), but the phase was not different among pregnant groups (P = 0.180). These results suggest that both obesity and sleep apnea may have a detrimental effect on dynamic CA in the supine position during early pregnancy. CBF may be more vulnerable to spontaneous blood pressure fluctuations in early pregnant women during orthostatic stress compared with supine rest due to less efficient dynamic CA, regardless of obesity and/or sleep apnea.
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Affiliation(s)
- Takuro Washio
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sarah L Hissen
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ryosuke Takeda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kazumasa Manabe
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John D Akins
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Belinda Sanchez
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
| | - Andrew W D'Souza
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - David B Nelson
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Safia Khan
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Andrew R Tomlinson
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tony G Babb
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA.
- The University of Texas Southwestern Medical Center, Dallas, TX, USA.
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12
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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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13
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Chen H, Xu E, Zhou F, Li Q, Zeng J, Mei S, Xing Y. Impaired dynamic cerebral autoregulation: A potential mechanism of orthostatic hypotension and dementia in Parkinson’s disease. Front Aging Neurosci 2022; 14:927009. [PMID: 36158547 PMCID: PMC9492951 DOI: 10.3389/fnagi.2022.927009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background Orthostatic hypotension (OH) and cognitive impairment are common non-motor symptoms of Parkinson’s disease (PD). This study aimed to investigate whether impaired dynamic cerebral autoregulation (dCA) is associated with OH and Parkinson’s disease dementia (PDD), and analyze the related risk factors in patients with PDD. Materials and methods We enrolled 89 patients with PD and 20 age- and sex-matched healthy controls (HCs). Cognition and different cognitive domains were assessed by the Montreal Cognitive Assessment scale. Non-invasive continuous beat-to-beat blood pressure and cerebral blood flow velocity were assessed using a servo-controlled finger plethysmograph and transcranial Doppler, respectively. dCA was examined using supine and orthostatic changes with transfer function analysis to derive the autoregulatory parameters of phase, gain, and coherence. Logistic regression analysis was performed to determine the risk factors for PDD. Results We found that 21 (23.6%) patients with PD had OH. These patients showed worse cognitive performance in specific cognitive tasks, such as language and orientation. The patients with OH also had poorer dCA; the very low frequency (VLF) phase in two different postures was lower than that in patients without OH as well as HCs (both P < 0.05). And the normalized gain in the VLF and low frequency (LF) in standing position was higher in PD patients with and without OH than in HCs. PDD patients also had significantly higher LF normalized gain when standing than patients without dementia (P = 0.015), indicating impaired dCA. LF normalized gain in standing (odds ratio: 3.756, 95% confidence interval: 1.241–11.367) and education were significantly associated with PDD. Conclusion Diminished dCA may represent a potential mechanism for OH and cognitive impairment and low educational level might be a significant factor contributing to the increased risk of PDD.
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Affiliation(s)
- Hongxiu Chen
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Erhe Xu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fubo Zhou
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Qiuping Li
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Jingrong Zeng
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shanshan Mei
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yingqi Xing
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
- *Correspondence: Yingqi Xing,
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14
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Transcranial Doppler Ultrasound, a Review for the Pediatric Intensivist. CHILDREN 2022; 9:children9050727. [PMID: 35626904 PMCID: PMC9171581 DOI: 10.3390/children9050727] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 12/04/2022]
Abstract
The use of transcranial Doppler ultrasound (TCD) is increasing in frequency in the pediatric intensive care unit. This review highlights some of the pertinent TCD applications for the pediatric intensivist, including evaluation of cerebral hemodynamics, autoregulation, non-invasive cerebral perfusion pressure/intracranial pressure estimation, vasospasm screening, and cerebral emboli detection.
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15
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Akins JD, Martin ZT, Patik JC, Curtis BM, Campbell JC, Olvera G, Brothers RM. Young, non-hispanic black men and women exhibit divergent peripheral and cerebral vascular reactivity. Exp Physiol 2022; 107:450-461. [PMID: 35344241 PMCID: PMC9058228 DOI: 10.1113/ep090168] [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: 10/24/2021] [Accepted: 03/21/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of the study? Does peripheral and cerebral vascular function differ in young, non-Hispanic Black men and women? What is the main finding and its importance? The non-Hispanic, Black women in this study presented greater peripheral conduit artery and cerebrovascular reactivity, yet similar peripheral microvascular function relative to the non-Hispanic, Black men. These preliminary findings suggest that young, Black women and men possess divergent vascular function, possibly contributing to the unique non-Hispanic Black sex differences in cardiovascular and cerebrovascular diseases. ABSTRACT In the U.S., cardiovascular and cerebrovascular diseases remain more prominent in the non-Hispanic Black (BL) population relative to other racial/ethnic groups. Typically, sex differences emerge in the manifestation of these diseases, though these differences may not fully materialize in the BL population. While numerous mechanisms are implicated, differences in vascular function likely contribute. Research has demonstrated blunted vasodilation in several vascular regions in BL versus non-Hispanic White individuals, though much of this work did not assess sex differences. Therefore, this study aimed to ascertain if indices of vascular function are different between young, BL women (BW) and men (BM). Eleven BW and 15 BM (22 (4) vs. 23 (3) y) participated in this study. Each participant underwent testing for brachial artery flow-mediated dilation (FMD), post-occlusive reactive hyperemia (RH), and cerebral vasomotor reactivity during rebreathing-induced hypercapnia. BW exhibited greater adjusted FMD than BM (P < 0.05 for all), but similar or lower RH when assessed as blood velocity (P > 0.39 for all) or blood flow reactivity (P < 0.05 for all), respectively. Across a range of hypercapnia, BW had greater middle cerebral artery blood velocity and cerebrovascular conductance index than BM (P < 0.001 for both). These preliminary data suggest that young, BW have greater vascular function relative to young, BM, though this was inconsistent across different indices. These findings provide insight into the divergent epidemiological findings between BM and BW. Further research is needed to elucidate possible mechanisms and relate these physiological responses to epidemiological observations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- John D Akins
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Zachary T Martin
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Jordan C Patik
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA.,Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Bryon M Curtis
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - Jeremiah C Campbell
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Guillermo Olvera
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
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16
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Sasaoka K, Ohta H, Ishizuka T, Kojima K, Sasaki N, Takiguchi M. Transcranial Doppler ultrasonography detects the elevation of cerebral blood flow during ictal-phase of pentetrazol-induced seizures in dogs. Am J Vet Res 2022; 83:331-338. [DOI: 10.2460/ajvr.21.06.0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
OBJECTIVE
To investigate the association between changes in cerebral blood flow and electrographic epileptic seizure in dogs using transcranial Doppler ultrasonography (TCD).
ANIMALS
6 healthy Beagle dogs.
PROCEDURES
Each dog was administered pentetrazol (1.5 mg/kg/min) or saline (0.9% NaCl) solution under general anesthesia with continuous infusion of propofol. Both pentetrazol and saline solution were administered to all 6 dogs, with at least 28 days interval between the experiments. Blood flow waveforms in the middle cerebral artery and the basilar artery were obtained using TCD at baseline, after pentetrazol administration, and after diazepam administration. TCD velocities, including peak systolic velocity, end-diastolic velocity, and mean velocity and resistance variables, were determined from the Doppler waveforms.
RESULTS
During ictal-phase of pentetrazol-induced seizures, the TCD velocities significantly increased in the basilar and middle cerebral arteries while TCD vascular resistance variables did not change in either artery. The TCD velocities significantly decreased after diazepam administration. Systemic parameters, such as the heart rate, mean arterial pressure, systemic vascular resistance, cardiac index, end-tidal carbon dioxide, oxygen saturation, and body temperature, did not change significantly during seizures.
CLINICAL RELEVANCE
This study showed that cerebral blood flow, as obtained from TCD velocities, increased by 130% during ictal-phase of pentetrazol-induced seizures in dogs. The elevated velocities returned to baseline after seizure suppression. Thus, TCD may be used to detect electrographic seizures during the treatment of status epilepticus in dogs, and further clinical studies clarifying the association between changes in cerebral blood flow and non-convulsive seizure cases are needed.
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Affiliation(s)
- Kazuyoshi Sasaoka
- 1Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Hiroshi Ohta
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Tomohito Ishizuka
- 1Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Kazuki Kojima
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Noboru Sasaki
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Mitsuyoshi Takiguchi
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
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17
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Schultz Martins R, Wallace PJ, Steele SW, Scott JS, Taber MJ, Hartley GL, Cheung SS. The Clamping of End-Tidal Carbon Dioxide Does Not Influence Cognitive Function Performance During Moderate Hyperthermia With or Without Skin Temperature Manipulation. Front Psychol 2021; 12:788027. [PMID: 35002880 PMCID: PMC8730541 DOI: 10.3389/fpsyg.2021.788027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Increases in body temperature from heat stress (i.e., hyperthermia) generally impairs cognitive function across a range of domains and complexities, but the relative contribution from skin versus core temperature changes remains unclear. Hyperthermia also elicits a hyperventilatory response that decreases the partial pressure of end-tidal carbon dioxide (PetCO2) and subsequently cerebral blood flow that may influence cognitive function. We studied the role of skin and core temperature along with PetCO2 on cognitive function across a range of domains. Eleven males completed a randomized, single-blinded protocol consisting of poikilocapnia (POIKI, no PetCO2 control) or isocapnia (ISO, PetCO2 maintained at baseline levels) during passive heating using a water-perfused suit (water temperature ~ 49°C) while middle cerebral artery velocity (MCAv) was measured continuously as an index of cerebral blood flow. Cognitive testing was completed at baseline, neutral core-hot skin (37.0 ± 0.2°C-37.4 ± 0.3°C), hot core-hot skin (38.6 ± 0.3°C-38.7 ± 0.2°C), and hot core-cooled skin (38.5 ± 0.3°C-34.7 ± 0.6°C). The cognitive test battery consisted of a detection task (psychomotor processing), 2-back task (working memory), set-shifting and Groton Maze Learning Task (executive function). At hot core-hot skin, poikilocapnia led to significant (both p < 0.05) decreases in PetCO2 (∆−21%) and MCAv (∆−26%) from baseline, while isocapnia clamped PetCO2 (∆ + 4% from baseline) leading to a significantly (p = 0.023) higher MCAv (∆−18% from baseline) compared to poikilocapnia. There were no significant differences in errors made on any task (all p > 0.05) irrespective of skin temperature or PetCO2 manipulation. We conclude that neither skin temperature nor PetCO2 maintenance significantly alter cognitive function during passive hyperthermia.
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Affiliation(s)
- Ricardo Schultz Martins
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Phillip J. Wallace
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Scott W. Steele
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Jake S. Scott
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Michael J. Taber
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- NM Consulting Inc., St. Catharines, ON, Canada
| | - Geoffrey L. Hartley
- Department of Physical and Health Education, Nipissing University, North Bay, ON, Canada
| | - Stephen S. Cheung
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- *Correspondence: Stephen S. Cheung,
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18
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Labrecque L, Burma JS, Roy MA, Smirl JD, Brassard P. Reproducibility and diurnal variation of the directional sensitivity of the cerebral pressure-flow relationship in men and women. J Appl Physiol (1985) 2021; 132:154-166. [PMID: 34855525 DOI: 10.1152/japplphysiol.00653.2021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The cerebral pressure-flow relationship has directional sensitivity, meaning the augmentation in cerebral blood flow is attenuated when mean arterial pressure (MAP) increases vs MAP decreases. We employed repeated squat-stands (RSS) to quantify it using a novel metric. However, its within-day reproducibility and the impacts of diurnal variation and biological sex are unknown. Study aims were to evaluate this metric for: 1) within-day reproducibility and diurnal variation in middle (MCA; ∆MCAvT/∆MAPT) and posterior cerebral arteries (PCA; ∆PCAvT/∆MAPT); 2) sex differences. ∆MCAvT/∆MAPT and ∆PCAvT/∆MAPT were calculated at seven time-points (08:00-17:00) in 18 participants (8 women; 24 ± 3 yrs) using the minimum-to-maximum MCAv or PCAv and MAP for each RSS at 0.05 Hz and 0.10 Hz. Relative metric values were also calculated (%MCAvT/%MAPT, %PCAvT/%MAPT). Intraclass correlation coefficient (ICC) evaluated reproducibility, which was good (0.75-0.90) to excellent (>0.90). Time-of-day impacted ∆MCAvT/∆MAPT (0.05 Hz: p = 0.002; 0.10 Hz: p = 0.001), %MCAvT/%MAPT (0.05 Hz: p = 0.035; 0.10 Hz: p = 0.009), and ∆PCAvT/∆MAPT (0.05 Hz: p = 0.024), albeit with small/negligible effect sizes. MAP direction impacted both arteries' metric at 0.10 Hz (all p < 0.024). Sex differences in the MCA only (p = 0.003) vanished when reported in relative terms. These findings demonstrate this metric is reproducible throughout the day in the MCA and PCA and is not impacted by biological sex.
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Affiliation(s)
- Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Joel S Burma
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.,Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada
| | - Marc-Antoine Roy
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Jonathan David Smirl
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.,Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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19
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Koep JL, Weston ME, Barker AR, Bailey TG, Coombes JS, Lester A, Bond B. The within- and between-day reliability of cerebrovascular reactivity using traditional and novel analytical approaches. Exp Physiol 2021; 107:29-41. [PMID: 34806238 DOI: 10.1113/ep090031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/15/2021] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS What is the central question of the study? What is the reliability of middle cerebral artery velocity cerebrovascular reactivity (CVR) when using traditional and novel outcomes, as measured by transcranial Doppler? What is the main finding and its importance? Traditional CVR approaches presented acceptable reproducibility but should be expressed as an absolute CVR. Large within- and between-individual differences in the middle cerebral artery velocity response profile support using a dynamic peak, rather than a set time point, for the most reliable interpretation. The study highlights the utility of novel kinetic CVR outcomes, but due to increased variability in time-based metrics, this analysis requires larger sample sizes than traditional methods. ABSTRACT Cerebrovascular reactivity (CVR) of middle cerebral artery velocity (MCAv) to CO2 is a common method to assess cerebrovascular function. Yet, the approaches used to calculate CVR outcomes vary. The aim of this study was to explore the within- and between-day reliability of traditional CVR outcomes. The second aim was to explore the reliability of novel kinetic-based analyses. Healthy adults (n = 10, 22.3 ± 3.4 years) completed assessments of CVR over 4 min using a fixed fraction of inspired CO2 (6%). This was repeated across four separate visits (between-day), and on one visit measures were repeated 2.5 h later (within-day). No mean biases were present between assessments for traditional CVR metrics, expressed as absolute (cm/s/mmHg) or relative (%/mmHg) outcomes (minute 3, minute 4, peak 1 s, peak 30 s) (between-day: P > 0.14, ηp 2 < 0.20; within-day: P > 0.22, d > 0.27). Absolute, rather than relative, CVR yielded the most reproducible parameters (coefficient of variation: 8.1-13.2% vs. 14-83%, respectively). There were significant differences between CVR outcomes (P < 0.001, ηp 2 > 0.89) dependent on the time point used to determine CVR, as a steady state MCAv response was rarely observed. Furthermore, the MCAv response was not reproducible within an individual (κ = 0.15, P = 0.09). No mean differences were present for novel kinetic outcomes (amplitude, time-delay, time constant) (between-day: P > 0.05, d < 0.33; within-day: P > 0.38, d < 0.25). The results support the need for standardisation and indicate CVR should be defined as a dynamic peak, rather than a set time point for increased reliability. For novel kinetic outcomes variability was greater (CV: 8.7-120.9%) due to the nature of time-based metrics.
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Affiliation(s)
- Jodie L Koep
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Max E Weston
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.,School of Nursing Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alice Lester
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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20
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Zienkiewicz A, Favre M, Ferdinando H, Iring S, Serrador J, Myllylä T. Blood pressure wave propagation - a multisensor setup for cerebral autoregulation studies. Physiol Meas 2021; 42. [PMID: 34731844 DOI: 10.1088/1361-6579/ac3629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/03/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cerebral autoregulation is critically important to maintain proper brain perfusion and supply the brain with oxygenated blood. Non-invasive measures of blood pressure (BP) are critical in assessing cerebral autoregulation. Wave propogation velocity may be a useful technique to estimate BP but the effect of the location of the sensors on the readings has not been thoroughly examined. In this paper, we were interested to study if propagation velocity of the pressure wave in the direction from the heart to the brain may differ compared with propagation from the heart to the periphery, as well as across different physiological tasks and/or health conditions. Using non-invasive sensors simultaneously placed on different locations of the human body allow for the study of how propagation velocity of the pressure wave, based on pulse transit time (PTT), varies across different directions. APPROACH We present multi-sensor BP wave propagation measurement setup aimed for cerebral autoregulation studies. The presented sensor setup consists of three sensors, one each placed on the neck, chest and finger, allowing simultaneous measurement of changes in BP propagation velocity towards the brain and to the periphery. We show how commonly tested physiological tasks affect the relative changes of PTT and correlations with BP. MAIN RESULTS We observed that during maximal blow, valsalva and breath hold breathing tasks, the relative changes of PTT were higher when PTT was measured in the direction from the heart to the brain than from the heart to the peripherals. In contrast, during a deep breathing task, the relative change in PTT from the heart to the brain was lower. In addition, we present a short literature review of PTT methods used in brain research. SIGNIFICANCE These preliminary data suggest that physiological task and direction of PTT measurement may affect relative PTT changes. Presented three-sensor setup provides an easy and neuroimaging compatible method for cerebral autoregulation studies by allowing to measure BP wave propagation velocity towards the brain vs. towards the periphery.
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Affiliation(s)
- Aleksandra Zienkiewicz
- Optoelectronics and Measurement Techniques Research Unit, University of Oulu, Oulu, FINLAND
| | - Michelle Favre
- Department of Pharmacology, Physiology & Neuroscience, Rutgers The State University of New Jersey, Newark, New Jersey, UNITED STATES
| | - Hany Ferdinando
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Pohjois-Pohjanmaa, FINLAND
| | - Stephanie Iring
- Department of Pharmacology, Physiology & Neuroscience, Rutgers The State University of New Jersey, Newark, New Jersey, UNITED STATES
| | - Jorge Serrador
- Department of Pharmacology, Physiology & Neuroscience, Rutgers The State University of New Jersey, Newark, New Jersey, UNITED STATES
| | - Teemu Myllylä
- Optoelectronics and Measurement Techniques Research Unit, University of Oulu, Oulu, FINLAND
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21
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Perry BG, Lucas SJE. The Acute Cardiorespiratory and Cerebrovascular Response to Resistance Exercise. SPORTS MEDICINE-OPEN 2021; 7:36. [PMID: 34046740 PMCID: PMC8160070 DOI: 10.1186/s40798-021-00314-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/07/2021] [Indexed: 12/18/2022]
Abstract
Resistance exercise (RE) is a popular modality for the general population and athletes alike, due to the numerous benefits of regular participation. The acute response to dynamic RE is characterised by temporary and bidirectional physiological extremes, not typically seen in continuous aerobic exercise (e.g. cycling) and headlined by phasic perturbations in blood pressure that challenge cerebral blood flow (CBF) regulation. Cerebral autoregulation has been heavily scrutinised over the last decade with new data challenging the effectiveness of this intrinsic flow regulating mechanism, particularly to abrupt changes in blood pressure over the course of seconds (i.e. dynamic cerebral autoregulation), like those observed during RE. Acutely, RE can challenge CBF regulation, resulting in adverse responses (e.g. syncope). Compared with aerobic exercise, RE is relatively understudied, particularly high-intensity dynamic RE with a concurrent Valsalva manoeuvre (VM). However, the VM alone challenges CBF regulation and generates additional complexity when trying to dissociate the mechanisms underpinning the circulatory response to RE. Given the disparate circulatory response between aerobic and RE, primarily the blood pressure profiles, regulation of CBF is ostensibly different. In this review, we summarise current literature and highlight the acute physiological responses to RE, with a focus on the cerebral circulation.
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Affiliation(s)
- Blake G Perry
- School of Health Sciences, Massey University, Wellington, New Zealand.
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences & Centre for Human Brain Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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22
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Labrecque L, Drapeau A, Rahimaly K, Imhoff S, Brassard P. Dynamic cerebral autoregulation and cerebrovascular carbon dioxide reactivity in middle and posterior cerebral arteries in young endurance-trained women. J Appl Physiol (1985) 2021; 130:1724-1735. [PMID: 33955257 DOI: 10.1152/japplphysiol.00963.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The integrated responses regulating cerebral blood flow are understudied in women, particularly in relation to potential regional differences. In this study, we compared dynamic cerebral autoregulation (dCA) and cerebrovascular reactivity to carbon dioxide (CVRco2) in the middle (MCA) and posterior cerebral arteries (PCA) in 11 young endurance-trained women (age, 25 ± 4 yr; maximal oxygen uptake, 48.1 ± 4.1 mL·kg-1·min-1). dCA was characterized using a multimodal approach including a sit-to-stand and a transfer function analysis (TFA) of forced blood pressure oscillations (repeated squat-stands executed at 0.05 Hz and 0.10 Hz). The hyperoxic rebreathing test was utilized to characterize CVRco2. Upon standing, the percent reduction in blood velocity per percent reduction in mean arterial pressure during initial orthostatic stress (0-15 s after sit-to-stand), the onset of the regulatory response, and the rate of regulation did not differ between MCA and PCA (all P > 0.05). There was an ANOVA effect of anatomical location for TFA gain (P < 0.001) and a frequency effect for TFA phase (P < 0.001). However, normalized gain was not different between arteries (P = 0.18). Absolute CVRco2 was not different between MCA and PCA (1.55 ± 0.81 vs. 1.30 ± 0.49 cm·s-1/Torr, P = 0.26). Relative CVRco2 was 39% lower in the MCA (2.16 ± 1.02 vs. 3.00 ± 1.09%/Torr, P < 0.01). These findings indicate that the cerebral pressure-flow relationship appears to be similar between the MCA and the PCA in young endurance-trained women. The absence of regional differences in absolute CVRco2 could be women specific, although a direct comparison with a group of men will be necessary to address that issue.NEW & NOTEWORTHY Herein, we describe responses from two major mechanisms regulating cerebral blood flow with a special attention on regional differences in young endurance-trained women. The novel findings are that dynamic cerebral autoregulation and absolute cerebrovascular reactivity to carbon dioxide appear similar between the middle and posterior cerebral arteries of these young women.
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Affiliation(s)
- Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Québec, Canada
| | - Audrey Drapeau
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Québec, Canada
| | - Kevan Rahimaly
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Québec, Canada
| | - Sarah Imhoff
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Québec, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Québec, Canada
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23
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Hemodialysis Patients Have Impaired Cerebrovascular Reactivity to CO 2 Compared to Chronic Kidney Disease Patients and Healthy Controls: A Pilot Study. Kidney Int Rep 2021; 6:1868-1877. [PMID: 34307981 PMCID: PMC8258459 DOI: 10.1016/j.ekir.2021.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/11/2021] [Accepted: 04/05/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Recurrent hemodialysis (HD)–induced ischemia has emerged as a mechanism responsible for cognitive impairment in HD patients. Impairment of cerebrovascular function in HD patients may render the brain vulnerable to HD-induced ischemic injury. Cerebrovascular reactivity to CO2 (CVR) is a noninvasive marker of cerebrovascular function. Whether CVR is impaired in HD patients is unknown. In this study, we compared CVR between healthy participants, HD patients, and chronic kidney disease (CKD) patients not yet requiring dialysis. Methods This was a single-center prospective observational study carried out at Kidney Clinical Research Unit in London, Canada. We used carefully controlled hypercapnia to interrogate brain vasomotor control. Transcranial Doppler was combined with 10–mm Hg step changes in CO2 from baseline to hypercapnia (intervention) and back to baseline (recovery) to assess CVR in 8 HD, 10 CKD, and 17 heathy participants. Results HD patients had lower CVR than CKD or healthy participants during both intervention and recovery (P < 0.0001). There were no differences in CVR between healthy and CKD participants during either intervention (P = 0.88) or recovery (P = 0.99). The impaired CVR in HD patients was independent of CO2-induced changes in blood pressure, heart rate, cardiac output, or dialysis vintage. In the CKD group, CVR was not associated with the estimated glomerular filtration rate. Conclusions Our study shows that HD patients have impaired CVR relative to CKD and healthy participants. This renders HD patients vulnerable to ischemic injury during circulatory stress of dialysis and may contribute to the pathogenesis of cognitive impairment.
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24
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Suri S, Bulte D, Chiesa ST, Ebmeier KP, Jezzard P, Rieger SW, Pitt JE, Griffanti L, Okell TW, Craig M, Chappell MA, Blockley NP, Kivimäki M, Singh-Manoux A, Khir AW, Hughes AD, Deanfield JE, Jensen DEA, Green SF, Sigutova V, Jansen MG, Zsoldos E, Mackay CE. Study Protocol: The Heart and Brain Study. Front Physiol 2021; 12:643725. [PMID: 33868011 PMCID: PMC8046163 DOI: 10.3389/fphys.2021.643725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND It is well-established that what is good for the heart is good for the brain. Vascular factors such as hypertension, diabetes, and high cholesterol, and genetic factors such as the apolipoprotein E4 allele increase the risk of developing both cardiovascular disease and dementia. However, the mechanisms underlying the heart-brain association remain unclear. Recent evidence suggests that impairments in vascular phenotypes and cerebrovascular reactivity (CVR) may play an important role in cognitive decline. The Heart and Brain Study combines state-of-the-art vascular ultrasound, cerebrovascular magnetic resonance imaging (MRI) and cognitive testing in participants of the long-running Whitehall II Imaging cohort to examine these processes together. This paper describes the study protocol, data pre-processing and overarching objectives. METHODS AND DESIGN The 775 participants of the Whitehall II Imaging cohort, aged 65 years or older in 2019, have received clinical and vascular risk assessments at 5-year-intervals since 1985, as well as a 3T brain MRI scan and neuropsychological tests between 2012 and 2016 (Whitehall II Wave MRI-1). Approximately 25% of this cohort are selected for the Heart and Brain Study, which involves a single testing session at the University of Oxford (Wave MRI-2). Between 2019 and 2023, participants will undergo ultrasound scans of the ascending aorta and common carotid arteries, measures of central and peripheral blood pressure, and 3T MRI scans to measure CVR in response to 5% carbon dioxide in air, vessel-selective cerebral blood flow (CBF), and cerebrovascular lesions. The structural and diffusion MRI scans and neuropsychological battery conducted at Wave MRI-1 will also be repeated. Using this extensive life-course data, the Heart and Brain Study will examine how 30-year trajectories of vascular risk throughout midlife (40-70 years) affect vascular phenotypes, cerebrovascular health, longitudinal brain atrophy and cognitive decline at older ages. DISCUSSION The study will generate one of the most comprehensive datasets to examine the longitudinal determinants of the heart-brain association. It will evaluate novel physiological processes in order to describe the optimal window for managing vascular risk in order to delay cognitive decline. Ultimately, the Heart and Brain Study will inform strategies to identify at-risk individuals for targeted interventions to prevent or delay dementia.
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Affiliation(s)
- Sana Suri
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Daniel Bulte
- Oxford Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Scott T. Chiesa
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Klaus P. Ebmeier
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Peter Jezzard
- FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Sebastian W. Rieger
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
- FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Jemma E. Pitt
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Ludovica Griffanti
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
- FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Thomas W. Okell
- FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Martin Craig
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Nottingham Biomedical Research Centre, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Michael A. Chappell
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Nottingham Biomedical Research Centre, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | | | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Archana Singh-Manoux
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Ashraf W. Khir
- Mechanical Engineering, Brunel University London, Uxbridge, United Kingdom
| | - Alun D. Hughes
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - John E. Deanfield
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Daria E. A. Jensen
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Sebastian F. Green
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Veronika Sigutova
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Michelle G. Jansen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Enikő Zsoldos
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Clare E. Mackay
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
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25
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Alwatban MR, Aaron SE, Kaufman CS, Barnes JN, Brassard P, Ward JL, Miller KB, Howery AJ, Labrecque L, Billinger SA. Effects of age and sex on middle cerebral artery blood velocity and flow pulsatility index across the adult lifespan. J Appl Physiol (1985) 2021; 130:1675-1683. [PMID: 33703940 DOI: 10.1152/japplphysiol.00926.2020] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Reduced middle cerebral artery blood velocity (MCAv) and flow pulsatility are contributors to age-related cerebrovascular disease pathogenesis. It is unknown whether the rate of changes in MCAv and flow pulsatility support the hypothesis of sex-specific trajectories with aging. Therefore, we sought to characterize the rate of changes in MCAv and flow pulsatility across the adult lifespan in females and males as well as within specified age ranges. Participant characteristics, mean arterial pressure, end-tidal carbon dioxide, unilateral MCAv, and flow pulsatility index (PI) were determined from study records compiled from three institutional sites. A total of 524 participants [18-90 yr; females 57 (17) yr, n = 319; males 50 (21) yr, n = 205] were included in the analysis. MCAv was significantly higher in females within the second (P < 0.001), fifth (P = 0.01), and sixth (P < 0.01) decades of life. Flow PI was significantly lower in females within the second decade of life (P < 0.01). Rate of MCAv decline was significantly greater in females than males (-0.39 vs. -0.26 cm s-1·yr, P = 0.04). Rate of flow PI rise was significantly greater in females than males (0.006 vs. 0.003 flow PI, P = 0.01). Rate of MCAv change was significantly greater in females than males in the sixth decade of life (-1.44 vs. 0.13 cm s-1·yr, P = 0.04). These findings indicate that sex significantly contributes to age-related differences in both MCAv and flow PI. Therefore, further investigation into cerebrovascular function within and between sexes is warranted to improve our understanding of the reported sex differences in cerebrovascular disease prevalence.NEW & NOTEWORTHY We present the largest dataset (n = 524) pooled from three institutions to study how age and sex affect middle cerebral artery blood velocity (MCAv) and flow pulsatility index (PI) across the adult lifespan. We report the rate of MCAv decline and flow PI rise is significantly greater in females compared with in males. These data suggest that sex-specific trajectories with aging and therapeutic interventions to promote healthy brain aging should consider these findings.
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Affiliation(s)
- Mohammed R Alwatban
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.,Abiomed, Inc., Danvers, Massachusetts
| | - Stacey E Aaron
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Carolyn S Kaufman
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec, Canada
| | - Jaimie L Ward
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Kathleen B Miller
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anna J Howery
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec, Canada
| | - Sandra A Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.,Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas.,Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas.,Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas
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Barnes JN, Charkoudian N. Integrative cardiovascular control in women: Regulation of blood pressure, body temperature, and cerebrovascular responsiveness. FASEB J 2020; 35:e21143. [PMID: 33151577 DOI: 10.1096/fj.202001387r] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/21/2020] [Accepted: 10/13/2020] [Indexed: 12/14/2022]
Abstract
Over the past several decades, it has become increasingly clear that women have distinct cardiovascular profiles compared to men. In this review, our goal is to provide an overview of the literature regarding the influences of female sex and reproductive hormones (primarily estradiol) on mechanisms of cardiovascular control relevant to regulation of blood pressure, body temperature, and cerebral blood flow. Young women tend to have lower resting blood pressure compared with men. This sex difference is reversed at menopause, when women develop higher sympathetic nerve activity and the risk of systemic hypertension increases sharply as postmenopausal women age. Vascular responses to thermal stress, including cutaneous vasodilation and vasoconstriction, are also affected by reproductive hormones in women, where estradiol appears to promote vasodilation and heat dissipation. The influence of reproductive hormones on cerebral blood flow and sex differences in the ability of the cerebral vasculature to increase its blood flow (cerebrovascular reactivity) are relatively new areas of investigation. Sex and hormonal influences on integrative blood flow regulation have further implications during challenges to physiological homeostasis, including exercise. We propose that increasing awareness of these sex-specific mechanisms is important for optimizing health care and promotion of wellness in women across the life span.
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Affiliation(s)
- Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Nisha Charkoudian
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
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27
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Labrecque L, Drapeau A, Rahimaly K, Imhoff S, Billaut F, Brassard P. Comparable blood velocity changes in middle and posterior cerebral arteries during and following acute high-intensity exercise in young fit women. Physiol Rep 2020; 8:e14430. [PMID: 32342622 PMCID: PMC7186567 DOI: 10.14814/phy2.14430] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/04/2020] [Indexed: 12/13/2022] Open
Abstract
The cerebral blood flow response to high-intensity interval training (HIIT) remains unclear. HIIT induces surges in mean arterial pressure (MAP), which could be transmitted to the brain, especially early after exercise onset. The aim of this study was to describe regional cerebral blood velocity changes during and following 30 s of high-intensity exercise. Ten women (age: 27 ± 6 years; VO2max : 48.6 ± 3.8 ml·kg·min-1 ) cycled for 30 s at the workload reached at V ˙ O2max followed by 3min of passive recovery. Middle (MCAvmean ) and posterior cerebral artery mean blood velocities (PCAvmean ; transcranial Doppler ultrasound), MAP (finger photoplethysmography), and end-tidal carbon dioxide partial pressure (PET CO2 ; gaz analyzer) were measured. MCAvmean (+19 ± 10%) and PCAvmean (+21 ± 14%) increased early after exercise onset, returning toward baseline values afterward. MAP increased throughout exercise (p < .0001). PET CO2 initially decreased by 3 ± 2 mmHg (p < .0001) before returning to baseline values at end-exercise. During recovery, MCAvmean (+43 ± 15%), PCAvmean (+42 ± 15%), and PET CO2 (+11 ± 3 mmHg; p < .0001) increased. In young fit women, cerebral blood velocity quickly increases at the onset of a 30-s exercise performed at maximal workload, before returning to baseline values through the end of the exercise. During recovery, cerebral blood velocity augments in both arteries, along with PET CO2 .
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Affiliation(s)
- Lawrence Labrecque
- Department of KinesiologyFaculty of MedicineUniversité LavalQuébecQuébecCanada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec‐Université LavalQuébecQuébecCanada
| | - Audrey Drapeau
- Department of KinesiologyFaculty of MedicineUniversité LavalQuébecQuébecCanada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec‐Université LavalQuébecQuébecCanada
| | - Kevan Rahimaly
- Department of KinesiologyFaculty of MedicineUniversité LavalQuébecQuébecCanada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec‐Université LavalQuébecQuébecCanada
| | - Sarah Imhoff
- Department of KinesiologyFaculty of MedicineUniversité LavalQuébecQuébecCanada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec‐Université LavalQuébecQuébecCanada
| | - François Billaut
- Department of KinesiologyFaculty of MedicineUniversité LavalQuébecQuébecCanada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec‐Université LavalQuébecQuébecCanada
| | - Patrice Brassard
- Department of KinesiologyFaculty of MedicineUniversité LavalQuébecQuébecCanada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec‐Université LavalQuébecQuébecCanada
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