Ultrasound Tissue Pulsatility Imaging Suggests Impairment in Global Brain Pulsatility and Small Vessels in Elderly Patients with Orthostatic Hypotension

Biogeau, Julie; Desmidt, Thomas; Dujardin, Paul‐Armand; Ternifi, Redouane; Eudo, Charlotte; Vierron, Emilie; Remeniéras, Jean-Pierre; Patat, F.; Camus, Vincent; Constans, T.

doi:10.1016/j.jstrokecerebrovasdis.2016.09.002

Cited by 21 publications

(25 citation statements)

References 16 publications

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“…Interestingly, this decrease in MAP was observed with the mild degree of hypocapnic change generated in this study. Whilst blood pressure has previously been shown to affect BTP measurements [8], it is important to further consider why changes in MAP occurred in our study without a significant effect on BTP amplitude.…”

Section: Context With Respect To Existing Literaturementioning

confidence: 85%

“…Over the last few decades, BTPs have been separately investigated using magnetic resonance imaging (MRI) and ultrasound methods [5]. Studies have found that BTP changes occur in various clinical conditions (such as orthostatic hypotension, depression, and in the presence of white matter hyperintensity) [6][7][8][9]. However, few studies have investigated the effects of natural physiological changes on brain tissue pulsations [5].…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Hypocapnia on Brain Tissue Pulsations

et al. 2020

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Hypocapnia is known to affect patients with acute stroke and plays a key role in governing cerebral autoregulation. However, the impact of hypocapnia on brain tissue pulsations (BTPs) is relatively unexplored. As BTPs are hypothesised to result from cerebrovascular resistance to the inflow of pulsatile arterial blood, it has also been hypothesised that cerebral autoregulation changes mediated by hypocapnia will alter BTP amplitude. This healthy volunteer study reports measurements of BTPs obtained using transcranial tissue Doppler (TCTD). Thirty participants underwent hyperventilation to induce mild hypocapnia. BTP amplitude, EtCO2, blood pressure, and heart rate were then analysed to explore the impact of hypocapnia on BTP amplitude. Significant changes in BTP amplitude were noted during recovery from hypocapnia, but not during the hyperventilation manoeuvre itself. However, a significant increase in heart rate and pulse pressure and decrease in mean arterial pressure were also observed to accompany hypocapnia, which may have confounded our findings. Whilst further investigation is required, the results of this study provide a starting point for better understanding of the effects of carbon dioxide levels on BTPs. Further research in this area is needed to identify the major physiological drivers of BTPs and quantify their interactions with other aspects of cerebral haemodynamics.

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Section: Context With Respect To Existing Literaturementioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The Effects of Hypocapnia on Brain Tissue Pulsations

et al. 2020

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“…OH is caused by orthostatic stress overwhelming the body's compensatory autonomic response . Neurobiologically, it has been shown that this orthostatic stress could lead to cerebral hypo‐perfusion and subsequent formation of white matter hyperinsensities, a well known finding in late life depression (LLD). OH is also highly associated with syncope, falls, and overall increased mortality …”

Section: Introductionmentioning

confidence: 99%

“…A recent systematic review showed a consistent and significant link between hypotension and late life depressive symptoms based on data from five cross‐sectional studies . Some authors also suggest that a diagnosis of OH could be a predictor of the severity of LLD . OH can be assessed using the traditional supine to standing, active stand test .…”

Section: Introductionmentioning

confidence: 99%

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Orthostatic hypotension in patients with late‐life depression: Prevalence and validation of a new screening tool

Shanbhag

Awai

Rej

et al. 2018

Int J Geriat Psychiatry

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Magnetic resonance imaging of the pulsing brain: a systematic review

Almudayni

Alharbi

Chowdhury

et al. 2022

Magn Reson Mater Phy

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Objective To perform a systematic review of the literature exploring magnetic resonance imaging (MRI) methods for measuring natural brain tissue pulsations (BTPs) in humans. Methods A prospective systematic search of MEDLINE, SCOPUS and OpenGrey databases was conducted by two independent reviewers using a pre-determined strategy. The search focused on identifying reported measurements of naturally occurring BTP motion in humans. Studies involving non-human participants, MRI in combination with other modalities, MRI during invasive procedures and MRI studies involving externally applied tests were excluded. Data from the retrieved records were combined to create Forest plots comparing brain tissue displacement between Chiari-malformation type 1 (CM-I) patients and healthy controls using an independent samples t-test. Results The search retrieved 22 eligible articles. Articles described 5 main MRI techniques for visualisation or quantification of intrinsic brain motion. MRI techniques generally agreed that the amplitude of BTPs varies regionally from 0.04 mm to ~ 0.80 mm, with larger tissue displacements occurring closer to the centre and base of the brain compared to peripheral regions. Studies of brain pathology using MRI BTP measurements are currently limited to tumour characterisation, idiopathic intracranial hypertension (IIH), and CM-I. A pooled analysis confirmed that displacement of tissue in the cerebellar tonsillar region of CM-I patients was + 0.31 mm [95% CI 0.23, 0.38, p < 0.0001] higher than in healthy controls. Discussion MRI techniques used for measurements of brain motion are at an early stage of development with high heterogeneity across the methods used. Further work is required to provide normative data to support systematic BTPs characterisation in health and disease.

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Ultrasound Tissue Pulsatility Imaging Suggests Impairment in Global Brain Pulsatility and Small Vessels in Elderly Patients with Orthostatic Hypotension

Cited by 21 publications

References 16 publications

The Effects of Hypocapnia on Brain Tissue Pulsations

The Effects of Hypocapnia on Brain Tissue Pulsations

Orthostatic hypotension in patients with late‐life depression: Prevalence and validation of a new screening tool

Magnetic resonance imaging of the pulsing brain: a systematic review

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