Early Childhood Gender Differences in Anterior and Posterior Cerebral Blood Flow Velocity and Autoregulation

Tontisirin, Nuj; Muangman, Saipin; Suz, Pilar; Pihoker, Catherine; Fisk, Dana M.; Moore, Anne; Lam, Arthur M.; Vavilala, Monica S.

doi:10.1542/peds.2006-2110

Cited by 79 publications

(72 citation statements)

References 22 publications

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“…We observed higher mean MCA velocity in women (due to both higher systolic and higher ) indicates a significant interaction effect between posture and age (i.e., there was a smaller increase of heart rate during standing compared with sitting in the older groups, whereas there was a larger increase of heart rate during standing compared with sitting in the younger groups). diastolic MCA velocity) compared with men, which has been well documented (9,43,64,67). It has also previously been shown that premenopausal women have greater resting brain blood flow compared with age-matched men (despite a smaller brain mass) (19,20).…”

Section: Discussionmentioning

confidence: 77%

Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men

Edgell

Robertson

Hughson

2012

Journal of Applied Physiology

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Edgell H, Robertson AD, Hughson RL. Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men. J Appl Physiol 112: 1482-1493, 2012. First published February 23, 2012 doi:10.1152/japplphysiol.01204.2011.-Increased incidence of orthostatic hypotension and presyncopal symptoms in young women could be related to hormonal factors that might be isolated by comparing cardiovascular and cerebrovascular responses to postural change in young and older men and women. Seven young women, 11 young men, 10 older women (Ͼ1 yr postmenopausal, no hormone therapy), and 9 older men participated in a supine-to-sit-to-stand test while measuring systemic hemodynamics, end-tidal PCO2, and blood flow velocity of the middle cerebral artery (MCA). Women had a greater reduction in stroke volume index compared with age-matched men (change from supine to standing: young women: Ϫ22.9 Ϯ 1.6 ml/m 2 ; young men: Ϫ14.4 Ϯ 2.4 ml/m 2 ; older women: Ϫ17.4 Ϯ 3.3 ml/m 2 ; older men: Ϫ13.8 Ϯ 2.2 ml/m 2 ). This was accompanied by offsetting changes in heart rate, particularly in young women, resulting in no age or sex differences in cardiac output index. Mean arterial pressure (MAP) was higher in older subjects and increased with movement to upright postures. Younger men and women had higher forearm vascular resistance that increased progressively in the upright posture compared with older men and women. There was no difference between sexes or ages in total peripheral resistance index. Women had higher MCA velocity, but both sexes had reduced MCA velocity while upright, which was a function of reduced blood pressure at the MCA and a significant reduction in end-tidal PCO2. The reductions in stroke volume index suggested impaired venous return in women, but augmented responses of heart rate and forearm vascular resistance protected MAP in younger women. Overall, these results showed significant sex and age-related differences, but compensatory mechanisms preserved MAP and MCA velocity in young women. cerebrovascular; sex; age; orthostatic ORTHOSTATIC HYPOTENSION (a condition that sometimes leads to fainting) is an important and sometimes dangerous condition that particularly affects young women during daily life, as reflected by admission to emergency rooms (51). It has been speculated that female sex hormones might modulate reflex neural or vascular properties, resulting in the greater incidence of orthostatic hypotension in young women (5,14,15,52,69). An additional indication of impaired orthostatic responses in women includes the observation that women have a greater propensity towards postural orthostatic tachycardia syndrome (18, 60).Contrary to observations for young women, clinical evidence supports the concept that orthostatic hypotension occurs less frequently in women ages 40 -60 yr (many of whom could be postmenopausal) (51). Investigations of men and women from 23-77 yr of age indicated that the heart rate response to tilt was reduced with aging, but vascular responses a...

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Section: Discussionmentioning

confidence: 77%

Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men

Edgell

Robertson

Hughson

2012

Journal of Applied Physiology

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“…10,18 Two other reports, however, did show these differences, 23,24 which were explained by sex differences in cerebrovascular resistance and vascular reactivity. In children with SCD, altered resistance and reactivity may counterbalance sex differences in Doppler parameters.…”

Section: Discussionmentioning

confidence: 90%

Sickle Cell Disease: Reference Values and Interhemispheric Differences of Nonimaging Transcranial Doppler Blood Flow Parameters

Arkuszewski¹,

Krejza²,

Chen³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:TCD screening is widely used to identify children with SCD at high risk of stroke. Those with high mean flow velocities in major brain arteries have increased risk of stroke. Thus, our aim was to establish reference values of interhemispheric differences and ratios of blood flow Doppler parameters in the tICA, MCA, and ACA as determined by conventional TCD in children with sickle cell anemia.

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“…For example, although anterior circulation flow velocities are higher in both boys and girls than posterior circulation flow velocities. Girls aged 4-16 years have higher V MCA and V BAS than age-matched boys [20,21]. Gender differences in blood viscosity because of hematocrit, or differences in hormones, vessel size, cerebral metabolism, and/or cerebrovascular resistance may partially explain these observed gender differences [21].…”

Section: Cerebral Blood Flowmentioning

confidence: 99%

“…Girls aged 4-16 years have higher V MCA and V BAS than age-matched boys [20,21]. Gender differences in blood viscosity because of hematocrit, or differences in hormones, vessel size, cerebral metabolism, and/or cerebrovascular resistance may partially explain these observed gender differences [21]. Whether or not these gender differences are present at birth is unknown and the relationship between all these factors and CBF have not been examined by both age and gender.…”

Section: Cerebral Blood Flowmentioning

confidence: 99%

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Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Udomphorn

Armstead

Vavilala

2008

Pediatric Neurology

Self Cite

127

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Traumatic brain injury is a global health concern and is the leading cause of traumatic morbidity and mortality in children. Despite a lower overall mortality than in adult traumatic brain injury, the cost to society from the sequelae of pediatric traumatic brain injury is very high. Predictors of poor outcome after traumatic brain injury include altered systemic and cerebral physiology, including altered cerebral hemodynamics. Cerebral autoregulation is often impaired following traumatic brain injury and may adversely impact poor outcome. Although altered cerebrovascular hemodynamics early after traumatic brain injury may contribute to disability in children, there is a paucity of information regarding changes in cerebral blood flow and cerebral autoregulation after pediatric traumatic brain injury. In this article, we discuss normal pediatric cerebral physiology and cerebrovascular pathophysiology following pediatric traumatic brain injury.

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Early Childhood Gender Differences in Anterior and Posterior Cerebral Blood Flow Velocity and Autoregulation

Cited by 79 publications

References 22 publications

Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men

Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men

Sickle Cell Disease: Reference Values and Interhemispheric Differences of Nonimaging Transcranial Doppler Blood Flow Parameters

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

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