Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease
Gregori-Pla, Clara (Institut de Ciències Fotòniques)
Mesquita, Rickson C. (University of Campinas)
Favilla, Christopher G. (University of Pennsylvania)
Busch, David R. (University of Texas Southwestern Medical Center)
Blanco, Igor (Institut de Ciències Fotòniques)
Zirak, Peyman (Institut de Ciències Fotòniques)
Frisk, Lisa Kobayashi (Institut de Ciències Fotòniques)
Avtzi, Stella (Institut de Ciències Fotòniques)
Maruccia, Federica (Hospital Universitari Vall d'Hebron)
Giacalone, Giacomo (San Raffaele Scientific Institute)
Cotta, Gianluca (Institut de Ciències Fotòniques)
Camps-Renom, Pol (Institut d'Investigació Biomèdica Sant Pau)
Mullen, Michael T. (University of Pennsylvania. Department of Neurology)
Martí-Fàbregas, Joan (Institut d'Investigació Biomèdica Sant Pau)
Prats-Sánchez, Luis Antonio (Institut d'Investigació Biomèdica Sant Pau)
Martínez-Domeño, Alejandro (Institut d'Investigació Biomèdica Sant Pau)
Kasner, Scott E. (University of Pennsylvania)
Greenberg, Joel H. (University of Pennsylvania)
Zhou, Chao (Washington University in St. Louis)
Edlow, Brian L. (Massachusetts General Hospital (Boston))
Putt, Mary E. (University of Pennsylvania)
Detre, John A. (University of Pennsylvania)
Yodh, Arjun G. (University of Pennsylvania)
Durduran, Turgut (Institució Catalana de Recerca i Estudis Avançats)
Delgado Mederos, Raquel (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	The cortical microvascular cerebral blood flow response (CBF) to different changes in head-of-bed (HOB) position has been shown to be altered in acute ischemic stroke (AIS) by diffuse correlation spectroscopy (DCS) technique. However, the relationship between these relative ΔCBF changes and associated systemic blood pressure changes has not been studied, even though blood pressure is a major driver of cerebral blood flow. Transcranial DCS data from four studies measuring bilateral frontal microvascular cerebral blood flow in healthy controls (n = 15), patients with asymptomatic severe internal carotid artery stenosis (ICA, n = 27), and patients with acute ischemic stroke (AIS, n = 72) were aggregated. DCS-measured CBF was measured in response to a short head-of-bed (HOB) position manipulation protocol (supine/elevated/supine, 5 min at each position). In a sub-group (AIS, n = 26; ICA, n = 14; control, n = 15), mean arterial pressure (MAP) was measured dynamically during the protocol. After elevated positioning, DCS CBF returned to baseline supine values in controls (p = 0. 890) but not in patients with AIS (9. 6% [6. 0,13. 3], mean 95% CI, p < 0. 001) or ICA stenosis (8. 6% [3. 1,14. 0], p = 0. 003)). MAP in AIS patients did not return to baseline values (2. 6 mmHg [0. 5, 4. 7], p = 0. 018), but in ICA stenosis patients and controls did. Instead ipsilesional but not contralesional CBF was correlated with MAP (AIS 6. 0%/mmHg [− 2. 4,14. 3], p = 0. 038; ICA stenosis 11. 0%/mmHg [2. 4,19. 5], p < 0. 001). The observed associations between ipsilateral CBF and MAP suggest that short HOB position changes may elicit deficits in cerebral autoregulation in cerebrovascular disorders. Additional research is required to further characterize this phenomenon. The online version contains supplementary material available at 10. 1186/s12883-021-02179-8.
Grants:	Ministerio de Economía, Industria y Competitividad PHOTODEMENTIA Ministerio de Economía, Industria y Competitividad PHOTOMETABO Ministerio de Economía, Industria y Competitividad DPI2015-64358-C2-1-R Ministerio de Economía, Industria y Competitividad PRE2018-085082 Instituto de Salud Carlos III PI09/0557 Instituto de Salud Carlos III MEDPHOTAGE Instituto de Salud Carlos III DTS16/00087 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017/SGR-1380 European Commission. Horizon 2020 654148 European Commission. Horizon 2020 713729 European Commission 317526 Fundació la Marató de TV3 201709.30 Fundació la Marató de TV3 201709.31
Note:	Altres ajuts: Redes Temáticas de Investigación Cooperativa (RETICS-INVICTUS RD012/0014 and RD16/0019/0010); Fundació CELLEX Barcelona; the "Severo Ochoa" Programme for Centres of Excellence in R&D (SEV-2015-0522), the Obra Social "la Caixa" Foundation (LlumMedBcn).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cerebrovascular disease ; Mean arterial pressure ; Cerebral blood flow ; Cerebral autoregulation ; Diffuse correlation spectroscopy ; Diffuse optics
Published in:	BMC Neurology, Vol. 21 (april 2021) , ISSN 1471-2377

DOI: 10.1186/s12883-021-02179-8
PMID: 33836684

12 p, 1.5 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
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