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.
ARTICLES
Cerebral autoregulation dynamics in humans
Institute of Applied Physiology and Medicine, Seattle, Washington.
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F. Pott, J. J. Van Lieshout, K. Ide, P. Madsen, and N. H. Secher Middle cerebral artery blood velocity during intense static exercise is dominated by a Valsalva maneuver J Appl Physiol, April 1, 2003; 94(4): 1335 - 1344. [Abstract] [Full Text] [PDF]
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J. J. Van Lieshout, W. Wieling, J. M. Karemaker, and N. H. Secher Syncope, cerebral perfusion, and oxygenation J Appl Physiol, March 1, 2003; 94(3): 833 - 848. [Abstract] [Full Text] [PDF]
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M. R. Edwards, Z. L. Topor, and R. L. Hughson A new two-breath technique for extracting the cerebrovascular response to arterial carbon dioxide Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2003; 284(3): R853 - R859. [Abstract] [Full Text] [PDF]
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S. M. Hancock, R. P. Mahajan, and L. Athanassiou Noninvasive Estimation of Cerebral Perfusion Pressure and Zero Flow Pressure in Healthy Volunteers: The Effects of Changes in End-Tidal Carbon Dioxide Anesth. Analg., March 1, 2003; 96(3): 847 - 851. [Abstract] [Full Text] [PDF]
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C. W. Park, M. Sturzenegger, C. M. Douville, R. Aaslid, and D. W. Newell Autoregulatory Response and CO2 Reactivity of the Basilar Artery Stroke, January 1, 2003; 34(1): 34 - 39. [Abstract] [Full Text] [PDF]
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B. Schmidt, M. Czosnyka, A. Raabe, H. Yahya, J. J. Schwarze, D. Sackerer, D. Sander, and J. Klingelhofer Adaptive Noninvasive Assessment of Intracranial Pressure and Cerebral Autoregulation Stroke, January 1, 2003; 34(1): 84 - 89. [Abstract] [Full Text] [PDF]
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N. Uzuner, I. Ak, D. Gucuyener, T. Asil, E. Vardareli, and G. Ozdemir Cerebral Hemodynamic Patterns With Technetium Tc 99m Exametazime Single Photon Emission Computed Tomography and Transcranial Doppler Sonography: A Validation Study Using Visual Stimulation J. Ultrasound Med., September 1, 2002; 21(9): 955 - 959. [Abstract] [Full Text] [PDF]
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M. R. Edwards, J. K. Shoemaker, and R. L. Hughson Dynamic modulation of cerebrovascular resistance as an index of autoregulation under tilt and controlled PETCO2 Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2002; 283(3): R653 - R662. [Abstract] [Full Text] [PDF]
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 L. M. Carusone, J. Srinivasan, D. R. Gitelman, M. M. Mesulam, and T. B. Parrish Hemodynamic Response Changes in Cerebrovascular Disease: Implications for Functional MR Imaging AJNR Am. J. Neuroradiol., August 1, 2002; 23(7): 1222 - 1228. [Abstract] [Full Text] [PDF]
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E W Lang, H M Mehdorn, N W C Dorsch, and M Czosnyka Continuous monitoring of cerebrovascular autoregulation: a validation study J. Neurol. Neurosurg. Psychiatry, May 1, 2002; 72(5): 583 - 586. [Abstract] [Full Text] [PDF]
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M J Hilz, F B Axelrod, U Haertl, C M Brown, and B Stemper Transcranial Doppler sonography during head up tilt suggests preserved central sympathetic activation in familial dysautonomia J. Neurol. Neurosurg. Psychiatry, May 1, 2002; 72(5): 657 - 660. [Abstract] [Full Text] [PDF]
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P J Eames, M J Blake, S L Dawson, R B Panerai, and J F Potter Dynamic cerebral autoregulation and beat to beat blood pressure control are impaired in acute ischaemic stroke J. Neurol. Neurosurg. Psychiatry, April 1, 2002; 72(4): 467 - 472. [Abstract] [Full Text] [PDF]
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M. S. Olufsen, A. Nadim, and L. A. Lipsitz Dynamics of cerebral blood flow regulation explained using a lumped parameter model Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2002; 282(2): R611 - R622. [Abstract] [Full Text] [PDF]
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H. Endoh, T. Honda, S. Ohashi, S. Hida, C. Shibue, and N. Komura The Influence of Nicardipine-, Nitroglycerin-, and Prostaglandin E1-Induced Hypotension on Cerebral Pressure Autoregulation in Adult Patients During Propofol-Fentanyl Anesthesia Anesth. Analg., January 1, 2002; 94(1): 169 - 173. [Abstract] [Full Text] [PDF]
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R. Schondorf, R. Stein, R. Roberts, J. Benoit, and W. Cupples Dynamic cerebral autoregulation is preserved in neurally mediated syncope J Appl Physiol, December 1, 2001; 91(6): 2493 - 2502. [Abstract] [Full Text] [PDF]
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R. L. Hughson, M. R. Edwards, D. D. O'Leary, and J. K. Shoemaker Critical Analysis of Cerebrovascular Autoregulation During Repeated Head-Up Tilt Stroke, October 1, 2001; 32(10): 2403 - 2408. [Abstract] [Full Text] [PDF]
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N. M. Bedforth, K. J. Girling, H. J. Skinner, and R. P. Mahajan Effects of desflurane on cerebral autoregulation Br. J. Anaesth., August 1, 2001; 87(2): 193 - 197. [Abstract] [Full Text] [PDF]
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J. Sato, M. Tachibana, T. Numata, T. Nishino, and A. Konno Differences in the dynamic cerebrovascular response between stepwise up tilt and down tilt in humans Am J Physiol Heart Circ Physiol, August 1, 2001; 281(2): H774 - H783. [Abstract] [Full Text] [PDF]
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F. Vernieri, P. Pasqualetti, M. Matteis, F. Passarelli, E. Troisi, P. M. Rossini, C. Caltagirone, and M. Silvestrini Effect of Collateral Blood Flow and Cerebral Vasomotor Reactivity on the Outcome of Carotid Artery Occlusion Stroke, July 1, 2001; 32(7): 1552 - 1558. [Abstract] [Full Text] [PDF]
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R. K. Tibble, K. J. Girling, and R. P. Mahajan A Comparison of the Transient Hyperemic Response Test and the Static Autoregulation Test to Assess Graded Impairment in Cerebral Autoregulation During Propofol, Desflurane, and Nitrous Oxide Anesthesia Anesth. Analg., July 1, 2001; 93(1): 171 - 176. [Abstract] [Full Text] [PDF]
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R. B. Panerai, S. L. Dawson, P. J. Eames, and J. F. Potter Cerebral blood flow velocity response to induced and spontaneous sudden changes in arterial blood pressure Am J Physiol Heart Circ Physiol, May 1, 2001; 280(5): H2162 - H2174. [Abstract] [Full Text] [PDF]
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