Modern methods of cerebral autoregulation assessment
https://doi.org/10.24884/1682-6655-2011-10-4-13-27
Abstract
An assessment of cerebral autoregulation (CA) is one of the important part of cerebral hemodynamics evaluation in normal and pathologic states. The results of CA assessment in healthy volunteers and neurosurgical patients with variety of methods applying modern technologies based on the multichannel registration of spontaneous oscillations of parameters of systemic and cerebral hemodynamics for the cross-spectral analysis and correlation coefficient measurement was reviewed.
About the Authors
V. B. Semenyutin
Russian Polenov Neurosurgical Institute, Saint-Petersburg
Russian Federation
Russian Federation
V. A. Aliev
Russian Polenov Neurosurgical Institute, Saint-Petersburg
Russian Federation
Russian Federation
References
1. Гайдар, Б. В. Допплерографическая оценка ауторегуляции кровоснабжения головного мозга при нейрохирургической патологии / Б. В. Гайдар [и др.] / Нейрохирургия. - 1998. - № 3. - С. 31-36.
2. Семенютин, В. Б. Ауторегуляция мозгового кровотока у больных с внутричерепными аневризмами / В. Б. Семенютин [и др.] // Регионарное кровообращение и микроциркуляция. - 2004 - № 1 (9). - С. 13-20.
3. Семенютин, В. Б. Неинвазивный метод оценки функционального значения афферентного сосуда артериовенозной мальформации / В. Б. Семенютин [и др.] // Рос. нейрохирургия. - 2008 - №2 (21).
4. Семенютин, В. Б. Оценка состояния системы мозгового кровообращения с помощью кросс-спектрального анализа спонтанных колебаний системной и церебральной гемодинамики / В. Б. Семенютин [и др.] // Нейрохирургия. - 2008. - № 1. - С. 48-57.
5. Семенютин, В. Б. Неинвазивная оценка ауторегуляции мозгового кровотока / В. Б. Семенютин [и др.] // Функциональная диагностика. - № 3. - 2006. - С. 57-63.
6. Семенютин, В. Б. Особенности нарушения ауторегуляции мозгового кровотока в остром периоде черепно-мозговой травмы / В. Б. Семенютин [и др.] // Рос. нейрохирургия. - 2009. - № 2 (23).
7. Шемагонов, А. В. Динамическая церебральная ауторегуляция: науч.-метод. пособие / А. В. Шемагонов. - Минск: БелМАПО, 2007. - 40 с.
8. Флейшман, А. Н. Медленные колебаний гемодинамики. Теория, практическое применение в клинической медицине и профилактике / А. Н. Флейшман. - Новосибирск: Наука, 1999. - 215 с.
9. Aaslid, R. Accuracy of an ultrasound Doppler servo method for noninvasive determination of instantaneous and mean arterial blood pressure / R. Aaslid, A. Brubakk // Circulation. - 1981. - Vol. 64. - P. 753-759.
10. Aaslid, R. Noninvasive transcranial ultrasound recording of flow velocities in basal cerebral arteries / R. Aaslid, T. Markwalder, H. Nornes // J. Neurosurg. - 1982. - Vol. 57. - P. 769-774.
11. Aaslid, R. Cerebral autoregulation dynamics in humans / R. Aaslid [et al] // Stroke. - 1989 - Vol. 20. - P 45-52.
12. Agnoli, A. Autoregulation of cerebral blood flow / A. Agnoli [et al] // Circulation. - 1968. - Vol. 38. - P. 800-812.
13. Auer, L. Intracranial pressure oscillations (B-waves) caused by oscillations in cerebrovascular volume / L. Auer, H. Sayama // Acta Neurochir. - 1983. - Vol. 68. - P. 93-100.
14. Balestreri, M. Impact of intracranial pressure and cerebral perfusion pressure on severe disability and mortality after head injury / M. Balestreri [et al] // Neurocrit Care. - 2006. - Vol. 4. - P. 8-13.
15. Bellapart, J. Transcranial Doppler assessment of cerebral autoregulation / J. Bellapart, J. Fraser // Ultrasound Med Biol. - 2009. - Vol. 35(6). - P. 883-893.
16. Birch, A. Assessment of autoregulation by means of periodic changes in blood pressure / A. Birch [et al] // Stroke. - 1995. - Vol. 26 (5). - P. 834-837.
17. Blaber, A. Transfer function analysis of cerebral autoregulation dynamics in autonomic failure patients / A. Blaber [et al] // Stroke. - 1997. - Vol. 28. - P. 1686-1692.
18. Brady, K. Continuous time-domain analysis of cerebrovascular autoregulation using near-infrared spectroscopy / K. Brady [et al] // Stroke. - 2007. - Vol. 37. - P. 2818-2825.
19. Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons, Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. IX. Cerebral perfusion thresholds //J. Neurotrauma. - 2007. - Vol. 24 (Suppl. 1). - S. 59-64.
20. Bonvento, G. Evidence for differing origins of the serotonergic innervation of major cerebral arteries and small pial vessels in the rat / G. Bonvento [et al] // J. Neurochem. -1991. - Vol. 56. - P. 681-689.
21. Brown, C. Assessment of cerebrovascular and cardiovascular responses to lower body negative pressure as a test of cerebral autoregulation / C. Brown [et al] // J. Neurol. Sci. - 2003 - Vol. 208. - P. 71-78.
22. Busija, D. Continuous measurements of cerebral bloodflow in anesthetized cats and dogs / D. Busija, D. Heistad, M. Marcus // Am. J. Physiol. - 1981. - Vol. 241. - P. 228-234.
23. Chillon, J.-M. Autoregulation: arterial and intracranial pressure / J.-M. Chillon // Cerebral blood flow and metabolism, (Edvinsson L, Krause DN, eds). - Philadelphia: Lippincott Williams & Wilkins, 2002. - P. 395-412.
24. Conti, A. Cerebral haemodynamic changes during propofol-remifentanil or sevoflurane anaesthesia: transcranial Doppler study under bispectral index monitoring / A. Conti [et al] // British Journal of Anaesthesia. - 2006. - Vol. 97. - P. 333-339.
25. Czosnyka, M. Relationship between transcranial Doppler-determined pulsatility index and cerebrovascular resistance: an experimental study / M. Czosnyka [et al] // J. Neurosurg. - 1996. - Vol. 84.- P 79-84.
26. Czosnyka, M. Monitoring of cerebral autoregulation in head-injured patients / M. Czosnyka [et al] // Stroke. - 1996. - Vol. 27. - P. 1829-1834.
27. Czosnyka, M. Continuous assessment of the cerebral vasomotor reactivity in head injury / M. Czosnyka [et al] // Neurosurgery. - 1997 - Vol. 41. - P 11-17.
28. Czosnyka, Z. Cerebral Autoregulation among Patients with Symptoms of Hydrocephalus / Z. Czosnyka [et al] // Neurosurgery. - 2002. - Vol. 50. - P 526-533.
29. Czosnyka, M. Monitoring and interpretation of intracranial pressure / M. Czosnyka [et al] // J. Neurol. Neurosurg. Psychiatry - 2004. - Vol. 75. - P 813-821.
30. Czosnyka, M. An assessment of dynamic autoregulation from spontaneousfluctuations of cerebral bloodflow velocity: a comparison of two models, index of autoregulation and mean flow index / M. Czosnyka [et al] // Anesth. Analg. - 2008. - Vol. 106. - P. 234-239.
31. Czosnyka, M. Monitoring of Cerebrovascular Autoregulation: Facts, Myths, and Missing Links / M. Czosnyka [et al] // Neurocrit Care. - 2009. - Vol. 10(3). - P. 373-386.
32. Diehl, R. Phase relationship between cerebral blood flow velocity and blood pressure. A clinical test of autoregulation / R. Diehl [et al] // Stroke. - 1995. - Vol. 26. - P. 1801-1804.
33. Diehl, R. Cerebral autoregulation in clinical practice / R. Diehl // European Journal of Ultrasound. - 2002. - V. 16. - P. 31-36.
34. Droste, D. Rhythmic oscillations with a wavelength of 0.5-2 min in transcranial Doppler recordings / D. Droste [et al] // Acta Neurol. Scand. - 1994. - Vol. 90. - P. 99-104.
35. Ekstrom-Jodal, B. Cerebral bloodflow autoregulation at high arterial pressures and different levels of carbon dioxide tension in dogs / B. Ekstrom-Jodal [et al] // EurNeurol. - 1971. - Vol. 6. - P. 6-10.
36. Enevoldsen, E. Autoregulation and CO2 responses of cerebral bloodflow in patients with acute severe head injury / A. Enevoldsen, T. Finn // Neurosurg. - 1978. - Vol. 48. - P. 689-703.
37. Fog, M. Cerebral circulation: The reaction of the pial arteries to a fall in blood pressure / M. Fog // Arch. Neurol. Psychiatry. - 1937. - Vol. - 37. - P. 351-364.
38. Fu, C. Effects of different classes of antihypertensive drugs on cerebral hemodynamics in elderly hypertensive patients / C. Fu, C. Yang, T. Kuo // Am. J. Hypertens. - 2005. - Vol. 18. - P. 1621-1625.
39. Giller, C. The frequency-dependent behavior of cerebral autoregulation / C. Giller // Neurosurgery - 1990. - Vol. 27 - P. 362-368.
40. Giller, С. Evaluation of the cerebral hemodynamic response to rhythmic handgrip / C. Giller [et al] // Journal of Applied Physiology - 2000. - Vol. 88. - P 2205-2213.
41. Goadsby, P. Stimulation of the trigeminal ganglion increases flow in the extracerebral but not the cerebral circulation of the monkey / P. Goadsby, G. Lambert, J. Lance // Brain Res. - 1986. - Vol. 381. - P. 63-67.
42. Gooskens, I. Pressure-autoregulation, CO2 reactivity and asymmetry of haemodynamic parameters in patients with carotid artery stenotic disease. A clinical appraisal / I. Gooskens [et al] // Acta Neurochir (Wien). - 2003. - Vol. 145. - P. 527-532.
43. Harper, A. Autoregulation of cerebral blood flow: Influence of the arterial blood pressure on the blood flow through the cerebral cortex / A. Harper // J. Neurol. Neurosurg. Psychiatry. - 1966. - Vol. 29. - P 398-403.
44. Hea van Beek, A. Cerebral autoregulation: an overview of current concepts and methodology with special focus on the elderly / A. Hea van Beek [et al] // Journal of Cerebral Blood Flow & Metabolism. - 2008. - Vol. 28. - P 1071-1085.
45. Heckmann, J. G. Delayed cerebrovascular autoregulatory response to ergometer exercise in normotensive elderly humans / J. G. Heckmann [et al] // Cerebrovasc. Dis. - 2003. - Vol. 16. - P. 423-429.
46. Hilz, M. J. Mechanisms of cerebral autoregulation, assessment and interpretation by means of transcranial doppler sonography / M. J. Hilz [et al] // Fortschr. Neurol. Psychiatr. - 2000. - Vol. 68(9). - P. 398-412.
47. Hlatky, R. Analysis of dynamic autoregulation assessed by the cuff deflation method / R. Hlatky [et al] // Neurocrit. Care. - 2006. - Vol. 4. - P 127-132.
48. Hu, K. Nonlinear assessment of cerebral autoregulation from spontaneous blood pressure and cerebral blood flow fluctuations / K. Hu [et al] // Cardiovasc. Eng. - 2008. - Vol. 8. - P. 60-71.
49. Hu, K. Nonlinear pressure-flow relationship is able to detect asymmetry of brain blood circulation associated with midline shift / K. Hu [et al] // J. Neurotrauma. - 2009. - Vol. 26(2). - P. 227-233.
50. Janssen, B. Hemodynamic basis of oscillations in systemic arterial pressure inconscious rats / B. Janssen [et al] // Am. J. Physiol - 1995. - P. 269. - P. 62-71.
51. Julien, C. The enigma of Mayer waves: Facts and models / C. Julien // Cardiovasc Res. - 2006. - Vol. 70(1). - P. 12-21.
52. Kety, S. The nitrous oxide methodfor the quantitative determination of cerebral bloodflow in man: theory, procedure and normal values / S. Kety, C. Schmidt // J Clin Invest. - 1948. - Vol. 29. - P. 476-483.
53. Kontos, H. Responses of cerebral arteries and arterioles to acute hypotension and hypertension / H. Kontos [et al] // Am. J. Physiol. - 1978. - Vol. 234. - P. H371-H383.
54. Kontos, H. Validity of cerebral arterial blood flow calculations from velocity measurements / H. Kontos // Stroke. -1989. - Vol. 20. - P. 1-3.
55. Kuo, T. Mechanisms underlying phase lag between systemic arterial blood pressure and cerebral blood flow velocity / T. Kuo [et al] // Cerebrovasc Dis. - 2003. - Vol. 16. - P. 402-409.
56. Lang, E. Spontaneous oscillations of arterial blood pressure: Cerebral and peripheral blood flow in healthy and comatose subjects / E. Lang, R. Diehl, L. Timmermann // Neurological Research. - 1999. - Vol. 21. - P 665-669.
57. Lang, E. A review of cerebral autoregulation: assessment and measurements / E. Lang [et al] // Australasian Anaesthesia - 2005. - Vol. 20. - P 161-172.
58. Lassen, N. A utoregulation of cerebral bloodflow / N. Lassen // Circ Res. - 1964. -Vol. 15. - P. 201-204.
59. Latka, M. Phase dynamics in cerebral autoregulation / M. Latka [et al] // Am. J. Physiol. Heart Circ. Physiol. - 2005. - Vol. 289. - P. H2272-H2779.
60. Lewis, S. Transcranial Doppler identification of changing autoregulatory thresholds after autoregulatory impairment / S. Lewis [et al] // Neurosurgery. - 2001. - P. 48. - P. 369-375.
61. Lewis, P. Phase shift and correlation coefficient measurement of cerebral autoregulation during deep breathing in Traumatic Brain Injury (TBI) / P. Lewis [et al] // Acta Neurochirur (Wien). - 2008. - Vol. 150. - P 139-146.
62. Lindegaard, K. Variations in middle cerebral artery bloodflow investigated with noninvasive transcranial Doopler blood flow velocity measurements / K. Lindegaard [et al] // Stroke. -1987. - Vol. 18. - P. 1025-1030.
63. Lipsitz, L. Antihypertensive therapy increases cerebral blood flow and carotid distensibility in hypertensive elderly subjects / L. Lipsitz [et al] // Hypertension - 2005 - Vol. 45. - P. 216-221.
64. Lundberg, N. Continious recording and control of ventricular fluid pressure in neurosurgical practice / N. Lundberg // Acta Psychiat and Neurolog. Scand. - 1960. - Vol. 149. - P. 1-193.
65. MacKenzie, E. Effects of hemorrhagic hypotension on the cerebral circulation. I. Cerebral blood flow and pial arteriolar caliber / E. MacKenzie, J. Farrar, W. Fitch // Stroke. -1979. - № 10. - P 711-718.
66. Malpas, S. Neural influences on cardiovascular variability: possibilities and pitfalls / S. Malpas // Am. J. Physiol. Heart Circ. Physiol. - 2002. - Vol. 282. - P. 6-20.
67. Mayer, S. Studien zur physiologie des herens und der blutgefasse / S. Mayer // Sitz Kaiser Akad. Wiss. - 1876. - Vol. 76. - P. 281-307.
68. McHenry, L. Cerebral autoregulation in man / L. McHenry [et al] // Stroke. - 1974. - Vol. 5(6). - P 695-706.
69. Mitsis, G. Cerebral hemodynamics during orthostatic stress assessed by nonlinear modeling / G. Mitsis [et al] // J Appl Physiol. - 2006. - Vol. 101. - P. 354-366.
70. Myburgh, J. Quantifying cerebral autoregulation in health and disease / J. Myburgh // Critical care and Resuscitation. - 2004. - Vol. 6. - P. 59-67.
71. Newell, D. Transcranial Doppler in cerebral vasospasm / D. Newell, H. Winn // Neurosurg. Clin. North Am. -1990. - Vol. 1. - P. 319-328.
72. Newell, D. The relationship of blood flow velocity fluctuations to intracranial pressure B waves / D. Newell [et al] // J. Neurosurg. - 1992 - Vol. 76. - P. 415-421.
73. Newell, D. Effect of transient moderate hyperventilation on dynamic cerebral autoregulation after severe head injury / D. Newell [et al] // Neurosurgery. - 1996. - Vol. 39. - P 35-43.
74. Nornes, H. Cerebral arterial bloodflow and aneurysm surgery, Part 2 / H. Nornes, H. Knutzen, P. Wikeby // J. Neurosurg. - 1977. - Vol. 47. - P 819-827.
75. Novak, V. Multimodal pressure-flow method to assess dynamics of cerebral autoregulation in stroke and hypertension / V. Novak [et al] // Biomed. Eng. Online. - 2004. - Vol. 3(1). - P. 39-50.
76. Ogawa, Y. The Effect of Sevoflurane on Dynamic Cerebral Blood Flow Autoregulation Assessed by Spectral and Transfer Function Analysis / Y. Ogawa [et al] // Anesth. Analg. - 2006. - Vol. 102. - P. 552-559.
77. Obrist, W. Regional cerebral blood flow estimated by 133Xenon inhalation / W. Obrist [et al] // Stroke. - 1975. - Vol. 6. - P. 245-256.
78. Panerai, R. Cerebral Autoregulation Dynamics in Premature Newborns / R. Panerai [et al] // Stroke. - 1995. - Vol. 26. - P. 74-80.
79. Panerai, R. Grading of cerebral dynamic autoregulation from spontaneous fluctuations in arterial blood pressure / R. Panerai [et al] // Stroke. - 1998. - Vol. 29. - P. 341-346.
80. Panerai, R. Association between dynamic cerebral autoregulation and mortality in severe head injury / R. Panerai [et al] // Br. J. Neurosurg. - 2004. - Vol. 18. - P. 471-479.
81. Panerai, R. Cerebral autoregulation: from models to clinical applications / R. Panerai // Cardiovascular Engineering. - 2008. - Vol. 8(1). - P 42-59.
82. Panerai, R. Transcranial Doppler for evaluation of cerebral autoregulation / R. Panerai // Clin Auton Res. - 2009. - Vol. 19(4). - P. 197-211.
83. Parati, G. Spectral analysis of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal / G. Parati [et al] // Hypertension. - 1995. - Vol. 25. - P. 1276-1286.
84. Paulson, O. Cerebral autoregulation / O. Paulson, S. Strandgaard // Stroke. - 1984. - Vol. 15. - P 413-416.
85. Paulson, O. Cerebral autoregulation / O. Paulson, S. Strandgaard, L. Edvinsson // Cerebrovasc Brain Metab Rev. -1990. - Vol. 2. - P. 161-192.
86. Persson, P. Spectrum analysis of cardiovascular time series / P. Persson // Am. J. Physiol. - 1997. - Vol. 273. - P. 1201-1210.
87. Piechnik, S. K. The continuous assessment of cerebrovascular reactivity: a validation of the method in healthy volunteers / S. K. Piechnik [et al] // Anesth. Analg. - 1999. - Vol. 89. - P. 944-949.
88. Reinhard, M. Dynamic cerebral autoregulation testing as a diagnostic tool in patients with carotid artery stenosis / M. Reinhard [et al] // Neurol Res. - 2001. - Vol. 23. - P. 55-63.
89. Reinhard, M. Cerebral autoregulation in carotid artery occlusive disease assessed from spontaneous blood pressure fluctuations by the correlation coefficient index / M. Reinhard [et al] // Stroke. - 2003. - Vol. 34. - P 2138-2144.
90. Reinhard, M. Effect of Carotid Endarterectomy or Stenting on Impairment of Dynamic Cerebral Autoregulation /M. Reinhard [et al] // Stroke. - 2004. - Vol. 35. - P 1381-1387.
91. Schmidt, E. Asymmetry of pressure autoregulation after traumatic brain injury / E. Schmidt [et al] // J. Neurosurg. - 2003. - Vol. 99(6). - P. 991-998.
92. Semenyutin, V. B. The intracranial B-waves amplitude as prognostication criterion of neurological complications in neuroendovascular interventions / V. B. Semenyutin [et al] // Acta Neurochirurgica. - 2005. - Suppl. 94. - P. 53-58.
93. Smielewski, P. Assessment of cerebral autoregulation using carotid artery compression / P. Smielewski [et al] // Stroke. -1996. - Vol. 27. - P. 2917-2203.
94. Soehle, M. Continuous assessment of cerebral autoregulation in subarachnoid hemorrhage / M. Soehle [et al] // Anesth Analg. - 2004. - Vol. 98. - P. 1133-1139.
95. Steiner, L. Assessment of cerebrovascular autoregulation in head-injured patients: a validation study / L. Steiner [et al] // Stroke. - 2003. - Vol. 34. - P. 2404-2409.
96. Steiner, L. A. Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury / L. A. Steiner [et al] // Crit. Care Med. - 2002. - Vol. 30. - P. 733-738.
97. Steinmeier, R. Slow Rhythmic Oscillations of Blood Pressure, Intracranial Pressure, Microcirculation, and Cerebral Oxygenation / R. Steinmeier [et al] // Stroke. - 1996. - Vol. 27. - P. 2236-2243.
98. Strandgaard, S. Upper limit of autoregulation of cerebral blood flow in the baboon / S. Strandgaard [et al] // Circ. Res. - 1974. - Vol. 34. - P. 435-440.
99. Strebel, S. Dynamic and static cerebral autoregulation during isoflurane, desflurane, and propofol anesthesia / S. Strebel [et al] // Anesthesiology. - 1995. - Vol. 83 (1). - P. 66-76.
100. Symon, L. A study of regional autoregulation in the cerebral circulation to increased perfusion pressure in normocapnia and hypercapnia / L. Symon [et al] // Stroke. - 1973. - Vol. 4. - P. 139-147.
101. Tiecks, F. Comparison of static and dynamic cerebral autoregulation measurements / F. Tiecks [et al] // Stroke. - 1995. - Vol. 26. - P. 1014-1019.
102. Tiecks, F. Effects of the Valsalva maneuver on cerebral circulation in healthy adults. A transcranial Doppler Study / B. Tiecks [et al] // Stroke - 1995. - Vol. 26. - P. 13861392.
103. Tsai, S. Retrograde localization of the innervation of the middle cerebral artery with horseradish peroxidase in cats / S. Tsai [et al] // Neurosurgery. - 1985. - Vol. 16. - P. 463-467.
104. Voldby, B. Cerebrovascular reactivity in patients with ruptured intracranial aneurysms / B. Voldby, E. Enevoldsen, F. Jensen // J. Neurosurg. - 1985. - Vol. 62 - P 59-64.
105. Zhang, R. Transfer function analysis of dynamic cerebral autoregulation in humans / R. Zhang [et al] // Am. J. Physiol. - 1998 - Vol. 274. - P. H233-H241.
106. Zunker, P. Detection ofcentral and peripheral B- and M-waves with transcranial and laser Doppler-sonography / P. Zunker [et al] // Klingelhofer J, Bartels E and Ringelstein EB (eds): New Trends in Cerebral Hemodynamics and Neurosonology. - Amsterdam: The Netherlands, Elsevier, 1997. - P. 718-722.
Review
For citations:
Semenyutin V.B., Aliev V.A. Modern methods of cerebral autoregulation assessment. Regional blood circulation and microcirculation. 2011;10(4):13-27. (In Russ.) https://doi.org/10.24884/1682-6655-2011-10-4-13-27
Views:
348
Email this article 
