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Cerebral autoregulation

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https://www.readbyqxmd.com/read/29677060/cerebral-small-vessel-but-not-large-vessel-disease-is-associated-with-impaired-cerebral-autoregulation-during-cardiopulmonary-bypass-a-retrospective-cohort-study
#1
Yohei Nomura, Roland Faegle, Daijiro Hori, Abbas Al-Qamari, Alexander J Nemeth, Rebecca Gottesman, Gayane Yenokyan, Charles Brown, Charles W Hogue
BACKGROUND: Impaired cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass (CPB) is associated with stroke and other adverse outcomes. Large and small arterial stenosis is prevalent in patients undergoing cardiac surgery. We hypothesize that large and/or small vessel cerebral arterial disease is associated with impaired cerebral autoregulation during CPB. METHODS: A retrospective cohort analysis of data from 346 patients undergoing cardiac surgery with CPB enrolled in an ongoing prospectively randomized clinical trial of autoregulation monitoring were evaluated...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29668713/alterations-in-the-coupling-functions-between-cerebral-oxyhaemoglobin-and-arterial-blood-pressure-signals-in-post-stroke-subjects
#2
Honglun Su, Congcong Huo, Bitian Wang, Wenhao Li, Gongcheng Xu, Qianying Liu, Zengyong Li
Cerebral autoregulation (CA) is the complex homeostatic regulatory relationship between blood pressure (BP) and cerebral blood flow (CBF). This study aimed to analyze the frequency-specific coupling function between cerebral oxyhemoglobin concentrations (delta [HbO2]) and mean arterial pressure (MAP) signals based on a model of coupled phase oscillators and dynamical Bayesian inference. Delta [HbO2] was measured by 24-channel near-infrared spectroscopy (NIRS) and arterial BP signals were obtained by simultaneous resting-state measurements in patients with stroke, that is, 9 with left hemiparesis (L-H group), 8 with right hemiparesis (R-H group), and 17 age-matched healthy individuals as control (healthy group)...
2018: PloS One
https://www.readbyqxmd.com/read/29665012/wavelet-pressure-reactivity-index-a-validation-study
#3
Xiuyun Liu, Marek Czosnyka, Joseph Donnelly, Danilo Cardim, Manuel Cabeleira, Peter J Hutchinson, Xiao Hu, Peter Smielewski, Ken Brady
KEY POINTS: The brain is vulnerable to damage from too little or too much blood flow. A physiological mechanism called cerebral autoregulation (CA) exists to maintain stable blood flow even if cerebral perfusion pressure (CPP) is changing. A robust method for assessing CA is not yet available. There are still some problems with the traditional measure, the pressure reactivity index (PRx). We introduced a new method, wavelet transform method (wPRx) to assess CA using data from two sets of controlled hypotension experiments in piglets: One set with artificially manipulated ABP oscillations; the other group were spontaneous ABP waves...
April 17, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29662898/comparing-different-recording-lengths-of-dynamic-cerebral-autoregulation-5-versus-10-minutes
#4
Nai-Fang Chi, Cheng-Yen Wang, Lung Chan, Han-Hwa Hu
We compared the dynamic cerebral autoregulation (dCA) indices between 5- and 10-minute data lengths by analyzing 37 patients with ischemic stroke and 51 controls in this study. Correlation coefficient ( Mx ) and transfer function analysis were applied for dCA analysis. Mx and phase shift in all frequency bands were not significantly different between 5- and 10-minute recordings [mean difference: Mx = 0.02; phase shift of very low frequency (0.02-0.07 Hz) = 0.3°, low frequency (0.07-0.20 Hz) = 0.6°, and high frequency (0...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29652541/dynamic-cerebral-autoregulation-is-impaired-during-sub-maximal-isometric-handgrip-in-patients-with-heart-failure
#5
Juliana R Caldas, Ronney B Panerai, Angela S M Salinet, Edson Bor-Seng-Shu, Filomena R B G Galas, Graziela S R Ferreira, Ligia Camara, Rogerio Hora Passos, Juliano P Almeida, Ricardo C Nogueira, Marcelo de Lima Oliveira M, Thompson G Robinson, Ludhmila A Hajjar
BACKGROUND: The incidence of neurological complications, including stroke and cognitive dysfunction is elevated in heart failure (HF) patients with reduced ejection fraction. We hypothesized that the cerebrovascular response to isometric handgrip (iHG) is altered in HF patients. METHODS: Adults with HF and healthy volunteers were included. Cerebral blood velocity (CBV, transcranial Doppler, middle cerebral artery) and arterial blood pressure (BP, Finometer) were continuously recorded supine for 6 minutes, corresponding to one min baseline, three min of iHG exercise, at 30% maximum voluntary contraction, followed by two min of recovery...
April 13, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29629988/early-evidence-of-sepsis-associated-hyperperfusion-a-study-of-cerebral-blood-flow-measured-with-mri-arterial-spin-labeling-in-critically-ill-septic-patients-and-control-subjects
#6
Marie-Hélène Masse, Marie Anne Richard, Frédérick D'Aragon, Charles St-Arnaud, Michael Mayette, Neill K J Adhikari, William Fraser, André Carpentier, Steven Palanchuck, David Gauthier, Luc Lanthier, Matthieu Touchette, Albert Lamontagne, Jean Chénard, Sangeeta Mehta, Yanick Sansoucy, Etienne Croteau, Martin Lepage, François Lamontagne
OBJECTIVES: Mechanisms underlying sepsis-associated encephalopathy remain unclear, but reduced cerebral blood flow, alone or in conjunction with altered autoregulation, is reported as a potential contributor. We compared cerebral blood flow of control subjects and vasopressor-dependent septic patients. DESIGN: Randomized crossover study. SETTING: MRI with arterial spin labeling. PATIENTS: Ten sedated septic patients on mechanical ventilation (four with controlled chronic hypertension) and 12 control subjects (six with controlled chronic hypertension) were enrolled...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29622488/cerebral-autoregulation-and-conventional-and-diffusion-tensor-imaging-magnetic-resonance-imaging-in-neonatal-hypoxic-ischemic-encephalopathy
#7
Melisa Carrasco, Jamie Perin, Jacky M Jennings, Charlamaine Parkinson, Maureen M Gilmore, Raul Chavez-Valdez, An N Massaro, Raymond C Koehler, Frances J Northington, Aylin Tekes, Jennifer K Lee
BACKGROUND: Deviation of mean arterial blood pressure (MAP) from the range that optimizes cerebral autoregulatory vasoreactivity (optimal MAP) could increase neurological injury from hypoxic-ischemic encephalopathy (HIE). We tested whether a global magnetic resonance imaging (MRI) brain injury score and regional diffusion tensor imaging (DTI) are associated with optimal MAP in neonates with HIE. METHODS: Twenty-five neonates cooled for HIE were monitored with the hemoglobin volume index...
April 2, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29611066/application-of-wavelet-analysis-to-detect-dysfunction-in-cerebral-blood-flow-autoregulation-during-experimental-hyperhomocysteinaemia
#8
Valery V Aleksandrin, Alexander V Ivanov, Edward D Virus, Polina O Bulgakova, Aslan A Kubatiev
The purpose of the present study was to investigate the use of laser Doppler flowmetry (LDF) signals coupled with spectral wavelet analysis to detect endothelial link dysfunction in the autoregulation of cerebral blood flow in the setting of hyperhomocysteinaemia (HHcy). Fifty-one rats were assigned to three groups (intact, control, and HHcy) according to the results of biochemical assays of homocysteine level in blood plasma. LDF signals on the rat brain were recorded by LAKK-02 device to measure the microcirculatory blood flow...
April 3, 2018: Lasers in Medical Science
https://www.readbyqxmd.com/read/29595918/dynamic-cerebral-autoregulation-is-preserved-during-isometric-handgrip-and-head-down-tilt-in-healthy-volunteers
#9
Maria Skytioti, Signe Søvik, Maja Elstad
In healthy humans, cerebral blood flow (CBF) is autoregulated against changes in arterial blood pressure. Spontaneous fluctuations in mean arterial pressure (MAP) and CBF can be used to assess cerebral autoregulation. We hypothesized that dynamic cerebral autoregulation is affected by changes in autonomic activity, MAP, and cardiac output (CO) induced by handgrip (HG), head-down tilt (HDT), and their combination. In thirteen healthy volunteers, we recorded blood velocity by ultrasound in the internal carotid artery (ICA), HR, MAP and CO-estimates from continuous finger blood pressure, and end-tidal CO2 ...
March 2018: Physiological Reports
https://www.readbyqxmd.com/read/29593024/feasibility-of-improving-cerebral-autoregulation-in-acute-intracerebral-haemorrhage-breathe-ich-study-a-protocol-for-an-experimental-interventional-study
#10
Jatinder S Minhas, Ronney B Panerai, Thompson G Robinson
INTRODUCTION: Cerebral autoregulation (CA) is impaired in a multitude of neurological conditions. Increasingly, clinical studies are correlating the nature of this impairment with prognostic markers. In acute intracerebral haemorrhage (ICH), impairment of CA has been associated with worsening clinical outcomes including poorer Glasgow Coma Score and larger haematoma volume. Hypocapnia has been shown to improve CA despite concerns over hypoperfusion and consequent ischaemic risks, and it is therefore hypothesised that hypocapnia (via hyperventilation) in acute ICH may improve CA and consequently clinical outcome...
March 27, 2018: BMJ Open
https://www.readbyqxmd.com/read/29568762/compromised-dynamic-cerebral-autoregulation-in-patients-with-epilepsy
#11
Shan Lv, Zhen-Ni Guo, Hang Jin, Xin Sun, Meiyan Jia, Hongyin Ma, Yudan Lv, Quanli Qiu, Jia Liu, Yi Yang
Objective: The aim of this study is to analyze dynamic cerebral autoregulation (dCA) in patients with epilepsy. Methods: One hundred patients with epilepsy and 100 age- and sex-matched healthy controls were recruited. Noninvasive continuous cerebral blood flow velocity of the bilateral middle artery and arterial blood pressure were recorded. Transfer function analyses were used to analyze the autoregulatory parameters (phase difference and gain). Results: The overall phase difference of patients with epilepsy was significantly lower than that of the healthy control group ( p = 0...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29567858/serum-bicarbonate-concentration-and-cognitive-function-in-hypertensive-adults
#12
Mirela Dobre, Sarah A Gaussoin, Jeffrey T Bates, Michel B Chonchol, Debbie L Cohen, Thomas H Hostetter, Kalani L Raphael, Addison A Taylor, Alan J Lerner, Jackson T Wright, Mahboob Rahman
BACKGROUND AND OBJECTIVES: Cognitive function worsens as kidney function declines, but mechanisms contributing to this association are not completely understood. Metabolic acidosis, a common complication of CKD, leads to neural networks overexcitation and is involved in cerebral autoregulation. We aimed to evaluate the association between serum bicarbonate concentration as a measure of metabolic acidosis, and cognitive function in hypertensive adults with and without CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Five cognitive summary scores were measured (global cognitive function, executive function, memory, attention/concentration, and language) in 2853 participants in the Systolic BP Intervention Trial (SPRINT)...
March 22, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29561955/salvinorin-a-preserves-cerebral-pial-artery-autoregulation-after-forebrain-ischemia-via-the-pi3k-akt-cgmp-pathway
#13
H P Dong, W Zhou, X X Ma, Z Z He, Z H Wang
This study aimed to investigate the protective effect of salvinorin A on the cerebral pial artery after forebrain ischemia and explore related mechanisms. Thirty Sprague-Dawley rats received forebrain ischemia for 10 min. The dilation responses of the cerebral pial artery to hypercapnia and hypotension were assessed in rats before and 1 h after ischemia. The ischemia reperfusion (IR) control group received DMSO (1 µL/kg) immediately after ischemia. Two different doses of salvinorin A (10 and 20 µg/kg) were administered following the onset of reperfusion...
March 15, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29556806/cerebral-hyperperfusion-syndrome-after-carotid-revascularization-and-acute-ischemic-stroke
#14
REVIEW
Kathryn F Kirchoff-Torres, Ekaterina Bakradze
PURPOSE OF REVIEW: Cerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion. RECENT FINDINGS: CHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke...
March 19, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29547089/cerebral-autoregulation-cerebrospinal-fluid-outflow-resistance-and-outcome-following-cerebrospinal-fluid-diversion-in-normal-pressure-hydrocephalus
#15
Afroditi Despina Lalou, Marek Czosnyka, Joseph Donnelly, John D Pickard, FMedSci, Eva Nabbanja, Nicole C Keong, Matthew Garnett, Zofia H Czosnyka
OBJECTIVE Normal pressure hydrocephalus is not simply the result of a disturbance in CSF circulation, but often includes cardiovascular comorbidity and abnormalities within the cerebral mantle. In this study, the authors have examined the relationship between the global autoregulation pressure reactivity index (PRx), the profile of disturbed CSF circulation and pressure-volume compensation, and their possible effects on outcome after surgery. METHODS The authors studied a cohort of 131 patients in whom a clinical suspicion of normal pressure hydrocephalus was investigated...
March 16, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29538363/elevated-arterial-blood-pressure-after-superior-cavo-pulmonary-anastomosis-is-associated-with-elevated-pulmonary-artery-pressure-and-cerebrovascular-dysautoregulation
#16
Antonio G Cabrera, Kathleen K Kibler, R Blaine Easley, Michelle Goldsworthy, Lara S Shekerdemian, Dean B Andropoulos, Jeffrey Heinle, Erin A Gottlieb, Eric Vu, Ken M Brady
BACKGROUND: Elevated arterial blood pressure (ABP) is common after superior bidirectional cavo-pulmonary anastomosis (BCPA). The effects of elevated ABP after BCPA on cerebrovascular hemodynamics are unknown. We sought to determine the relationship between elevated ABP and cerebrovascular autoregulation after BCPA. METHODS: Prospective, observational study on infants with single-ventricle physiology after BCPA surgery. Continuous recordings of mean ABP, mean cavo-pulmonary pressure (PAP), near-infrared spectroscopy measures of cerebral oximetry (rSO2), and relative cerebral blood volume index (BVI) were obtained from admission to extubation...
March 14, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29519640/emotional-orienting-during-interoceptive-threat-in-orthostatic-intolerance-dysautonomic-contributions-to-psychological-symptomatology-in-the-postural-tachycardia-syndrome-and-vasovagal-syncope
#17
Andrew P Owens, David A Low, Hugo D Critchley, Christopher J Mathias
Cognitive and emotional processes are influenced by interoception (homeostatic somatic feedback), particularly when physiological arousal is unexpected and discrepancies between predicted and experienced interoceptive signals may engender anxiety. Due to the vulnerability for comorbid psychological symptoms in forms of orthostatic intolerance (OI), this study investigated psychophysiological contributions to emotional symptomatology in 20 healthy control participants (13 females, mean age 36 ± 8 years), 20 postural tachycardia syndrome (PoTS) patients (18 females, mean age 38 ± 13 years) and 20 vasovagal syncope (VVS) patients (15 females, mean age 39 ± 12 years)...
January 31, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29515421/central-variant-posterior-reversible-encephalopathy-syndrome-with-albuminocytologic-dissociation
#18
Sang-Woo Lee, Seung-Jae Lee
Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic brain edema which mainly involves the parieto-occipital lobes in various clinical settings. The main mechanism is known to be cerebral autoregulation failure and endothelial dysfunction leading to the disruption of the blood-brain barrier. We report the case of a 47-year-old woman with PRES which involved the brain stem and thalami, sparing the cerebral hemispheres. She was admitted to the emergency room because of acute-onset confusion...
January 2018: Case Reports in Neurology
https://www.readbyqxmd.com/read/29508065/nicorandil-increased-the-cerebral-blood-flow-via-nitric-oxide-pathway-and-atp-sensitive-potassium-channel-opening-in-mice
#19
Masakazu Kotoda, Tadahiko Ishiyama, Kazuha Mitsui, Sohei Hishiyama, Takashi Matsukawa
PURPOSE: Nicorandil has dual properties and acts as a nitric oxide donor and an ATP-sensitive potassium (KATP ) channel opener. Considering its pharmacological profile, nicorandil might exert protective effects on the brain as well as on the heart. The purpose of this study was to directly evaluate the effect of nicorandil on cerebral blood flow (CBF) in mice using a transcranial Doppler method. METHODS: Under general anesthesia, the nicorandil groups received a single-bolus intraperitoneal injection of the respective doses of nicorandil (1, 5, or 10 mg/kg), while the control group received vehicle only...
March 5, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29507847/does-a-spontaneous-intracerebral-hemorrhage-predispose-to-a-secondary-distant-intracerebral-hemorrhage-a-case-report-and-review-of-the-literature
#20
Nakul Katyal, Christopher R Newey
Cerebrovascular autoregulation may be dysfunctional after acute intracerebral hemorrhage (ICH). This disruption in autoregulation can potentially result in secondary neurological damage that may present as an intracranial hemorrhage at locations distant from the primary site of hemorrhage. We discuss a case of 68-year-old female who presented with acute left hemiparesis from a spontaneous right frontal ICH. Magnetic resonance imaging (MRI) was negative for any other blooming artifact. Her weakness was improving, but after 72 hours from admission, she had an acute change in her mental status and was found to have a new left frontal ICH distant from the primary hemorrhage...
December 29, 2017: Curēus
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