Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-19T03:41:51.010Z Has data issue: false hasContentIssue false
  • English
  • Français

Cerebrovascular autoregulation as a neuroimaging tool

Published online by Cambridge University Press:  24 June 2014

Jim Lagopoulos ,
Gin S. Malhi ,
Belinda Ivanovski ,
Catherine M. Cahill ,
Erhard W. Lang ,
Yugan Mudaliar ,
Nick Dorsch ,
Alan Yam ,
Jane Griffith  and
Jamin Mulvey
Jim Lagopoulos*
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia Mayne Clinical Research Imaging Center, Randwick, Australia Department of Neurology, Westmead Hospital, Westmead, Australia
Gin S. Malhi
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia Mayne Clinical Research Imaging Center, Randwick, Australia
Belinda Ivanovski
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia
Catherine M. Cahill
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia
Erhard W. Lang
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Yugan Mudaliar
Affiliation:
Intensive Care Unit, Westmead Hospital, Westmead, Australia
Nick Dorsch
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Alan Yam
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Jane Griffith
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Jamin Mulvey
Affiliation:
Intensive Care Unit, Westmead Hospital, Westmead, Australia
*
Dr Jim Lagopoulos, Mayne Clinical Research Imaging Center, Prince of Wales Medical Research Institute, Barker Street, Randwick, NSW 2031 Australia. Tel: +61 2 93822998; Fax: +61 2 93828208; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Functional transcranial Doppler (fTCD) sonography provides a high temporal resolution measure of blood flow and has over the years proved to be a valuable tool in the clinical evaluation of patients with cerebrovascular disorders. More recently, due to advances in physics and computing, it has become possible to derive indices of cerebrovascular autoregulation (CA) as well as cerebrovascular pressure reactivity (CR), using non-invasive techniques. These indices provide a dynamic representation of the brain's regulatory blood flow mechanisms not only in pathological states but also in health. However, whilst the temporal resolution of these regulatory indices is very good, spatially, the localization of brain regions remains very poor, thus limiting its brain mapping capacity. Functional MRI, on the contrary, is a brain-imaging technique that operates on similar blood flow principles; however, unlike fTCD, it provides high spatial resolution. Because both fTCD and fMRI determine blood flow-dependant imaging parameters, the coupling of fTCD with fMRI may provide greater insight into brain function by virtue of the combined enhanced temporal and spatial resolution that each technique affords. This review summarizes the fTCD technique with particular emphasis on the CA and CR indices and their relationship in traumatic brain injury as well as in health.

Keywords

BOLDcerebrovascular autoregulationfMRIfTCD
Type
Review Article
Information
Acta Neuropsychiatrica , Volume 18 , Issue 2 , April 2006 , pp. 100 - 104
Copyright
Copyright © 2006 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bandettini, PA, Wong, EC, Hinks, RS, Tikofsky, RS, Hyde, JS.Time course EPI of human brain function during task activation. Magn Reson Med 1992;25: 390–397. CrossRefGoogle ScholarPubMed
Frahm, J, Bruhn, H, Merboldt, KD, Hanicke, W.Dynamic MR imaging of human brain oxygenation during rest and photic stimulation. J Magn Reson Imaging 1992;2: 501–505. CrossRefGoogle ScholarPubMed
Kwong, KK, Belliveau, JW, Chesler, DAet al. Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation. Proc Natl Acad Sci USA 1992;89: 5675–5679. CrossRefGoogle ScholarPubMed
Ogawa, S, Lee, TM, Kay, AR, Tank, DW.Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci USA 1990;87: 9868–9872. CrossRefGoogle ScholarPubMed
Turner, RLE, Bihan, D, Moonen, CT, Despres, D, Frank, J.Echo-planar time course MRI of cat brain oxygenation changes. Magn Reson Med 1991;22: 159–166. CrossRefGoogle ScholarPubMed
McHenry, LC, West, JW, Cooper, ES, Goldberg, HI, Jaffe, ME.Cerebral autoregulation in man. Stroke 1974;5: 695–706. CrossRefGoogle ScholarPubMed
Paulson, OB, Strandgaard, S, Edvinsson, L.Cerebral autoregulation. Cerebrovasc Brain Metab Rev 1990;2: 161–192. Google ScholarPubMed
Strandgaard, S.Autoregulation of cerebral blood flow in hypertensive patients. The modifying influence or prolonged antihypertensive treatment on the tolerance to acute, drug-induced hypotension. Circulation 1976;53: 720–727. CrossRefGoogle ScholarPubMed
Strandgaard, S, Olesen, J, Skinhoj, E, Lassen, NA.Autoregulation of brain circulation in severe arterial hypertension. Br Med J 1973;1: 507–510. CrossRefGoogle ScholarPubMed
Kellie, G.An account of the appearances observed in the dissection of two of the three individuals presumed to have perished in the storm of the 3rd, and whose bodies were discovered in the vicinity of Leith on the morning of the. with some reflections on the pathology of the brain. Trans Med Chir Sci 1824;1: 84–160. Google Scholar
Monro, A. Observations on the structure and function of the nervous system, Edinburgh, Creech and Johnson.Google Scholar
Bishop, CC, Powell, S, Rutt, D, Browse, NL. Transcranial Doppler measurement of middle cerebral artery blood flow velocity: a validation study. Stroke 1986;17: 913–915. CrossRefGoogle ScholarPubMed
Larsen, FS, Olsen, KS, Hansen, BA, Paulson, OB, Knudsen, GM.Transcranial Doppler is valid for determination of the lower limit of cerebral blood flow autoregulation. Stroke 1994;25: 1985–1988. CrossRefGoogle ScholarPubMed
Betz, E, Heuser, D.Cerebral cortical blood flow during changes in acid-base equilibrium the brain. J Appl Physiol 1967;23: 726–733. Google Scholar
Cotev, S, Severinghaus, JW.Role of cerebrospinal fluid pH in management of respiratory problems. Anesth Analg 1969: 42–47. CrossRefGoogle ScholarPubMed
Raichle, ME, Posner, JB, Plum, F.Cerebral blood flow during and after hyperventilation. Arch Neurol 1970;23: 394–403. CrossRefGoogle ScholarPubMed
Ekstrom-Jodal, B, Haggendal, E, Linder, LE, Nilsson, NJ.Cerebral blood flow autoregulation at high arterial pressures and different levels of carbon dioxide tension in dogs. Eur Neurol 1971;6: 6–10. CrossRefGoogle ScholarPubMed
Raichle, ME, Stone, HL.Cerebral blood flow autoregulation and graded hypercapnia. Eur Neurol 1971;6: 1–5. CrossRefGoogle ScholarPubMed
Cold, GE.Cerebral blood flow in acute head injury. The regulation of cerebral blood flow and metabolism during the acute phase of head injury, and its significance for therapy. Acta Neurochir Suppl (Wien) 1990;49: 1–64. Google Scholar
Obrist, WD, Langfitt, TW, Jaggi, JL, Cruz, J, Gennarelli, TA.Cerebral blood flow and metabolism in comatose patients with acute head injury. Relationship to intracranial hypertension. J Neurosurg 1984;61: 241–253. CrossRefGoogle ScholarPubMed
Olesen, J.Contralateral focal increase of cerebral blood flow in man during arm work. Brain 1971;94: 635–646. CrossRefGoogle ScholarPubMed
Baumbach, GL, Heistad, DD.Heterogeneity of brain blood flow and permeability during acute hypertension. Am J Physiol 1985;249: H629–H637. Google ScholarPubMed
MacKenzie, ET, Strandgaard, S, Graham, DI.Effects of acutely induced hypertension in cats on pial arteriolar caliber, local cerebral blood flow, and the blood–brain barrier. Circ Res 1976;39: 33–41. CrossRefGoogle ScholarPubMed
Lundberg, N.Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiatr Neurol Scand 1960;149: 1–193. Google Scholar
Auer, LM, Sayama, I.Intracranial pressure oscillations (B-waves) caused by oscillations in cerebrovascular volume. Acta Neurochir (Wien) 1983;68: 93–100. CrossRefGoogle ScholarPubMed
Droste, DW, Krauss, JK, Berger, W, Schuler, E, Brown, MM.Rhythmic oscillations with wavelength of 0.5–2 min in transcranial Doppler recordings. Acta Neurol Scand 1994;90: 99–104. CrossRefGoogle Scholar
Steinmeier, R, Bauhuf, C, Hubner, U.Slow rhythmic oscillations of blood pressure, intracranial pressure, microcirculation, and cerebral oxygenation. Dynamic interrelation and time course in humans. Stroke 1996;27: 2236–2243. CrossRefGoogle ScholarPubMed
Czosnyka, M, Smielewski, P, Kirkpatric, P, Menon, DK, Pickard, JD.Monitoring of cerebral autoregulation in head-injured patients. Stroke 1996;27: 1829–1834. CrossRefGoogle ScholarPubMed
Lang, EW, Lagopoulos, J, Griffith, J.Noninvasive cerebrovascular autoregulation assessment in traumatic brain injury: validation and utility. J Neurotrauma 2003b;20: 69–75. CrossRefGoogle ScholarPubMed
Czosnyka, M, Smielewski, P, Kirkpatric, P.Continuous assessment of the cerebral vasomotor reactivity in head injury. Neurosurgery 1997;41: 11–17. CrossRefGoogle ScholarPubMed
Lang, EW, Lagopoulos, J, Griffith, J.Cerebral vasomotor reactivity testing in head injury. the link between pressure and flow. J Neurol Neurosurg Psychiatry 2003a;74: 1053–1059. CrossRefGoogle Scholar
Lang, EW, Yip, K, Griffith, J, Lagopoulos, J, Mudalair, Y, Dorsch, NWC.Hemispheric asymmetry and temporal profiles of cerebral autoregulation in head injury. J Clin Neurosci 2003c;10: 670–673. CrossRefGoogle ScholarPubMed
Vavilala, MS, Newell, DW, Junger, E.Dynamic cerebral autoregulation in healthy adolescents. Acta Anaesthesiol Scan 2002;46: 393–397. CrossRefGoogle ScholarPubMed
Yam, A, Lang, EW, Lagopoulos, J, Yip, K, Griffith, J, Mudalair, NWC.Effects of aging on cerebral autoregulation. J Clin Neurosci 2005;12 (2):643–646. CrossRefGoogle ScholarPubMed