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Cerebral autoregulation

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https://www.readbyqxmd.com/read/29922396/effect-of-intracranial-stenosis-revascularization-on-dynamic-and-static-cerebral-autoregulation
#1
Santiago Ortega-Gutierrez, Edgar A Samaniego, Amy Huang, Arjun Masurkar, Binbin Zheng-Lin, Colin P Derdeyn, David Hasan, Randolph Marshall, Nils Petersen
Introduction: Severe intracranial stenosis might lead to acute cerebral ischemia. It is imperative to better assess patients who may benefit from immediate reperfusion and blood pressure management to prevent injury to peri-infarct tissue. Methods: We assessed cerebral autoregulation using static and dynamic methods in an 81-year-old woman suffering acute cerebral ischemia from severe intracranial stenosis in the petrous segment of the left internal carotid artery (LICA)...
June 2018: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29917239/sodium-nitroprusside-dilates-cerebral-vessels-and-enhances-internal-carotid-artery-flow-in-young-men
#2
Niels D Olesen, Mads Fischer, Niels H Secher
KEY POINTS: Sodium nitroprusside lowers blood pressure by vasodilation but is reported to reduce cerebral blood flow. In healthy young men sodium nitroprusside reduced blood pressure, total peripheral resistance, and arterial CO2 tension and yet cerebral blood flow was maintained with an increase in internal carotid artery blood flow and cerebrovascular conductance. Sodium nitroprusside induces both systemic and cerebral vasodilation affecting internal carotid artery more than vertebral artery flow...
June 19, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29908901/neonatal-rbc-transfusions-do-benefits-outweigh-risks
#3
REVIEW
Iman F Iskander, Khaled M Salama, Rasha M Gamaleldin, Jerard Seghatchian
Preterm neonates represent one of the most transfused categories of patients. Their target hematocrits, however, are mainly based on expert opinion. The risk of transfusions are very high in the smallest preterm baby with a weak immune response, immature antioxidant ability, fragile germinal matrix and impaired cerebral autoregulation, yet red cell transfusions remain the only life saving measure in the baby with symptomatic anemia. Minimizing phlebotomy losses, following a restrictive transfusion policy and using screened, leukocyte depleted, irradiated, single donor blood remain the best means of avoiding the possible risks while maximizing the benefits of red cell transfusions in the preterm newborn...
May 9, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29893643/regional-cerebral-blood-flow-in-children-and-young-adults-with-chronic-kidney-disease
#4
Hua-Shan Liu, Erum A Hartung, Abbas F Jawad, Jeffrey B Ware, Nina Laney, Allison M Port, Ruben C Gur, Stephen R Hooper, Jerilynn Radcliffe, Susan L Furth, John A Detre
Purpose To investigate the pathophysiologic effects of chronic kidney disease (CKD) on brain function in children with CKD by correlating cerebral blood flow (CBF) with clinical and behavioral indexes. Materials and Methods In this prospective study, 73 pediatric patients with CKD (mean age, 15.80 years ± 3.63; range, 9-25 years) and 57 control subjects (mean age, 15.65 years ± 3.76; range, 9-25 years) were recruited. CBF measurements were acquired with an MRI arterial spin labeling scheme. Neurocognitive measurements were performed with traditional and computerized neurocognitive batteries...
June 12, 2018: Radiology
https://www.readbyqxmd.com/read/29878870/regular-walking-breaks-prevent-the-decline-in-cerebral-blood-flow-associated-with-prolonged-sitting
#5
Sophie E Carter, Richard Draijer, Sophie M Holder, Louise Brown, Dick H J Thijssen, Nicola D Hopkins
Decreased cerebrovascular blood flow and function are associated with lower cognitive functioning and increased risk of neurodegenerative diseases. Prolonged sitting impairs peripheral blood flow and function, but its effects on the cerebrovasculature are unknown. This study explored the effect of uninterrupted sitting and breaking up sitting time on cerebrovascular blood flow and function of healthy desk workers. Fifteen participants (10 male, 35.8{plus minus}10.2 years, BMI: 25.5{plus minus}3.2 kg∙m-2 ) completed, on separate days, three 4-hr conditions in a randomised order: a) uninterrupted sitting (SIT), b) sitting with 2-min light intensity walking breaks every 30-min (2WALK) or c) sitting with 8-min light intensity walking breaks every 2-hrs (8WALK)...
June 7, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29877854/near-infrared-spectroscopy-study-of-cortical-excitability-during-electrical-stimulation-assisted-cycling-for-neurorehabilitation-of-stroke-patients
#6
Chao-Chen Lo, Pei-Yi Lin, Zheng-Yu Hoe, Jia-Jin J Chen
In addition to generating functional limb movement via electrical stimulation, other research proposed lower intensity stimulation for stroke patients from proprioceptive and neuro-biofeedback aspects. This paper investigates the effects of different intensity levels of electrical stimulation during passive cycling on cortical activation using multichannel near infrared spectroscopy (NIRS) covering premotor cortex, supplementary motor area, sensorimotor cortex (SMC), and secondary sensory cortex (S2) regions...
June 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29868521/measuring-near-infrared-spectroscopy-derived-cerebral-autoregulation-in-neonates-from-research-tool-toward-bedside-multimodal-monitoring
#7
REVIEW
Liesbeth Thewissen, Alexander Caicedo, Petra Lemmers, Frank Van Bel, Sabine Van Huffel, Gunnar Naulaers
Introduction: Cerebral autoregulation (CAR), the ability of the human body to maintain cerebral blood flow (CBF) in a wide range of perfusion pressures, can be calculated by describing the relation between arterial blood pressure (ABP) and cerebral oxygen saturation measured by near-infrared spectroscopy (NIRS). In literature, disturbed CAR is described in different patient groups, using multiple measurement techniques and mathematical models. Furthermore, it is unclear to what extent cerebral pathology and outcome can be explained by impaired CAR...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29867536/relationship-between-short-term-variability-stv-and-onset-of-cerebral-hemorrhage-at-ischemia-reperfusion-load-in-fetal-growth-restricted-fgr-mice
#8
Takahiro Minato, Takuya Ito, Yoshiyuki Kasahara, Sayaka Ooshio, Tomofumi Fushima, Akiyo Sekimoto, Nobuyuki Takahashi, Nobuo Yaegashi, Yoshitaka Kimura
Fetal growth restriction (FGR) is a risk factor exacerbating a poor neurological prognosis at birth. A disease exacerbating a poor neurological prognosis is cerebral palsy. One of the cause of this disease is cerebral hemorrhage including intraventricular hemorrhage. It is believed to be caused by an inability to autoregulate cerebral blood flow as well as immaturity of cerebral vessels. Therefore, if we can evaluate the function of autonomic nerve, cerebral hemorrhage risk can be predicted beforehand and appropriate delivery management may be possible...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29859053/compromised-dynamic-cerebral-autoregulation-in-patients-with-generalized-anxiety-disorder-a-study-using-transfer-function-analysis
#9
Zhen-Ni Guo, Shan Lv, Jia Liu, Zan Wang, Hang Jin, Quanli Qiu, Xin Sun, Yi Yang
BACKGROUND: Patients with generalized anxiety disorder (GAD) usually present with various neurological symptoms, but the mechanisms remain unclear. We aimed to analyze the characteristics of dynamic cerebral autoregulation (dCA) in patients with GAD. METHODS: Patients (aged ≥18 years) who were diagnosed with GAD were enrolled in this study. Medically and psychiatrically healthy volunteers were recruited as controls. Subjects received the Hamilton Rating Scale for Anxiety (HAMA) and 17-item Hamilton Depression Rating Scale (HAMD) evaluation...
June 1, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29844143/dynamic-regulation-of-cerebral-blood-flow-in-patients-with-alzheimer-disease
#10
Rianne A A de Heus, Daan L K de Jong, Marit L Sanders, Gerrita J van Spijker, Madelijn H Oudegeest-Sander, Maria T Hopman, Brian A Lawlor, Marcel G M Olde Rikkert, Jurgen A H R Claassen
Cerebral autoregulation and baroreflex sensitivity are key mechanisms that maintain cerebral blood flow. This study assessed whether these control mechanisms are affected in patients with dementia and mild cognitive impairment due to Alzheimer disease, as this would increase the risks of antihypertensive treatment. We studied 53 patients with dementia (73.1 years [95% confidence interval (CI), 71.4-74.8]), 37 patients with mild cognitive impairment (69.2 years [95% CI, 66.4-72.0]), and 47 controls (69.4 years [95% CI, 68...
May 29, 2018: Hypertension
https://www.readbyqxmd.com/read/29813077/underlying-mechanism-of-subcortical-brain-protection-during-hypoxia-and-reoxygenation-in-a-sheep-model-influence-of-%C3%AE-1-adrenergic-signalling
#11
René Schiffner, Sabine Juliane Bischoff, Thomas Lehmann, Florian Rakers, Sven Rupprecht, Georg Matziolis, Harald Schubert, Matthias Schwab, Otmar Huber, Cornelius Lemke, Martin Schmidt
While the cerebral autoregulation sufficiently protects subcortical brain regions during hypoxia or asphyxia, the cerebral cortex is not as adequately protected, which suggests that regulation of the cerebral blood flow (CBF) is area-specific. Hypoxia was induced by inhalation of 5% oxygen, for reoxygenation 100% oxygen was used. Cortical and subcortical CBF (by laser Doppler flowmetry), blood gases, mean arterial blood pressure (MABP), heart rate and renal blood flow were constantly monitored. Low dosed urapidil was used for α1A-adrenergic receptor blockade...
2018: PloS One
https://www.readbyqxmd.com/read/29801906/novel-management-strategies-for-medically-refractory-vasospasm-following-aneurysmal-subarachnoid-hemorrhage
#12
REVIEW
Fawaz Al-Mufti, Krishna Amuluru, Nitesh Damodara, Mohammad El-Ghanem, Rolla Nuoman, Naveed Kamal, Sarmad Al-Marsoummi, Nicholas A Morris, Neha S Dangayach, Stephan A Mayer
Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) is an important cause of further morbidity and mortality after an already devastating condition. Though traditionally attributed to vasospasm of large capacitance arteries and the resulting down-stream disruption of cerebral blood flow, the pathogenesis of DCI has proven to be more complex with early brain injury, blood-brain barrier disruption, microthrombosis, cortical spreading depolarizations, and the failure of cerebral autoregulation as newly elucidated factors...
July 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29791320/modelling-the-cerebral-haemodynamic-response-in-the-physiological-range-of-paco-sub-2-sub
#13
Jatinder Singh Minhas, Ronney B Panerai, Thompson G Robinson
Objective
 Arterial CO<sub>2</sub> (PaCO<sub>2</sub>) has a strong effect on cerebral blood flow (CBF), but its influence on CBF regulatory mechanisms and circulatory systemic variables has not been fully described over the entire physiological range of PaCO<sub>2</sub>. 
 
 Approach
 CBF velocity (CBV, transcranial Doppler), blood pressure (BP, Finometer) and end-tidal CO<sub>2</sub> (EtCO<sub>2</sub>, capnography) were measured in 45 healthy volunteers (19 male, mean age 37...
May 23, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29785667/cerebral-autoregulation-in-stroke
#14
REVIEW
Pedro Castro, Elsa Azevedo, Farzaneh Sorond
PURPOSE OF REVIEW: Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29782388/glasgow-coma-scale-score-fluctuations-are-inversely-associated-with-a-nirs-based-index-of-cerebral-autoregulation-in-acutely-comatose-patients
#15
Ryan J Healy, Andres Zorrilla-Vaca, Wendy Ziai, Marek A Mirski, Charles W Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Lucia Rivera-Lara
BACKGROUND: The Glasgow Coma Scale (GCS) is an essential coma scale in critical care for determining the neurological status of patients and for estimating their long-term prognosis. Similarly, cerebral autoregulation (CA) monitoring has shown to be an accurate technique for predicting clinical outcomes. However, little is known about the relationship between CA measurements and GCS scores among neurological critically ill patients. This study aimed to explore the association between noninvasive CA multimodal monitoring measurements and GCS scores...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29773488/identifying-the-myogenic-and-metabolic-components-of-cerebral-autoregulation
#16
S J Payne
Cerebral autoregulation is the term used to describe a number of mechanisms that act together to maintain a near constant cerebral blood flow in response to changes in arterial blood pressure. These mechanisms are complex and known to be affected in a range of cerebrovascular diseases. However, it can be difficult to assign an alteration in cerebral autoregulation to one of the underlying physiological mechanisms without the use of a complex mathematical model. In this paper, we thus set out a new approach that enables these mechanisms to be related to the autoregulation behaviour and hence inferred from experimental measurements...
May 14, 2018: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29770889/autoregulation-in-the-neuro-icu
#17
REVIEW
Anson Wang, Santiago Ortega-Gutierrez, Nils H Petersen
PURPOSE OF REVIEW: The purpose of this review is to briefly describe the concept of cerebral autoregulation, to detail several bedside techniques for measuring and assessing autoregulation, and to outline the impact of impaired autoregulation on clinical and functional outcomes in acute brain injury. Furthermore, we will review several autoregulation studies in select forms of acute brain injuries, discuss the potential for its use in patient management in the ICU, and suggest further avenues for research...
May 17, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29748058/unusual-aspect-of-posterior-reversible-encephalopathy-syndrome-in-an-elderly-adult
#18
Benjamin Hebant, Omar Bennani
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) classically occurs in patients presenting with a sudden increase of arterial pressure or eclampsia, but the range of etiologies is very wide. Although the mechanisms underlying PRES remain unclear, research suggests that when the extent of hypertension exceeds the threshold of cerebral blood flow autoregulation, this induces blood-brain barrier disruption that leads to brain edema. Unusual presentations on magnetic resonance imaging (MRI) are possible, including the involvement of frontal or temporal lobes, cerebellar hemispheres, basal ganglia, brainstem, or deep white matter...
May 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29744226/cerebral-pathophysiology-in-extracorporeal-membrane-oxygenation-pitfalls-in-daily-clinical-management
#19
REVIEW
Syed Omar Kazmi, Sanjeev Sivakumar, Dimitrios Karakitsos, Abdulrahman Alharthy, Christos Lazaridis
Extracorporeal membrane oxygenation (ECMO) is a life-saving technique that is widely being used in centers throughout the world. However, there is a paucity of literature surrounding the mechanisms affecting cerebral physiology while on ECMO. Studies have shown alterations in cerebral blood flow characteristics and subsequently autoregulation. Furthermore, the mechanical aspects of the ECMO circuit itself may affect cerebral circulation. The nature of these physiological/pathophysiological changes can lead to profound neurological complications...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29727362/effect-of-body-temperature-on-cerebral-autoregulation-in-acutely-comatose-neurocritically-ill-patients
#20
Krishma Adatia, Romergryko G Geocadin, Ryan Healy, Wendy Ziai, Luciano Ponce-Mejia, Mirinda Anderson-White, Dhaval Shah, Batya R Radzik, Caitlin Palmisano, Charles W Hogue, Charles Brown, Lucia Rivera-Lara
OBJECTIVES: Impaired cerebral autoregulation following neurologic injury is a predictor of poor clinical outcome. We aimed to assess the relationship between body temperature and cerebral autoregulation in comatose patients. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Neurocritical care unit of the Johns Hopkins Hospital. PATIENTS: Eighty-five acutely comatose patients (Glasgow Coma Scale score of ≤ 8) admitted between 2013 and 2017...
May 4, 2018: Critical Care Medicine
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