Reduced middle cerebral artery blood velocity (MCAv) and flow pulsatility are contributors to age-related cerebrovascular disease pathogenesis. It is unknown whether the rate of changes in MCAv and flow pulsatility support the hypothesis of sex specific trajectories with aging. Therefore, we sought to characterize the rate of changes in MCAv and flow pulsatility across the adult lifespan in females and males as well as within specified age ranges. Participant characteristics, mean arterial pressure, end-tidal carbon dioxide, unilateral MCAv and flow pulsatility index (PI) were determined from study records compiled from three institutional sites. 524 participants (18-90 years; 319 females; 205 males) were included in the analysis. MCAv was significantly higher in females within the 2nd (p <0.001), 5th (p = 0.01), and 6th (p <0.01) decades of life. Flow PI was significantly higher in females within the 2nd decade of life (p <0.01). Rate of MCAv decline was significantly greater in females than males (-0.39 vs. -0.26 cm s-1·yr, p = 0.04). Rate of flow PI rise was significantly greater in females than males (0.006 vs. 0.003 flow PI, p = 0.01). Rate of MCAv change was significantly greater in females than males in the 6th decade of life (-1.44 vs. 0.13 cm s-1·yr), p = 0.04). These findings indicate that sex significantly contributes to age-related differences in both MCAv and flow PI. Therefore, further investigation into cerebrovascular function within and between sexes is warranted to improve our understanding of the reported sex differences in cerebrovascular disease prevalence.

Despite its necessity for understanding healthy brain aging, the influence of exercise intensity on cerebrovascular kinetics is currently unknown. We, therefore characterized middle cerebral artery blood flow velocity (MCAv) kinetics associated with two exercise intensities: low and moderate. We hypothesized that increasing exercise intensity would increase the MCAv amplitude response (Amp) and that age and estimated fitness (VȮ2max) would be related to Amp. Baseline (BL) values were collected for 90-seconds followed by a 6-minute exercise bout. Heart rate, end-tidal CO 2 , mean arterial pressure and MCAv were recorded throughout. MCAv kinetics were described by Amp, time delay (TD) and time constant (τ). Sixty-four adults completed the study. Amp was greater during moderate compared to low exercise intensity (p<0.001) while no difference was observed in either TD (p=0.65) or τ (p=0.47). Amp was negatively associated with age (p<0.01) and positively correlated with estimated VȮ2max (p<0.01). Although Amp declines with age, maintaining higher VȮ2max may benefit the cerebrovascular response to exercise.

Introduction: High intensity interval exercise (HIIT) is performed widely. However, there is a gap in knowledge regarding the acute cerebrovascular response to low-volume HIIT. Our objective was to characterize the middle cerebral artery blood velocity (MCAv) response during an acute bout of low-volume HIIT in young healthy adults. We hypothesized MCAv would decrease below baseline (BL) 1) during HIIT, 2) immediately following HIIT, 3) and 30-minutes after HIIT. As a secondary objective, we investigated sex differences in the MCAv response during HIIT. Methods: Twenty-four young healthy adults completed HIIT (12 male, age 25 (SD 2)). HIIT included 10-minutes of 1-minute high intensity (~70% estimated maximal watts) and active recovery (10% estimated maximal watts) intervals on a recumbent stepper. MCAv, mean arterial pressure (MAP), heart rate (HR), and end tidal carbon dioxide (PETCO2), were recorded at BL, during HIIT, immediately following HIIT, and 30-minutes after HIIT. Results: Contrary to our hypothesis, MCAv remained above BL during HIIT. MCAv peaked at minute 3 then decreased concomitantly with PETCO2. MCAv was lower than BL immediately following HIIT (p < 0.001). Thirty-minutes after HIIT, MCAv returned to BL (p = 0.47). Compared to men, women had a higher MCAv at BL (p = 0.001), during HIIT (p = 0.009), immediately following HIIT (p = 0.004) and 30-minutes after HIIT (p = 0.001). Conclusions: MCAv did not decrease below BL during low-volume HIIT. However, MCAv decreased below BL immediately following HIIT and returned to resting values 30-minutes after HIIT. MCAv also differed between sex.

Background and Purpose. This study investigated the cardiopulmonary response and safety of exercise testing at peak effort in people during the chronic stage of stroke recovery. Methods. This retrospective study examined data from 62 individuals with chronic stroke (males: 32; mean (SD); age: (12.0) yr) participating in an exercise test. Results. Both males and females had low cardiorespiratory fitness levels. No significant differences were found between gender for peak HR (P = 0.27), or VO2 peak (P = 0.29). Males demonstrated higher values for minute ventilation, tidal volume, and respiratory exchange ratio. No major adverse events were observed in the exercise tests conducted. Discussion and Conclusion. There are differences between gender that may play a role in exercise testing performance and should be considered when developing exercise programs. The low VO2 peak of this cohort of chronic stroke survivors suggests the need for participation in exercise interventions.

Background The primary aim of this study was to characterize the middle cerebral artery blood velocity (MCAv) dynamic response to an acute bout of exercise in humans at 3‐ and 6‐months poststroke. As a secondary objective, we grouped individuals according to the MCAv dynamic response to the exercise bout as responder or nonresponder. We tested whether physical activity, aerobic fitness, and exercise mean arterial blood pressure differed between groups. Methods and Results Transcranial Doppler ultrasound measured MCAv during a 90‐second baseline followed by a 6‐minute moderate intensity exercise bout. Heart rate, mean arterial blood pressure, and end‐tidal CO 2 were additional variables of interest. The MCAv dynamic response variables included the following: baseline, time delay, amplitude, and time constant. Linear mixed model revealed no significant differences in our selected outcomes between 3‐ and 6‐months poststroke. Individuals characterized as responders demonstrated a faster time delay, higher amplitude, and reported higher levels of physical activity and aerobic fitness when compared with the nonresponders. No between‐group differences were identified for baseline, time constant, or exercise mean arterial blood pressure. In the nonresponders, we observed an immediate rise in MCAv following exercise onset followed by an immediate decline to near baseline values, while the responders showed an exponential rise until steady state was reached. Conclusions The MCAv dynamic response profile has the potential to provide valuable information during an acute exercise bout following stroke. Individuals with a greater MCAv response to the exercise stimulus reported statin use and regular participation in exercise.