Elisabeth M W Kooi, Michelle E van der Laan, Ryan E Accord, Marcus T R Roofthooft, Marcel J Aries, Jan Willem J Elting
Objective: During ligation of the ductus arteriosus, cerebrovascular autoregulation (CAR) may deteriorate. It is unknown whether different surgical approaches affect changes in CAR differently. The objective of this study was to compare the potential change in CAR in preterm infants during and after ligation comparing two surgical approaches: sternotomy and posterolateral thoracotomy. Design: This was an observational cohort pilot study. Setting: Level III NICU. Patients: Preterm infants (GA < 32 weeks) requiring ductal ligation were eligible for inclusion...
2020: Frontiers in Pediatrics
Vianney Gilard, Abdellah Tebani, Soumeya Bekri, Stéphane Marret
Germinal matrix-intraventricular-intraparenchymal hemorrhage (GMH-IVH-IPH) is a major complication of very preterm births before 32 weeks of gestation (WG). Despite progress in clinical management, its incidence remains high before 27 WG. In addition, severe complications may occur such as post-hemorrhagic hydrocephalus and/or periventricular intraparenchymal hemorrhage. IVH is strongly associated with subsequent neurodevelopmental disabilities. For this review, an automated literature search and a clustering approach were applied to allow efficient filtering as well as topic clusters identification...
July 31, 2020: Journal of Clinical Medicine
Brian Appavu, Stephen Foldes, Brian T Burrows, Austin Jacobson, Todd Abruzzo, Varina Boerwinkle, Anthony Willyerd, Tara Mangum, Vishal Gunnala, Iris Marku, P D Adelson
BACKGROUND: Management after cerebral arteriovenous malformation (AVM) rupture aims toward preventing hemorrhagic expansion while maintaining cerebral perfusion to avoid secondary injury. We investigated associations of model-based indices of cerebral autoregulation (CA) and autonomic function (AF) with outcomes after pediatric cerebral AVM rupture. METHODS: Multimodal neurologic monitoring data from the initial 3 days after cerebral AVM rupture were retrospectively analyzed in children (< 18 years)...
August 4, 2020: Neurocritical Care
Marcelo de-Lima-Oliveira, Almir Andrade Ferreira, Alessandro Rodrigo Belon, Angela Macedo Salinet, Ricardo Carvalho Nogueira, Brasil Chian Ping, Wellingson Silva Paiva, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu
OBJECTIVES: To analyze the influences of mild and severe intracranial hypertension on cerebral autoregulation (CA). PATIENTS AND METHODS: Duroc piglets were monitored with an intracranial pressure (ICP) catheter. Intracranial hypertension was induced via infusion of 4 or 7 ml of saline solution by a bladder catheter that was inserted into the parietal lobe. The static cerebral autoregulation (sCA) index was evaluated via cerebral blood flow velocities (CBFv). Piglets with ICPs ≤ 25 and > 25 mmHg were considered as group 1 and 2, respectively...
August 3, 2020: Brain Injury
Wei-Liang Chen, Julie Wagner, Nicholas Heugel, Jeffrey Sugar, Yu-Wen Lee, Lisa Conant, Marsha Malloy, Joseph Heffernan, Brendan Quirk, Anthony Zinos, Scott A Beardsley, Robert Prost, Harry T Whelan
Similar to functional magnetic resonance imaging (fMRI), functional near-infrared spectroscopy (fNIRS) detects the changes of hemoglobin species inside the brain, but via differences in optical absorption. Within the near-infrared spectrum, light can penetrate biological tissues and be absorbed by chromophores, such as oxyhemoglobin and deoxyhemoglobin. What makes fNIRS more advantageous is its portability and potential for long-term monitoring. This paper reviews the basic mechanisms of fNIRS and its current clinical applications, the limitations toward more widespread clinical usage of fNIRS, and current efforts to improve the temporal and spatial resolution of fNIRS toward robust clinical usage within subjects...
2020: Frontiers in Neuroscience
Abbie C Johnson
The adaptation of the cerebral circulation to pregnancy is unique compared with other organs and circulatory systems, because the brain requires relatively constant blood flow and water and solute composition to maintain homeostasis. Thus, a major adaptation of the maternal cerebrovasculature to pregnancy is to maintain normalcy in the face of expanded plasma volume, increased cardiac output, and high levels of permeability factors. In this chapter, the effect of pregnancy on critical functions of the cerebral circulation is discussed, including changes occurring at the endothelium and blood-brain barrier (BBB), which protect the maternal brain from changes in BBB permeability...
2020: Handbook of Clinical Neurology
Chun-Gu Cheng, Hsin Chu, Jiunn-Tay Lee, Wu-Chien Chien, Chun-An Cheng
(1) Background: Patients with benign prostatic hyperplasia (BPH) were questioned about quality of life and sleep. Most BPH patients were treated with alpha-1 adrenergic receptor antagonists, which could improve cerebral blood flow for 1-2 months. Patients with ischemic stroke (IS) could experience cerebral autoregulation impairment for six months. The relationship between BPH and recurrent IS remains unclear. The aim of this study was to determine the risk of one-year recurrent IS conferred by BPH. (2) Methods: We used data from the Taiwanese National Health Insurance Database to identify newly diagnosed IS cases entered from 1 January 2008 to 31 December 2008...
July 25, 2020: International Journal of Environmental Research and Public Health
Marc Kermorgant, Nathalie Nasr, Marek Czosnyka, Dina N Arvanitis, Ophélie Hélissen, Jean-Michel Senard, Anne Pavy-Le Traon
It is well known that exposure to microgravity in astronauts leads to a plethora physiological responses such as headward fluid shift, body unloading, and cardiovascular deconditioning. When astronauts return to Earth, some encounter problems related to orthostatic intolerance. An impaired cerebral autoregulation (CA), which could be compromised by the effects of microgravity, has been proposed as one of the mechanisms responsible for orthostatic intolerance. CA is a homeostatic mechanism that maintains cerebral blood flow for any variations in cerebral perfusion pressure by adapting the vascular tone and cerebral vessel diameter...
2020: Frontiers in Physiology
Teodor Svedung Wettervik, Henrik Engquist, Timothy Howells, Samuel Lenell, Elham Rostami, Lars Hillered, Per Enblad, Anders Lewén
BACKGROUND: Ischemic and hypoxic secondary brain insults are common and detrimental in traumatic brain injury (TBI). Treatment aims to maintain an adequate cerebral blood flow with sufficient arterial oxygen content. It has been suggested that arterial hyperoxia may be beneficial to the injured brain to compensate for cerebral ischemia, overcome diffusion barriers, and improve mitochondrial function. In this study, we investigated the relation between arterial oxygen levels and cerebral energy metabolism, pressure autoregulation, and clinical outcome...
July 27, 2020: Journal of Intensive Care Medicine
Elisabeth M W Kooi, Anne E Richter
Cerebrovascular autoregulation is the ability to maintain stable cerebral blood flow within a range of cerebral perfusion pressures. When cerebral perfusion pressure is outside the limits of effective autoregulation, the brain is subjected to hypoperfusion or hyperperfusion, which may cause vascular injury, hemorrhage, and/or hypoxic white matter injury. Infants born preterm, after fetal growth restriction, with congenital heart disease, or with hypoxic-ischemic encephalopathy are susceptible to a failure of cerebral autoregulation...
September 2020: Clinics in Perinatology
Shaoxun Wang, Wenshan Lv, Huawei Zhang, Yedan Liu, Longyang Li, Joshua R Jefferson, Ya Guo, Man Li, Wenjun Gao, Xing Fang, Ian A Paul, Grazyna Rajkowska, James P Shaffery, Thomas H Mosley, Xinlin Hu, Ruen Liu, Yangang Wang, Hongwei Yu, Richard J Roman, Fan Fan
Diabetes mellitus (DM) is a leading risk factor for aging-related dementia; however, the underlying mechanisms are not well understood. The present study, utilizing a non-obese T2DN diabetic model, demonstrates that the myogenic response of the middle cerebral artery (MCA) and parenchymal arteriole (PA) and autoregulation of cerebral blood flow (CBF) in the surface and deep cortex were impaired at both young and old ages. The impaired CBF autoregulation was more severe in old than young DM rats, and in the deep than the surface cortex...
July 21, 2020: GeroScience
Joseph R Whittaker, Ian D Driver, Marcello Venzi, Molly G Bright, Kevin Murphy
[This corrects the article DOI: 10.3389/fnins.2019.00433.].
2020: Frontiers in Neuroscience
Ronney B Panerai, Kannakorn Intharakham, Jatinder Singh Minhas, Osian Llwyd, Angela S M Salinet, Emmanuel Katsogridakis, Paola Maggio, Thompson G Robinson
OBJECTIVE: The reliability of dynamic cerebral autoregulation (dCA) parameters, obtained with transfer function analysis (TFA) of spontaneous fluctuations in arterial blood pressure (BP), require statistically significant values of the coherence function. A new algorithm (COHmax) is proposed to increase values of coherence by means of the automated, selective removal of sub-segments of data. APPROACH: Healthy subjects were studied at baseline (normocapnia) and during 5% breathing of CO2 (hypercapnia)...
July 15, 2020: Physiological Measurement
Mohamad H Tiba, Brendan M McCracken, Danielle C Leander, Carmen I Colmenero, Brandon C Cummings, Nicholas L Greer, Paul Picton, Craig A Williamson, Kevin R Ward
Cerebrovascular autoregulation (CA) is often impaired following traumatic brain injury. Established technologies and metrics used to assess CA are invasive and conducive for measurement, but not for continuous monitoring. We developed a trans-ocular brain impedance (TOBI) method that may provide non-invasive and continuous indices to assess CA. In this study, we monitored impedance metrics such as respiratory-induced impedance amplitude changes (dz) as well as a novel impedance index (DZx), which is a moving Pearson correlation between mean arterial pressure (MAP) and dz...
July 14, 2020: Journal of Clinical Monitoring and Computing
Ming-Tao Yang
Neurocritical monitoring is important in caring for patients in the neurological intensive care unit. Although clinical neurologic examination is standard for neurocritical monitoring, changes found during the examination are often late signs and insufficient to detect and prevent secondary brain injury. Therefore, various neuromonitoring tools have been developed to monitor different physiologic parameters, such as cerebral oxygenation, cerebral blood flow, cerebral pressure, cerebral autoregulation, cerebral electric activity, and cerebral metabolism...
May 28, 2020: Biomedical Journal
Andrew Crofts, Melissa Trotman-Lucas, Justyna Janus, Michael Kelly, Claire L Gibson
Hypertension is an important risk factor for age-related cognitive decline and neuronal pathologies. Studies have shown a correlation between hypertension, disruption in neurovascular coupling and cerebral autoregulation, and cognitive decline. However, the mechanisms behind this are unclear. To further understand this, it is advantageous to study neurovascular coupling as hypertension progresses in a rodent model. Here, we use a longitudinal functional MRI (fMRI) protocol to assess the impact of hypertension on neurovascular coupling in spontaneously hypertensive rats (SHRs)...
July 10, 2020: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Alexander Peng, Matthew J Chua, Bernard Chan, Matthias Jaeger, Anders Aneman, Alwin Chuan
BACKGROUND: Correlation coefficients between blood pressure and cerebral oxygen saturation measured using near-infrared spectrometry may be used to derive the tissue oximetry index of cerebral autoregulation. Cerebral oxygen saturations demonstrate poor agreement between near-infrared spectrometers however it is unclear if measurements of autoregulation are similarly specific to the equipment used. METHODS: Cerebral oxygen saturation was monitored bilaterally in 74 healthy volunteers using both the FORE-SIGHT and EQUANOX monitors in random order...
July 9, 2020: Neurological Research
Liyun Yu, Lizhi Sun, Fei Wang, Xiaoyan Zhao, Wenyong Han
Objective To investigate cerebral autoregulation(CA)in patients with severe unilateral carotid artery stenosis by near infrared spectroscopy. Methods Thirty patients who underwent general anesthesia in our hospital from January 2015 to February 2017 were enrolled in this study.The stenosis group included 15 patients with severe unilateral internal carotid artery stenosis,and the control group included 15 patients without carotid artery stenosis.Both groups were matched in sex and age.Cerebral tissue oxygenation index(TOI)and mean arterial pressure were recorded continuously under stable general anesthesia...
June 30, 2020: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Li Zhang, Evan P Pasha, Jie Liu, Chang-Yang Xing, Danilo Cardim, Takashi Tarumi, Kyle Womack, Linda S Hynan, C Munro Cullum, Rong Zhang
We examined whether steady-state cerebral autoregulation (CA) is impaired in older adults with amnestic mild cognitive impairment (aMCI), a prodromal stage of clinical Alzheimer disease (AD). Forty-two patients with aMCI and 27 cognitively normal older adults (NC) of similar age, sex, and education underwent stepwise decreases and increases in mean arterial pressure (MAP) induced by intravenous infusion of sodium nitroprusside and phenylephrine, respectively. Changes in cerebral blood flow (CBF) were measured in the internal carotid and vertebral artery...
July 2, 2020: Journal of Applied Physiology
Minna Kallioinen, Jussi P Posti, Melissa Rahi, Deepak Sharma, Ari Katila, Juha Grönlund, Tero Vahlberg, Janek Frantzén, Klaus T Olkkola, Teijo I Saari, Riikka Takala
BACKGROUND: Cerebral autoregulation is often impaired after aneurysmal subarachnoid haemorrhage (aSAH). Dexmedetomidine is being increasingly used, but its effects on cerebral autoregulation in patients with aSAH have not been studied before. Dexmedetomidine could be a useful sedative in patients with aSAH as it enables neurological assessment during the infusion. The aim of this preliminary study was to compare the effects of dexmedetomidine on dynamic and static cerebral autoregulation with propofol and/or midazolam in patients with aSAH...
July 1, 2020: Acta Anaesthesiologica Scandinavica
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