Stroke, Vol 20, 45-52, Copyright © 1989 by American Heart Association
R Aaslid, KF Lindegaard, W Sorteberg and H Nornes
We studied the response of cerebral blood flow to acute step decreases in
arterial blood pressure noninvasively and nonpharmacologically in 10 normal
volunteers during normocapnia, hypocapnia, and hypercapnia. The step
(approximately 20 mm Hg) was induced by rapidly deflating thigh blood
pressure cuffs following a 2-minute inflation above systolic blood
pressure. Instantaneous arterial blood pressure was measured by a new
servo-cuff method, and cerebral blood flow changes were assessed by
transcranial Doppler recording of middle cerebral artery blood flow
velocity. In hypocapnia, full restoration of blood flow to the pretest
level was seen as early as 4.1 seconds after the step decrease in blood
pressure, while the response was slower in normocapnia and hypercapnia. The
time course of cerebrovascular resistance was calculated from blood
pressure and blood flow recordings, and rate of regulation was determined
as the normalized change in cerebrovascular resistance per second during
2.5 seconds just after the step decrease in blood pressure. The reference
for normalization was the calculated change in cerebrovascular resistance
that would have nullified the effects of the step decrease in arterial
blood pressure on cerebral blood flow. The rate of regulation was 0.38,
0.20, and 0.11/sec in hypocapnia, normocapnia, and hypercapnia,
respectively. There was a highly significant inverse relation between rate
of regulation and PaCO2 (p less than 0.001), indicating that the response
rate of cerebral autoregulation in awake normal humans is profoundly
dependent on vascular tone.
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Cerebral autoregulation dynamics in humans
Institute of Applied Physiology and Medicine, Seattle, Washington.
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