Impaired cerebral autoregulation is associated with poststroke cognitive impairment

Chi, Nai‐Fang; Hu, Han Hwa; Chan, Lung; Wang, Cheng Yen; Chao, Shu Ping; Huang, Li; Ku, Hsiao Lun; Hu, Chaur Jong

doi:10.1002/acn3.51075

Cited by 22 publications

(16 citation statements)

References 39 publications

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“…The frequency intervals II and III used in the present work incorporate the frequency ranges where cerebral autoregulation is considered to be operant. The spontaneous oscillations in interval II are associated with vasomotion and sympathetic activity, whereas the spontaneous oscillations in interval III are associated with neural network activity [ 4 , 36 ]. In this study, the lower coupling strength in intervals II and III suggests that ABP oscillations have a weaker influence on Δ [O 2 Hb] fluctuations.…”

Section: Discussionmentioning

confidence: 99%

“…The spontaneous oscillations in interval I are related to the effects of respiratory activities [ 26 ]. The spontaneous oscillations in interval II are associated with vasomotion and sympathetic activity [ 4 ]. The spontaneous oscillations in interval III mainly reflect hemodynamic fluctuations that originate from spontaneous cortical neural activity [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

“…Recent evidence suggests that a further insight of the regulatory mechanism of the brain–cardiovascular system might be obtained through research on both cerebral hemodynamics and other cardiovascular parameters [ 3 ]. Cerebral autoregulation is an important physiological marker in cerebrovascular diseases that describes the regulatory response of cerebral hemodynamic variables to changes in blood pressure [ 4 ]. Impaired cerebral autoregulation results in unstable cerebral blood flow and is detrimental to the outcome of neurological diseases.…”

Section: Introductionmentioning

confidence: 99%

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Intermittent Sequential Pneumatic Compression Improves Coupling between Cerebral Oxyhaemoglobin and Arterial Blood Pressure in Patients with Cerebral Infarction

Huo

et al. 2021

Biology

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This study aims to explore the effect of intermittent sequential pneumatic compression (ISPC) intervention on the coupling relationship between arterial blood pressure (ABP) and changes in oxyhaemoglobin (Δ [O2Hb]). The coupling strength between the two physiological systems was estimated using a coupling function based on dynamic Bayesian inference. The participants were 22 cerebral infarction patients and 20 age- and sex-matched healthy controls. Compared with resting state, the coupling strength from ABP to Δ [O2Hb] oscillations was significantly lower in the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and temporal lobe cortex (TLC) during the ISPC intervention in cerebral infarction patients in interval II. Additionally, the coupling strength was significantly lower in the bilateral SMC in both groups in interval III. These findings indicate that ISPC intervention may facilitate cerebral circulation in the bilateral PFC, SMC, and TLC in cerebral infarction patients. ISPC may promote motor function recovery through its positive influences on motor-related networks. Furthermore, the coupling between Δ [O2Hb] and ABP allows non-invasive assessments of autoregulatory function to quantitatively assess the effect of rehabilitation tasks and to guide therapy in clinical situations.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intermittent Sequential Pneumatic Compression Improves Coupling between Cerebral Oxyhaemoglobin and Arterial Blood Pressure in Patients with Cerebral Infarction

Huo

et al. 2021

Biology

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“…There is an unexplored issue, that is, the association of dCA with post stroke dementia (PSD) [ 103 ]. It could be hypothesized that dCA is impaired in dementia, such as Alzheimer’s disease, but the findings are still controversial [ 104 , 105 ]. However, the consensus is that during cognitive tests, there is a change elicited by cerebral regulatory mechanisms [ 10 , 106 ].…”

Section: Ca and Outcome In Ismentioning

confidence: 99%

Cerebral Autoregulation in Ischemic Stroke: From Pathophysiology to Clinical Concepts

et al. 2021

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Ischemic stroke (IS) is one of the most impacting diseases in the world. In the last decades, new therapies have been introduced to improve outcomes after IS, most of them aiming for recanalization of the occluded vessel. However, despite this advance, there are still a large number of patients that remain disabled. One interesting possible therapeutic approach would be interventions guided by cerebral hemodynamic parameters such as dynamic cerebral autoregulation (dCA). Supportive hemodynamic therapies aiming to optimize perfusion in the ischemic area could protect the brain and may even extend the therapeutic window for reperfusion therapies. However, the knowledge of how to implement these therapies in the complex pathophysiology of brain ischemia is challenging and still not fully understood. This comprehensive review will focus on the state of the art in this promising area with emphasis on the following aspects: (1) pathophysiology of CA in the ischemic process; (2) methodology used to evaluate CA in IS; (3) CA studies in IS patients; (4) potential non-reperfusion therapies for IS patients based on the CA concept; and (5) the impact of common IS-associated comorbidities and phenotype on CA status. The review also points to the gaps existing in the current research to be further explored in future trials.

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“…A consensus white paper for standardizing the use of TFA from the Cerebral Autoregulation Research Network (CARNet) suggests that recordings of spontaneous fluctuations of BP and CBF velocity (CBFV) for TFA should last for a minimum of 5 min to yield robust estimates of transfer function parameters [ 1 ]. Different data lengths have been used in past studies, most commonly 5 min [ 2 , 3 ] or 10 min [ 4 , 5 ]. A wide range of other data lengths have been reported [ 6 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Data Length on the Assessment of Dynamic Cerebral Autoregulation with Transfer Function Analysis in Neurological ICU Patients

Zhang

et al. 2021

Neurocrit Care

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Background Cerebral autoregulation plays an important role in safeguarding adequate cerebral perfusion and reducing the risk of secondary brain injury, which is highly important for patients in the neurological intensive care unit (neuro-ICU). Although the consensus white paper suggests that a minimum of 5 min of data are needed for assessing dynamic cerebral autoregulation with transfer function analysis (TFA), it remains unknown if the length of these data is valid for patients in the neuro-ICU, of whom are notably different than the general populations. We aimed to investigate the effect of data length using transcranial Doppler ultrasound combined with invasive blood pressure measurement for the assessment of dynamic cerebral autoregulation in patients in the neuro-ICU. Methods Twenty patients with various clinical conditions (severe acute encephalitis, ischemic stroke, subarachnoid hemorrhage, brain injury, cerebrovascular intervention operation, cerebral hemorrhage, intracranial space-occupying lesion, and toxic encephalopathy) were recruited for this study. Continuous invasive blood pressure, with a pressure catheter placed at the radial artery, and bilateral continuous cerebral blood flow velocity with transcranial Doppler ultrasound were simultaneously recorded for a length of 10 min for each patient. TFA was applied to derive phase shift, gain, and coherence function at all frequency bands from the first 2, 3, 4, 5, 6, 7, 8, 9, and 10 min of the 10-min recordings in each patient on both hemispheres. The variability in the autoregulatory parameters in each hemisphere was investigated by repeated measures analysis of variance. Results Forty-one recordings (82 hemispheres) were included in the study. According to the critical values of coherence provided by the Cerebral Autoregulation Research Network white paper, acceptable rates for the data were 100% with a length ≥ 7 min. The final analysis included 68 hemispheres. The effects of data length on trends in phase shift in the very low frequency (VLF) band ( F 1.801,120.669 = 6.321, P = 0.003), in the LF band ( F 1.274,85.343 = 4.290, P = 0.032), and in the HF band ( F 1.391,93.189 = 3.868, P = 0.039) were significant for 3–7 min, for 4–7 min, and for 5–8 min, respectively. Effects were also significant on the gain in the VLF band ( F 1.927,129.134 = 3.215, P = 0.045) for 2–8 min and on the coherence function in all frequency bands (VLF F 2.846,190.671 = 90.247, P < 0.001, LF F 2.515,168.492 = 55.770, P < 0.001, HF F 2.411, 161.542 =...

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Impaired cerebral autoregulation is associated with poststroke cognitive impairment

Cited by 22 publications

References 39 publications

Intermittent Sequential Pneumatic Compression Improves Coupling between Cerebral Oxyhaemoglobin and Arterial Blood Pressure in Patients with Cerebral Infarction

Intermittent Sequential Pneumatic Compression Improves Coupling between Cerebral Oxyhaemoglobin and Arterial Blood Pressure in Patients with Cerebral Infarction

Cerebral Autoregulation in Ischemic Stroke: From Pathophysiology to Clinical Concepts

The Effect of Data Length on the Assessment of Dynamic Cerebral Autoregulation with Transfer Function Analysis in Neurological ICU Patients

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