Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease

Background The cortical microvascular cerebral blood flow response (CBF) to different changes in head-of-bed (HOB) position has been shown to be altered in acute ischemic stroke (AIS) by diffuse correlation spectroscopy (DCS) technique. However, the relationship between these relative Delta CBF chan...

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Autores: Gregori-Pla, C, Mesquita, RC, Favilla, CG, Busch, DR, Blanco, I, Zirak, P, Frisk, LK, Avtzi, S, Maruccia, F, Giacalone, G, Cotta, G, Camps-Renom, P, Mullen, MT, Marti-Fabregas, J, Prats-Sanchez, L, Martinez-Domeno, A, Kasner, SE, Greenberg, JH, Zhou, C, Edlow, BL, Putt, ME, Detre, JA, Yodh, AG, Durduran, T, Delgado-Mederos, R
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p4792
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4792
Access Level:acceso abierto
Palabra clave:Cerebrovascular disease
Mean arterial pressure
Cerebral blood flow
Cerebral autoregulation
Diffuse correlation spectroscopy
Diffuse optics
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spelling Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular diseaseGregori-Pla, CMesquita, RCFavilla, CGBusch, DRBlanco, IZirak, PFrisk, LKAvtzi, SMaruccia, FGiacalone, GCotta, GCamps-Renom, PMullen, MTMarti-Fabregas, JPrats-Sanchez, LMartinez-Domeno, AKasner, SEGreenberg, JHZhou, CEdlow, BLPutt, MEDetre, JAYodh, AGDurduran, TDelgado-Mederos, RCerebrovascular diseaseMean arterial pressureCerebral blood flowCerebral autoregulationDiffuse correlation spectroscopyDiffuse opticsBackground The cortical microvascular cerebral blood flow response (CBF) to different changes in head-of-bed (HOB) position has been shown to be altered in acute ischemic stroke (AIS) by diffuse correlation spectroscopy (DCS) technique. However, the relationship between these relative Delta CBF changes and associated systemic blood pressure changes has not been studied, even though blood pressure is a major driver of cerebral blood flow. Methods Transcranial DCS data from four studies measuring bilateral frontal microvascular cerebral blood flow in healthy controls (n = 15), patients with asymptomatic severe internal carotid artery stenosis (ICA, n = 27), and patients with acute ischemic stroke (AIS, n = 72) were aggregated. DCS-measured CBF was measured in response to a short head-of-bed (HOB) position manipulation protocol (supine/elevated/supine, 5 min at each position). In a sub-group (AIS, n = 26; ICA, n = 14; control, n = 15), mean arterial pressure (MAP) was measured dynamically during the protocol. Results After elevated positioning, DCS CBF returned to baseline supine values in controls (p = 0.890) but not in patients with AIS (9.6% [6.0,13.3], mean 95% CI, p < 0.001) or ICA stenosis (8.6% [3.1,14.0], p = 0.003)). MAP in AIS patients did not return to baseline values (2.6 mmHg [0.5, 4.7], p = 0.018), but in ICA stenosis patients and controls did. Instead ipsilesional but not contralesional CBF was correlated with MAP (AIS 6.0%/mmHg [- 2.4,14.3], p = 0.038; ICA stenosis 11.0%/mmHg [2.4,19.5], p < 0.001). Conclusions The observed associations between ipsilateral CBF and MAP suggest that short HOB position changes may elicit deficits in cerebral autoregulation in cerebrovascular disorders. Additional research is required to further characterize this phenomenon.BMC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4792BMC NeurologyISSN: 14712377reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p47922026-06-14T12:41:47Z
dc.title.none.fl_str_mv Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
title Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
spellingShingle Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
Gregori-Pla, C
Cerebrovascular disease
Mean arterial pressure
Cerebral blood flow
Cerebral autoregulation
Diffuse correlation spectroscopy
Diffuse optics
title_short Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
title_full Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
title_fullStr Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
title_full_unstemmed Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
title_sort Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
dc.creator.none.fl_str_mv Gregori-Pla, C
Mesquita, RC
Favilla, CG
Busch, DR
Blanco, I
Zirak, P
Frisk, LK
Avtzi, S
Maruccia, F
Giacalone, G
Cotta, G
Camps-Renom, P
Mullen, MT
Marti-Fabregas, J
Prats-Sanchez, L
Martinez-Domeno, A
Kasner, SE
Greenberg, JH
Zhou, C
Edlow, BL
Putt, ME
Detre, JA
Yodh, AG
Durduran, T
Delgado-Mederos, R
author Gregori-Pla, C
author_facet Gregori-Pla, C
Mesquita, RC
Favilla, CG
Busch, DR
Blanco, I
Zirak, P
Frisk, LK
Avtzi, S
Maruccia, F
Giacalone, G
Cotta, G
Camps-Renom, P
Mullen, MT
Marti-Fabregas, J
Prats-Sanchez, L
Martinez-Domeno, A
Kasner, SE
Greenberg, JH
Zhou, C
Edlow, BL
Putt, ME
Detre, JA
Yodh, AG
Durduran, T
Delgado-Mederos, R
author_role author
author2 Mesquita, RC
Favilla, CG
Busch, DR
Blanco, I
Zirak, P
Frisk, LK
Avtzi, S
Maruccia, F
Giacalone, G
Cotta, G
Camps-Renom, P
Mullen, MT
Marti-Fabregas, J
Prats-Sanchez, L
Martinez-Domeno, A
Kasner, SE
Greenberg, JH
Zhou, C
Edlow, BL
Putt, ME
Detre, JA
Yodh, AG
Durduran, T
Delgado-Mederos, R
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cerebrovascular disease
Mean arterial pressure
Cerebral blood flow
Cerebral autoregulation
Diffuse correlation spectroscopy
Diffuse optics
topic Cerebrovascular disease
Mean arterial pressure
Cerebral blood flow
Cerebral autoregulation
Diffuse correlation spectroscopy
Diffuse optics
description Background The cortical microvascular cerebral blood flow response (CBF) to different changes in head-of-bed (HOB) position has been shown to be altered in acute ischemic stroke (AIS) by diffuse correlation spectroscopy (DCS) technique. However, the relationship between these relative Delta CBF changes and associated systemic blood pressure changes has not been studied, even though blood pressure is a major driver of cerebral blood flow. Methods Transcranial DCS data from four studies measuring bilateral frontal microvascular cerebral blood flow in healthy controls (n = 15), patients with asymptomatic severe internal carotid artery stenosis (ICA, n = 27), and patients with acute ischemic stroke (AIS, n = 72) were aggregated. DCS-measured CBF was measured in response to a short head-of-bed (HOB) position manipulation protocol (supine/elevated/supine, 5 min at each position). In a sub-group (AIS, n = 26; ICA, n = 14; control, n = 15), mean arterial pressure (MAP) was measured dynamically during the protocol. Results After elevated positioning, DCS CBF returned to baseline supine values in controls (p = 0.890) but not in patients with AIS (9.6% [6.0,13.3], mean 95% CI, p < 0.001) or ICA stenosis (8.6% [3.1,14.0], p = 0.003)). MAP in AIS patients did not return to baseline values (2.6 mmHg [0.5, 4.7], p = 0.018), but in ICA stenosis patients and controls did. Instead ipsilesional but not contralesional CBF was correlated with MAP (AIS 6.0%/mmHg [- 2.4,14.3], p = 0.038; ICA stenosis 11.0%/mmHg [2.4,19.5], p < 0.001). Conclusions The observed associations between ipsilateral CBF and MAP suggest that short HOB position changes may elicit deficits in cerebral autoregulation in cerebrovascular disorders. Additional research is required to further characterize this phenomenon.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4792
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4792
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv BMC Neurology
ISSN: 14712377
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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