Attenuation of Blood Flow Pulsatility along the Atlas Slope: A Physiologic Property of the Distal Vertebral Artery?

Schubert, Tilman; Pansini, Michele; Bieri, Oliver; Stippich, Christoph; Wetzel, Stephan G.; Schaedelin, Sabine; Hessling, Alexander von; Santini, Francesco

doi:10.3174/ajnr.a4148

Cited by 12 publications

(12 citation statements)

References 26 publications

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“…Recent studies found that pulsatile flow is affected by physiological and pathological vascular geometry when investigating in a proximal-distal approach. 13,30,31 An important finding in this study was that the pulsatile flow that reaches distal arterial segments was augmented with age. Firstly, the PIs in large proximal arteries were increased in elderly (Table 2) and secondly the dampening capacity of the cerebral arteries was more efficient in the young group for all cerebral arterial segments (Table 3).…”

Section: Dampening Of Pulsatile Flow In the Cerebral Arteriesmentioning

confidence: 74%

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Aging alters the dampening of pulsatile blood flow in cerebral arteries

Zarrinkoob

Ambarki

Wåhlin

et al. 2016

J Cereb Blood Flow Metab

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Excessive pulsatile flow caused by aortic stiffness is thought to be a contributing factor for several cerebrovascular diseases. The main purpose of this study was to describe the dampening of the pulsatile flow from the proximal to the distal cerebral arteries, the effect of aging and sex, and its correlation to aortic stiffness. Forty-five healthy elderly (mean age 71 years) and 49 healthy young (mean age 25 years) were included. Phase-contrast magnetic resonance imaging was used for measuring blood flow pulsatility index and dampening factor (proximal artery pulsatility index/distal artery pulsatility index) in 21 cerebral and extra-cerebral arteries. Aortic stiffness was measured as aortic pulse wave velocity. Cerebral arterial pulsatility index increased due to aging and this was more pronounced in distal segments of cerebral arteries. There was no difference in pulsatility index between women and men. Dampening of pulsatility index was observed in all cerebral arteries in both age groups but was significantly higher in young subjects than in elderly. Pulse wave velocity was not correlated with cerebral arterial pulsatility index. The increased pulsatile flow in elderly together with reduced dampening supports the pulse wave encephalopathy theory, since it implies that a higher pulsatile flow is reaching distal arterial segments in older subjects.

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Section: Dampening Of Pulsatile Flow In the Cerebral Arteriesmentioning

confidence: 74%

“…10 Flow pulsations in cerebral arteries can be investigated using Doppler ultrasonography and phase-contrast magnetic resonance imaging (PCMRI). [11][12][13] Although Doppler is widely available, it has several drawbacks. The most important is that investigations are limited to the proximal branches of the cerebral arterial tree.…”

Section: Introductionmentioning

confidence: 99%

Aging alters the dampening of pulsatile blood flow in cerebral arteries

Zarrinkoob

Ambarki

Wåhlin

et al. 2016

J Cereb Blood Flow Metab

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“…[14][15][16] This characteristic of the brain is underlined by the finding that the large conducting arteries seem to have specific properties to decrease arterial pulsatility to the brain along their course. [17][18][19] It has been suggested in recent work that reduction in vascular elasticity and expansive and contractile forces change the amplitude and length of the arterial pulse and may affect the perivascular clearance of interstitial fluid, diminishing the physiologic transport of metabolites out of the brain including beta-amyloid (Ab). 8,[20][21][22][23][24] Consequently, there is interest in non-invasive methods to assess cerebrovascular hemodynamics as potential systemic pathogenic or exacerbating factors in AD and potential avenues for treatment.…”

Section: Introductionmentioning

confidence: 99%

Changes in intracranial venous blood flow and pulsatility in Alzheimer’s disease: A 4D flow MRI study

Rivera‐Rivera

Schubert

Turski

et al. 2016

J Cereb Blood Flow Metab

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Cerebral blood flow, arterial pulsation, and vasomotion may be important indicators of cerebrovascular health in aging and diseases of aging such as Alzheimer's disease. Noninvasive markers that assess these characteristics may be helpful in the study of co-occurrence of these diseases and potential additive and interacting effects. In this study, 4D flow MRI was used to measure intra-cranial flow features with cardiac-gated phase contrast MRI in cranial arteries and veins. Mean blood flow and pulsatility index as well as the transit time of the peak flow from the middle cerebral artery to the superior sagittal sinus were measured in a total of 104 subjects comprising of four groups: (a) subjects with Alzheimer's disease, (b) age-matched controls, (c) subjects with mild cognitive impairment, and (d) a group of late middle-aged with parental history of sporadic Alzheimer's disease. The Alzheimer's disease group exhibited: a significant decrease in mean blood flow in the superior sagittal sinus, transverse sinus, middle cerebral artery, and internal carotid arteries; a significant decrease of the peak and end diastolic blood flow in the middle cerebral artery and superior sagittal sinus; a faster transmission of peak flow from the middle cerebral artery to the superior sagittal sinus and increased pulsatility index along the carotid siphon.

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“…However, the use of aqueductal CSF stroke volume as a diagnostic marker of ICP alteration is still debated. For the vascular system, pulsatility or resistance indexes of cerebral blood flow are used as indirect measures for the biomechanical properties of the vascular tree and blood pressure [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…These authors attributed this result to the increasing flow pulsatility with increasing age, as a result of stiffness of the vessels when elastin is replaced by collagen [8]. In recent studies, Schubert et al showed that arterial blood flow pulsatility decreases from the distal to proximal part of the vessels and that this reduced pulsatility increased with the tortuosity of the vessels at the level of the atlas or of the carotid siphon [6,9]. A study by Stoquart-Elsankari et al in healthy young adults showed that jugular venous flow pulsatility is higher than the superior sagittal sinus flow pulsatility [10].…”

Section: Introductionmentioning

confidence: 99%

Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study

Lokossou

Metanbou

Gondry-Jouet

et al. 2020

Fluids Barriers CNS

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Background: Both aging and changes in blood flow velocity between the extracranial (intraspinal) and intracranial regions of cerebral vessels have an impact on brain hydro-hemodynamics. Arterial and venous cerebral blood flows interact with cerebrospinal fluid (CSF) in the both the cranial and spinal systems. Studies suggest that increased blood and CSF flow pulsatility plays an important role in certain neurological diseases. Here, we investigated the changes in blood-CSF flow pulsatility in the cranial and spinal systems with age as well as the impact of the intracranial compartment on flow patterns. Method: Phase-contrast magnetic resonance imaging (PC-MRI) was performed in 16 young and 19 elderly healthy volunteers to measure the flows of CSF and blood. CSF stroke volume (SV), blood SV, and arterial and venous pulsatility indexes (PIs) were assessed at intra-and extracranial levels in both samples. Correlations between ventricular and spinal CSF flow, and between blood and CSF flow during aging were also assessed. Results: There was a significant decrease in arterial cerebral blood flow and intracranial venous cerebral blood flow with aging. We also found a significant increase of intracranial blood SV, spinal CSF SV and arterial/venous pulsatility indexes with aging. In regard to intracranial compartment impact, arterial and venous PIs decreased significantly at intracranial level in elderly volunteers, while young adults exhibited decrease in venous PI only. Intracranial venous PI was paradoxically lower than extracranial venous PI, regardless of age. In both sample groups, spinal CSF SV and aqueductal CSF SV were positively correlated, and so were extracranial blood and spinal CSF SVs. Conclusion: The study demonstrates that aging changes blood flow but preserves blood and CSF interactions. We also showed that many parameters related to blood and CSF flows differ between young and elderly adults.

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Attenuation of Blood Flow Pulsatility along the Atlas Slope: A Physiologic Property of the Distal Vertebral Artery?

Cited by 12 publications

References 26 publications

Aging alters the dampening of pulsatile blood flow in cerebral arteries

Aging alters the dampening of pulsatile blood flow in cerebral arteries

Changes in intracranial venous blood flow and pulsatility in Alzheimer’s disease: A 4D flow MRI study

Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study

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