Nonlinear analyses applied in cerebral autoregulation and blood flow changes in patients with acute intracerebral hemorrhage

Lee, Yun-Kai; Tang, Sung‐Chun; Jeng, Jiann‐Shing; Shieh, Jiann-Shing

doi:10.1016/j.bspc.2016.07.009

Cited by 8 publications

(14 citation statements)

References 28 publications

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“…dCA assessed by TFA and mean flow correlation index (Mx), was impaired in the acute (<72 hours) period in most, but not all studies . However, this latter study reported that a “secondary decline” in dCA more than 5 days post‐ICH onset was associated with clinical features likely to be associated with poor prognosis, including hematoma volume and GCS .…”

Section: Resultsmentioning

confidence: 91%

“…Ultimately, the authors drew comparisons between Mx and nonlinear entropy analyses to assess sensitivity to CA changes. The data suggested that acute ICH does impair CA and increased CBV variability exists within the ipsilateral hemisphere …”

Section: Discussionmentioning

confidence: 98%

“…In addition to dynamic indices of autoregulation, the time correlation index known as the Mx, which is based on correlation coefficients between BP and CBV, was also studied. Two studies assessed Mx in acute ICH . Interestingly, the first of the two studies provided negative findings in the acute phase of ICH (<72 hours), demonstrating no difference between Mx values in patients and controls up to Day 5.…”

Section: Discussionmentioning

confidence: 99%

“…In one study, providing CBV data up to 30 days following ICH onset, it was reported that CBV in both the affected and unaffected hemispheres failed to return to control subject values at all assessed time-points until Day 30. 16 dCA assessed by TFA and mean flow correlation index (Mx), was impaired in the acute (<72 hours) period in most, 13,16,18,20 but not all studies. 14 However, this latter study reported that a "secondary decline" in dCA more than 5 days post-ICH onset was associated with clinical features likely to be associated with poor prognosis, including hematoma volume and GCS.…”

Section: Cerebral Hemodynamic Parametersmentioning

confidence: 97%

“…Six of the seven studies provided CBV for each hemisphere separately, 13,14,[16][17][18][19] with three providing comparable healthy control CBV values. [16][17][18] All eight studies assessed [13][14][15][16][17][18][19][20] cerebral hemodynamic measurements at rest. In one study, providing CBV data up to 30 days following ICH onset, it was reported that CBV in both the affected and unaffected hemispheres failed to return to control subject values at all assessed time-points until Day 30.…”

Section: Cerebral Hemodynamic Parametersmentioning

confidence: 99%

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Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta‐analysis of transcranial Doppler ultrasonography studies

Minhas

Panerai

Ghaly

et al. 2018

J of Clinical Ultrasound

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Purpose International guidelines advocate intensive blood pressure (BP) lowering within 6 hours of acute intracerebral hemorrhage (ICH) to a target systolic BP of 130‐140 mm Hg, though more intensive lowering may be associated with adverse outcome. Observational studies suggest impaired cerebral autoregulation (CA) following ICH. Transcranial Doppler ultrasonography (TCD), alongside continuous BP monitoring, provides a noninvasive bedside investigation that offers detailed perspectives on physiological perturbations post‐acute ICH. This systematic review and meta‐analysis focuses on all TCD studies of CA in ICH. Methods MEDLINE, EMBASE, and CENTRAL were searched for studies of hemorrhagic stroke and blood flow measurement. Results Eight studies met inclusion criteria (293 ICH patients); CA was impaired up to 12‐days post‐acute ICH. Impaired CA was evidenced by reduced transfer function analysis phase and higher mean flow correlation values: these were associated with worsened clinical parameters including ICH‐volume and Glasgow Coma Scale. Meta‐analysis of CBV demonstrated that, compared to controls, mean CBV was significantly lower in the ipsilateral (49.7 vs 64.8 cm s−1, Z = 4.26, P < .0001) and contralateral hemispheres following ICH (51.5 vs 64.8 cm s−1, Z = 3.44, P = .0006). Conclusion Lower mean CBV in combination with impaired CA may have implications for more intensive BP lowering and warrants further studies examining such strategies on cerebral blood flow and its regulatory mechanisms.

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Section: Resultsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Cerebral Hemodynamic Parametersmentioning

confidence: 97%

Section: Cerebral Hemodynamic Parametersmentioning

confidence: 99%

See 3 more Smart Citations

Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta‐analysis of transcranial Doppler ultrasonography studies

Minhas

Panerai

Ghaly

et al. 2018

J of Clinical Ultrasound

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A wavelet leaders model with multiscale entropy measures for diagnosing arrhythmia and congestive heart failure

Lahmiri¹

2023

Healthcare Analytics

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Reliability, reproducibility and validity of dynamic cerebral autoregulation in a large cohort with transient ischaemic attack or minor stroke

et al. 2020

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Objective: Cerebral autoregulation (CA) is critical to maintenance of cerebral perfusion but its relevance to the risk of stroke and dementia has been under-studied due to small study sizes and a lack of consensus as to the optimal method of measurement. We determined the reliability and reproducibility of multiple CA indices and the effect of intensive data-processing in a large population with transient ischaemic attack or minor stroke. Approach: Consecutive, consenting patients in the population-based Oxford Vascular Study (OXVASC) Phenotyped cohort underwent up to 10-min supine continuous blood pressure monitoring (Finometer) with bilateral middle cerebral artery (MCA) transcranial ultrasound (DWL-Dopplerbox). Un-processed waveforms (Un-A) were median-filtered, systematically reviewed, artefacts corrected and their quality blindly graded (optimal (A) to worst (E)). CA metrics were derived in time-domain (autoregulatory index (ARI), Pearson’s Mx, Sx, Dx) and in very-low (VLF) and low-frequency (LF) domains (WPS-SI: wavelet phase synchronisation, transfer function analysis), stratified by recording quality. Reliability and reproducibility (Cronbach’s alpha) were determined comparing MCA sides and the first vs. second 5-min of monitoring. Main results: In 453 patients, following manual data-cleaning, there was good reliability of indices when comparing MCA sides (Mx: 0.77; WPS-SI-VLF: 0.85; WPS-SI-LF 0.84), or repeated five minute epochs (Mx: 0.57; WPS-SI-VLF: 0.69; WPS-SI-LF 0.90), with persistently good reliability between sides even in lower quality Groups (Group D: Mx: 0.79; WPS-SI-VLF: 0.92; WPS-SI-LF: 0.91). Reliability was greatest for Pearson’s Mx and wavelet synchronisation index, with reasonable reliability of transfer function analyses, but ARI was prone to occasional, potentially defective, extreme estimates (left vs right MCA: 0.68). Significance: Resting-state measures of CA were valid, reproducible and robust to moderate noise, but require careful data-processing. Mx and wavelet synchronisation index were the most reliable indices for determining the prognostic value of CA in large epidemiological cohorts and its potential as a treatment target.

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Nonlinear analyses applied in cerebral autoregulation and blood flow changes in patients with acute intracerebral hemorrhage

Cited by 8 publications

References 28 publications

Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta‐analysis of transcranial Doppler ultrasonography studies

Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta‐analysis of transcranial Doppler ultrasonography studies

A wavelet leaders model with multiscale entropy measures for diagnosing arrhythmia and congestive heart failure

Reliability, reproducibility and validity of dynamic cerebral autoregulation in a large cohort with transient ischaemic attack or minor stroke

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