Cerebral Blood Flow Autoregulation and Dysautoregulation

Armstead, William M.

doi:10.1016/j.anclin.2016.04.002

Cited by 232 publications

(185 citation statements)

References 74 publications

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“…Comparing with healthy controls, we found that dCA on both the ipsilateral hemisphere and the contralateral hemisphere were impaired in AIS patients. Consistently with our study, previous researches also reported bilateral impaired CA in the acute stroke [28,29]. The mechanism of this trans-hemispheric communication may be diaschisis where there is distant functional depression due to the effects of loss of axons (mainly facilitatory) arising at the site of the lesion and, in the case of the cerebral hemispheres, these may synapse with neurons in the contralateral hemisphere via the corpus callosum [30].…”

Section: Choosing Dca As the Markersupporting

confidence: 90%

Dynamic cerebral autoregulation is an independent outcome predictor of acute ischemic stroke after endovascular therapy

et al. 2020

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Background: Endovascular therapy (EVT) is increasingly used to improve cerebral reperfusion after moderate-tosevere acute ischemic stroke (AIS). However, the influence of hemodynamic factors on clinical outcome is still unclear after EVT. Dynamic cerebral autoregulation (dCA) is an important brain reserve mechanism and is impaired after AIS. This study aimed to explore the role of dCA in predicting the outcome of AIS patients after EVT.Methods: AIS patients with severe stenosis/occlusion of unilateral middle cerebral artery (MCA) or internal carotid and treatment with EVT were enrolled to receive dCA examinations at the 24 h, 72 h and 7th day after stroke onset. Healthy volunteers were also recruited as controls. DCA was recorded from spontaneous fluctuations of blood pressure and MCA flow velocity. Transfer function analysis was used to derive dCA parameters, including phase difference (PD) and coherence in the low-frequency range (0.06-0.12 Hz). The clinical outcome was measured using the modified Rankin Scale (mRS) at 90 days after onset. Multivariate logistic regression was performed to reveal the correlation between dCA and clinical outcomes. The receiver operation characteristics (ROC) curve was performed to determine the cut-off point of PD. Results: A total of 62 AIS patients and 77 healthy controls were included. Compared with controls, dCA were impaired bilaterally till to 7th day after onset in patients, presenting as much lower PD value on the ipsilateral side. During followup, we found that PD on the ipsilateral side at 24 h after onset was significantly lower in patients with unfavourable outcome (n = 41) than those with favourable outcome (n = 21), even after adjustment of confounding factors (p = 0.009). ROC curve analysis revealed that PD < 26.93°was an independent predictor of unfavourable-outcome. Conclusion:In AIS patients after EVT, dCA was impaired on both sides over the first 7 days. PD on the ipsilateral side at 24 h after onset is an independent unfavourable-outcome predictor for AIS after EVT.

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Section: Choosing Dca As the Markersupporting

confidence: 90%

Dynamic cerebral autoregulation is an independent outcome predictor of acute ischemic stroke after endovascular therapy

et al. 2020

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“…46 This variability may be further elevated for CBF, as sex hormones are involved in numerous aspects of blood flow regulation. 47 Interestingly, the male and female control groups showed no significant differences in CBF variability within the temporal lobes, making it unlikely that the greater variability in female CBF is due to hormonal differences at the time of imaging. Supplementary analyses, which compared athletes with a single concussion to those with multiple concussions, demonstrated that elevated CBF variability in the female HOC group also may be related to clinical history.…”

Section: Sex Differences In Cbf After Concussion 1201mentioning

confidence: 91%

Sex Differences in Cerebral Blood Flow Associated with a History of Concussion

Hamer

Churchill

Hutchison

et al. 2020

Journal of Neurotrauma

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Growing evidence suggests that a history of sport concussion may lead to long-term changes in brain physiology, with cerebral blood flow (CBF) being particularly sensitive to injury. However, it is unknown whether these changes are sex specific. The goal of this study was to evaluate sex differences in CBF of asymptomatic athletes, with and without a history of concussion (HOC) using arterial spin labeling (ASL). Scans were acquired for 122 athletes, including those without HOC (33 male, 33 female) and those with HOC (28 male, 28 female). Males with HOC had lower CBF bilaterally than males without HOC, seen predominantly in the temporal lobes. In contrast, females with HOC showed no significant differences relative to females without HOC, although they had significantly higher variability in temporal CBF values compared with males with HOC. Additional analyses within the HOC groups found that females with multiple concussion had lower CBF posteriorly compared with those with a single concussion, whereas males showed no significant effects. This study provides the first evidence of sex differences in CBF associated with HOC.

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“…Further adding to the ischemic conditions, TBI is also associated with impaired pressure autoregulation or loss of cerebral vascular response to arterial blood pressure changes (Engelborghs et al, 2000;Lang et al, 2003;Lewelt, Jenkins, & Miller, 1980;Rodriguez et al, 2018). Autoregulation normally acts to preserve proper CBF when the cerebral perfusion pressure changes (Armstead, 2016;Castro, Azevedo, & Sorond, 2018). However, cerebral ischemia can be more adverse in terms of duration and intensity when this CBF maintenance system is damaged.…”

Section: Ischemiamentioning

confidence: 99%

The overlooked aspect of excitotoxicity: Glutamate‐independent excitotoxicity in traumatic brain injuries

Tehse

Taghibiglou

2019

Eur J of Neuroscience

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Traumatic brain injury (TBI) is a leading major cause of morbidity and mortality in youth and individuals under 45 year age. A wide variety of cellular and molecular mechanisms have been identified contributing to the pathogenesis of TBI. A better understanding of the pathophysiology behind TBI is essential for providing more effective treatment. Excitotoxicity as one of the secondary molecular events is a major contributing factor in apoptosis and neuronal death following the initial injury in TBI. Excitotoxicity is the rapid overload and influx of calcium into the cell cytoplasm, activating a series of deleterious signaling cascades causing the cell to undergo apoptosis. Conventional understanding is that the rapid influx of calcium is initiated through glutamate release. However, there are overlooked glutamate‐independent mechanisms that cause the rapid calcium influx into the neuronal cytoplasm, evoking or contributing to excitotoxicity. Therefore, the focus of this review will be on the role of the glutamate‐independent excitotoxic mechanisms of the mechanosensitive response of NMDA receptors, mechanoporation of the cell membrane, ischemia, and the release of calcium from intracellular stores. In conclusion, the shear and stretch forces during a TBI event may result in the mechanosensitive activation of NMDA receptors which contribute to glutamate‐independent excitotoxicity.

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Cerebral Blood Flow Autoregulation and Dysautoregulation

Cited by 232 publications

References 74 publications

Dynamic cerebral autoregulation is an independent outcome predictor of acute ischemic stroke after endovascular therapy

Dynamic cerebral autoregulation is an independent outcome predictor of acute ischemic stroke after endovascular therapy

Sex Differences in Cerebral Blood Flow Associated with a History of Concussion

The overlooked aspect of excitotoxicity: Glutamate‐independent excitotoxicity in traumatic brain injuries

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