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Stroke, Vol 20, 45-52, Copyright © 1989 by American Heart Association


ARTICLES

Cerebral autoregulation dynamics in humans

R Aaslid, KF Lindegaard, W Sorteberg and H Nornes
Institute of Applied Physiology and Medicine, Seattle, Washington.

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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StrokeHome page
M. Brozici, A. van der Zwan, and B. Hillen
Anatomy and Functionality of Leptomeningeal Anastomoses: A Review
Stroke, November 1, 2003; 34(11): 2750 - 2762.
[Abstract] [Full Text] [PDF]


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StrokeHome page
L. A. Steiner, J. P. Coles, A. J. Johnston, D. A. Chatfield, P. Smielewski, T. D. Fryer, F. I. Aigbirhio, J. C. Clark, J. D. Pickard, D. K. Menon, et al.
Assessment of Cerebrovascular Autoregulation in Head-Injured Patients: A Validation Study
Stroke, October 1, 2003; 34(10): 2404 - 2409.
[Abstract] [Full Text] [PDF]


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StrokeHome page
M. Reinhard, M. Roth, T. Muller, M. Czosnyka, J. Timmer, and A. Hetzel
Cerebral Autoregulation in Carotid Artery Occlusive Disease Assessed From Spontaneous Blood Pressure Fluctuations by the Correlation Coefficient Index
Stroke, September 1, 2003; 34(9): 2138 - 2144.
[Abstract] [Full Text] [PDF]


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StrokeHome page
C. Haubrich, W. Kruska, R.R. Diehl, W. Moller-Hartmann, and C. Klotzsch
Dynamic Autoregulation Testing in Patients With Middle Cerebral Artery Stenosis
Stroke, August 1, 2003; 34(8): 1881 - 1885.
[Abstract] [Full Text] [PDF]


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J. Neurol. Neurosurg. PsychiatryHome page
A Chieregato, F Calzolari, G Trasforini, L Targa, and N Latronico
Normal jugular bulb oxygen saturation
J. Neurol. Neurosurg. Psychiatry, June 1, 2003; 74(6): 784 - 786.
[Abstract] [Full Text] [PDF]


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J. Appl. Physiol.Home page
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. Appl. Physiol.Home page
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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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
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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Anesth. Analg.Home page
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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StrokeHome page
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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StrokeHome page
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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J Ultrasound MedHome page
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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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
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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Am. J. Neuroradiol.Home page
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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J. Neurol. Neurosurg. PsychiatryHome page
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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J. Neurol. Neurosurg. PsychiatryHome page
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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J. Neurol. Neurosurg. PsychiatryHome page
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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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
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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Anesth. Analg.Home page
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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J. Appl. Physiol.Home page
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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StrokeHome page
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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Br J AnaesthHome page
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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Am. J. Physiol. Heart Circ. Physiol.Home page
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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StrokeHome page
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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Anesth. Analg.Home page
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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Am. J. Physiol. Heart Circ. Physiol.Home page
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]