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cerebral vascular autoregulation

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https://www.readbyqxmd.com/read/28497934/cerebral-autoregulation-monitoring-in-acute-traumatic-brain-injury-what-s-the-evidence
#1
Leanne A Calviello, Joseph Donnelly, Frederick A Zeiler, Eric P Thelin, Peter Smielewski, Marek Czosnyka
Cerebral autoregulation is conceptualized as a vascular self-regulatory mechanism within the brain. Controlled by elusive relationships between various biophysical processes, it functions to protect the brain against potential damages caused by sudden changes in cerebral perfusion pressures and flow. Following events such as traumatic brain injuries (TBI), autoregulation may be compromised, potentially leading to an unfavorable outcome. In spite of its complexity, autoregulation has been able to be quantified non-invasively within the neuro-critical care setting with the aid of transcranial Doppler...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28416148/alterations-in-autonomic-cerebrovascular-control-after-spinal-cord-injury
#2
Dong-Il Kim, Can Ozan Tan
Among chronic cardiovascular and metabolic sequelae of spinal cord injury (SCI) is an up-to four-fold increase in the risk of ischemic and hemorrhagic stroke, suggesting that individuals with SCI cannot maintain stable cerebral perfusion. In able-bodied individuals, the cerebral vasculature is able to regulate cerebral perfusion in response to swings in arterial pressure (cerebral autoregulation), blood gases (cerebral vasoreactivity), and neural metabolic demand (neurovascular coupling). This ability depends, at least partly, on intact autonomic function, but high thoracic and cervical spinal cord injuries result in disruption of sympathetic and parasympathetic cerebrovascular control...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28384837/the-impact-of-integrated-evaluation-of-hemodynamics-on-management-of-preterm-infants-with-late-onset-compromised-systemic-circulation
#3
Reem Amer, Reem Kalash, Mary M Seshia, Yasser N Elsayed
Objectives To study the impact of integrated evaluation of hemodynamics (IEH), using targeted neonatal echocardiography (TNE), cerebral regional tissue oxygenation (crRTO), and fractional oxygen extraction (FOE), using near-infrared spectroscopy (NIRS) on the management of infants with late-onset compromised systemic circulation (LCSC), and evaluation of the hemodynamic characteristics. Study Design Retrospective cohort study comparing infants with LCSC who underwent IEH (April 2014 to May 2016) with an earlier EPOCH who did not undergo IEH (January 2012 to March 2014)...
April 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28302914/new-insights-into-mechanisms-of-small-vessel-disease-stroke-from-genetics
#4
REVIEW
Rhea Tan, Matthew Traylor, Loes Rutten-Jacobs, Hugh Markus
Cerebral small vessel disease (SVD) is a common cause of lacunar strokes, vascular cognitive impairment (VCI) and vascular dementia. SVD is thought to result in reduced cerebral blood flow, impaired cerebral autoregulation and increased blood-brain barrier (BBB) permeability. However, the molecular mechanisms underlying SVD are incompletely understood. Recent studies in monogenic forms of SVD, such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and 'sporadic' SVD have shed light on possible disease mechanisms in SVD...
April 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28268070/post-carotid-endarterectomy-hypertension-part-1-association-with-pre-operative-clinical-imaging-and-physiological-parameters
#5
J E Newman, M J Bown, R D Sayers, J P Thompson, T G Robinson, B Williams, R Panerai, P Lacy, A R Naylor
OBJECTIVE/BACKGROUND: Post-endarterectomy hypertension (PEH) is a well recognised, but poorly understood, phenomenon after carotid endarterectomy (CEA) that is associated with post-operative intracranial haemorrhage, hyperperfusion syndrome, and cardiac complications. The aim of the current study was to identify pre-operative clinical, imaging, and physiological parameters associated with PEH. METHODS: In total, 106 CEA patients undergoing CEA under general anaesthesia underwent pre-operative evaluation of 24 hour ambulatory arterial blood pressure (BP), baroreceptor sensitivity, cerebral autoregulation, and transcranial Doppler measurement of cerebral blood flow velocity (CBFv) and pulsatility index...
March 3, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28055302/t-type-ca-2-channels-and-autoregulation-of-local-blood-flow
#6
Lars Jørn Jensen, Morten Schak Nielsen, Max Salomonsson, Charlotte Mehlin Sørensen
L-type voltage gated Ca(2+) channels are considered to be the primary source of calcium influx during the myogenic response. However, many vascular beds also express T-type voltage gated Ca(2+) channels. Recent studies suggest that these channels may also play a role in autoregulation. At low pressures (40-80 mmHg) T-type channels affect myogenic responses in cerebral and mesenteric vascular beds. T-type channels also seem to be involved in skeletal muscle autoregulation. This review discusses the expression and role of T-type voltage gated Ca(2+) channels in the autoregulation of several different vascular beds...
January 5, 2017: Channels
https://www.readbyqxmd.com/read/27995510/mechanisms-of-global-cerebral-edema-formation-in-aneurysmal-subarachnoid-hemorrhage
#7
Erik G Hayman, Aaron Wessell, Volodymyr Gerzanich, Kevin N Sheth, J Marc Simard
A growing body of clinical literature emphasizes the impact of cerebral edema in early brain injury following aneurysmal subarachnoid hemorrhage (aSAH). Aneurysm rupture itself initiates global cerebral edema in up to two thirds of cases. Although cerebral edema is not a universal feature of aSAH, it portends a poor clinical course, with quantitative analysis revealing a direct correlation between cerebral edema and poor outcome, including mortality and cognitive deficits. Mechanistically, global cerebral edema has been linked to global ischemia at the time of aneurysm rupture, dysfunction of autoregulation, blood breakdown products, neuroinflammation, and hyponatremia/endocrine abnormalities...
April 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27927653/knockdown-of-add3-impairs-the-myogenic-response-of-renal-afferent-arterioles-and-middle-cerebral-arteries
#8
Fan Fan, Mallikarjuna R Pabbidi, Ying Ge, Longyang Li, Shaoxun Wang, Paige N Mims, Richard J Roman
We have reported that the myogenic response of the renal afferent arteriole (Af-art) and middle cerebral artery (MCA), and autoregulation of renal and cerebral blood flow are impaired in Fawn Hood Hypertensive (FHH) rats. Transfer of a region of chromosome 1 containing gamma-adducin (Add3) from Brown Norway rats rescues the vascular dysfunction and the development of renal disease. To examine whether Add3 is a viable candidate gene altering renal and cerebral hemodynamics in FHH rats, we knocked down the expression of Add3 in rat Af-art and MCA cultured for 36-hours using a 27-mer Dicer-substrate short interfering RNA (DsiRNA)...
December 7, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27891584/an-observational-study-of-the-macro-and-micro-haemodynamic-implications-of-epidural-anaesthesia-in-children
#9
L Triffterer, P Marhofer, G Lechner, T C Marksz, O Kimberger, W Schmid, D Marhofer
The haemodynamic implications of epidural anaesthesia in children are poorly documented. We report macro- and micro-haemodynamic data from an observational study of 25 children ranging from neonates to six-years old, who underwent surgery conducted with a specific combination of monitoring systems. We analysed 90 min of study-related monitoring after epidural catheterisation, with skin incision taking place after around 30 min. We recorded macrohaemodynamic parameters (monitored using LiDCOrapid) including heart rate, mean arterial pressure, cardiac output, stroke volume, systemic vascular resistance and stroke volume variation...
April 2017: Anaesthesia
https://www.readbyqxmd.com/read/27862767/dynamics-of-cerebral-blood-flow-in-patients-with-mild-non-ischaemic-heart-failure
#10
Christian D Erkelens, Haye H van der Wal, Bauke M de Jong, Jan-Willem Elting, Remco Renken, Marleen Gerritsen, Peter Jan van Laar, Vincent M van Deursen, Peter van der Meer, Dirk J van Veldhuisen, Adriaan A Voors, Gert-Jan Luijckx
AIMS: Heart failure (HF) is associated with tissue hypoperfusion and congestion leading to organ dysfunction. Although cerebral blood flow (CBF) is preserved over a wide range of perfusion pressures in healthy subjects, it is impaired in end-stage HF. We aimed to compare CBF, autoregulation, and cognitive function in patients with mild non-ischaemic HF with healthy controls. METHODS AND RESULTS: Fifteen patients with mild idiopathic dilated cardiomyopathy and 15 matched healthy controls were studied...
November 14, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27831856/the-dual-role-of-cerebral-autoregulation-and-collateral-flow-in-the-circle-of-willis-after-major-vessel-occlusion
#11
Flora Kennedy McConnell, Stephen Payne
OBJECTIVE: Ischaemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. To investigate the interaction of these mechanisms a one-dimensional steady state model of the cerebral arterial network was created. METHODS: Structural variants of the circle of Willis that present particular risk of stroke were recreated using a network model coupled with: (1) a steady state physiological model of cerebral autoregulation; (2) one wherein the cerebral vascular bed was modelled as a passive resistance...
November 1, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27828873/elevated-markers-of-vascular-remodeling-and-arterial-stiffness-are-associated-with-neurocognitive-function-in-older-hiv-adults-on-suppressive-antiretroviral-therapy
#12
Jessica L Montoya, Jennifer Iudicello, Pariya L Fazeli, Suzi Hong, Michael Potter, Ronald J Ellis, Igor Grant, Scott L Letendre, David J Moore
BACKGROUND: HIV is associated with elevated markers of vascular remodeling that may contribute to arterial fibrosis and stiffening and changes in pulse pressure (PP). These changes may, in turn, deleteriously affect autoregulation of cerebral blood flow and neurocognitive function. METHODS: To evaluate these mechanisms, we studied markers of vascular remodeling, PP, and neurocognitive function among older (≥50 years of age) HIV-infected (HIV+, n = 72) and HIV-seronegative (HIV-, n = 36) adults...
February 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27793855/functional-vascular-contributions-to-cognitive-impairment-and-dementia-mechanisms-and-consequences-of-cerebral-autoregulatory-dysfunction-endothelial-impairment-and-neurovascular-uncoupling-in-aging
#13
REVIEW
Peter Toth, Stefano Tarantini, Anna Csiszar, Zoltan Ungvari
Increasing evidence from epidemiological, clinical and experimental studies indicate that age-related cerebromicrovascular dysfunction and microcirculatory damage play critical roles in the pathogenesis of many types of dementia in the elderly, including Alzheimer's disease. Understanding and targeting the age-related pathophysiological mechanisms that underlie vascular contributions to cognitive impairment and dementia (VCID) are expected to have a major role in preserving brain health in older individuals...
January 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27662354/lipid-subhyaloid-maculopathy-and-exposure-to-high-altitude
#14
Roberta Rosas Petrocinio, Elga Dias Gomes
BACKGROUND: High altitude retinopathy (HAR) includes a number of diseases related to high altitude such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). High altitude retinopathy is mainly characterized by retinal hemorrhages, usually sparing the macular region, a condition specifically known as high altitude retinal hemorrhages (HARH). The pathogenesis of HARH is unclear. Many studies show that lack of oxygen causes an inadequate autoregulation of retinal circulation, causing vascular incompetence...
2016: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/27596833/contributions-of-structural-connectivity-and-cerebrovascular-parameters-to-functional-magnetic-resonance-imaging-signals-in-mice-at-rest-and-during-sensory-paw-stimulation
#15
Aileen Schroeter, Joanes Grandjean, Felix Schlegel, Bechara J Saab, Markus Rudin
Previously, we reported widespread bilateral increases in stimulus-evoked functional magnetic resonance imaging signals in mouse brain to unilateral sensory paw stimulation. We attributed the pattern to arousal-related cardiovascular changes overruling cerebral autoregulation thereby masking specific signal changes elicited by local neuronal activity. To rule out the possibility that interhemispheric neuronal communication might contribute to bilateral functional magnetic resonance imaging responses, we compared stimulus-evoked functional magnetic resonance imaging responses to unilateral hindpaw stimulation in acallosal I/LnJ, C57BL/6, and BALB/c mice...
January 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27526170/comparison-of-two-algorithms-for-analysis-of-perfusion-computed-tomography-data-for-evaluation-of-cerebral-microcirculation-in-chronic-subdural-hematoma
#16
Alexey O Trofimov, George Kalentiev, Oleg Voennov, Michail Yuriev, Darya Agarkova, Svetlana Trofimova, Denis E Bragin
The aim of this work was comparison of two algorithms of perfusion computed tomography (PCT) data analysis for evaluation of cerebral microcirculation in the perifocal zone of chronic subdural hematoma (CSDH). Twenty patients with CSDH after polytrauma were included in the study. The same PCT data were assessed quantitatively in cortical brain region beneath the CSDH (zone 1), and in the corresponding contralateral brain hemisphere (zone 2) without and with the use of perfusion calculation mode excluding vascular pixel 'Remote Vessels' (RV); 1st and 2nd analysis method, respectively...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27484894/cerebral-circulation-in-aging
#17
REVIEW
Ken Nagata, Takashi Yamazaki, Daiki Takano, Tetsuya Maeda, Yumi Fujimaki, Taizen Nakase, Yuichi Sato
Cerebral circulation is known to be protected by the regulatory function against the hypoperfusion that will affect the cognitive function as a result of brain ischemia and energy failure. The regulatory function includes cerebrovascular autoregulation, chemical control, metabolic control, and neurogenic control, and those compensatory mechanisms can be influenced by hypertension, atherosclerosis, cardiac diseases, cerebrovascular diseases and aging. On the other hand, large and/or small infarction, intracranial hemorrhage, subarachnoid hemorrhage, atherosclerosis, amylod angiopathy are also more directly associated with cognitive decline not only in those with vascular cognitive impairment or vascular dementia but also those with Alzheimer's disease...
September 2016: Ageing Research Reviews
https://www.readbyqxmd.com/read/27435029/effect-of-progressive-normobaric-hypoxia-on-dynamic-cerebral-autoregulation
#18
Masahiro Horiuchi, Junko Endo, Shohei Dobashi, Masataka Kiuchi, Katsuhiro Koyama, Andrew W Subudhi
What is the central question of this study? Acute hypoxia reduces dynamic cerebral autoregulation (dCA); however, it is unclear what level of hypoxia is necessary to exert this effect. We sought to investigate whether dCA would be reduced during progressive periods of normobaric hypoxia using a duplex Doppler ultrasound technique to evaluate the volumetric blood flow. What is the main finding and its importance? We showed that dCA decreased linearly as inspired O2 decreased from 21 to 12%. Additionally, symptoms of acute mountain sickness were related to changes in dCA...
October 1, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27358581/cerebral-hemodynamics-and-vascular-reactivity-in-mild-and-severe-ischemic-rodent-middle-cerebral-artery-occlusion-stroke-models
#19
Jeongeun Sim, Areum Jo, Bok-Man Kang, Sohee Lee, Oh Young Bang, Chaejeong Heo, Gil-Ja Jhon, Youngmi Lee, Minah Suh
Ischemia can cause decreased cerebral neurovascular coupling, leading to a failure in the autoregulation of cerebral blood flow. This study aims to investigate the effect of varying degrees of ischemia on cerebral hemodynamic reactivity using in vivo real-time optical imaging. We utilized direct cortical stimulation to elicit hyper-excitable neuronal activation, which leads to induced hemodynamic changes in both the normal and middle cerebral artery occlusion (MCAO) ischemic stroke groups. Hemodynamic measurements from optical imaging accurately predict the severity of occlusion in mild and severe MCAO animals...
June 2016: Experimental Neurobiology
https://www.readbyqxmd.com/read/27357378/neuropsychological-effects-of-cerebral-amyloid-angiopathy
#20
REVIEW
Matthew Schrag, Howard Kirshner
Cerebral amyloid angiopathy is a condition of the cerebral arterioles and to a lesser extent capillaries and veins, wherein beta-amyloid is deposited. In arterioles, this preferentially targets vascular smooth muscle cells and in the later stages undermines the stability of the vessel. This condition is frequently comorbid with Alzheimer's disease and its role in cognitive impairment and dementia is a topic of considerable recent research. This article reviews recent literature which confirms that CAA independently contributes to cognitive impairment by potentiating the neurodegeneration of Alzheimer's disease, by predisposing to microhemorrhagic and microischemic injury to the brain parenchyma, and by interfering with the autoregulation of CNS blood flow...
August 2016: Current Neurology and Neuroscience Reports
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