Cerebrovascular function and cognition in childhood: a systematic review of transcranial doppler studies

Abstract

BackgroundThe contribution of cerebrovascular function to cognitive performance is gaining increased attention. Transcranial doppler (TCD) is portable, reliable, inexpensive and extremely well tolerated by young and clinical samples. It enables measurement of blood flow velocity in major cerebral arteries at rest and during cognitive tasks.MethodsWe systematically reviewed evidence for associations between cognitive performance and cerebrovascular function in children (0-18 years), as measured using TCD. A total of 2778 articles were retrieved from PsychInfo, Pubmed, and EMBASE searches and 25 relevant articles were identified.ResultsMost studies investigated clinical groups, where decreased blood flow velocities in infants were associated with poor neurological functioning, and increased blood flow velocities in children with Sickle cell disease were typically associated with cognitive impairment and lower intelligence. Studies were also identified assessing autistic behaviour, mental retardation and sleep disordered breathing. In healthy children, the majority of studies reported cognitive processing produced lateralised changes in blood flow velocities however these physiological responses did not appear to correlate with behavioural cognitive performance.ConclusionPoor cognitive performance appears to be associated with decreased blood flow velocities in premature infants, and increased velocities in Sickle cell disease children using TCD methods. However knowledge in healthy samples is relatively limited. The technique is well tolerated by children, is portable and inexpensive. It therefore stands to make a valuable contribution to knowledge regarding the underlying functional biology of cognitive performance in childhood.

Neurological Injury and Cerebral Blood Flow in Single Ventricles Throughout Staged Surgical Reconstruction

“…In addition, the brain requires a certain amount of CBF to function independent of neurological injury of which a recent review of 25 studies bears this out. 40 In a study by Koide et al, 41 CBF and cognitive function was measured in 14 bradycardic adults before and after pacemaker implantation. Prior to implantation, verbal cognitive function was lower in bradycardic patients than in age-matched control subjects, however, after pacemaker implantation, both CBF and verbal intelligence improved.…”

Measuring cerebral hemodynamic changes during action observation with functional transcranial doppler

“…These findings indicate that AOT has a positive influence in terms of an increase in CBFV and CBFvol, since the brain requires more blood to meet the metabolic demand. Measurement of blood flow velocity in the main arteries using fTCD has been accepted in a variety of studies for analyzing brain activities during the performance of cognitive tasks 14 , 18 ) .…”

“…Recently, transcranial Doppler (TCD) ultrasonography has been increasingly employed as a non-invasive, inexpensive, safe, and portable technique for measuring cerebrovascular function. It permits continuous and bilateral recording of cerebral blood flow velocity (CBFV) through the major intracranial vessels 14 , 15 ) . It is also relatively resistant to movement artifacts and has good test-retest reliability 16 ) .…”

“…It is also relatively resistant to movement artifacts and has good test-retest reliability 16 ) . TCD can be performed easily, and has become an important alternative for quantifying CBF changes that accompany cerebral activity in the circulation of the human brain 17 ) , and for evaluating changes in CBFV at rest and during performance of cognitive tasks 14 , 18 ) .…”

What Box: A task for assessing language lateralization in young children

“…In addition, the simplicity of What Box makes it useful for working with populations where memory for and adherence to the rules associated with Word Generation limit its application; including, intellectual impairment (e.g., Down syndrome, Bowler, Cufflin, & Kiernan, 1985), What box language lateralisation 25 cognitive decline such as aging (Keage et al, 2015), dementia (Matteis et al, 1998), and brain damage (Bragoni et al, 2000). TCD per se has been applied successfully in a wide range of populations (for systematic reviews see Bakker et al, 2014in children, Keage et al, 2012 in aging and dementia), therefore the combination of fTCD and What Box provides a useful tool.…”