Incorrect Performance of the Breath Hold Method in the Old Underestimates Cerebrovascular Reactivity and Goes Unnoticed Without Concomitant Blood Pressure and End-Tidal CO2 Registration

Beek, Arenda H.E.A. van; Wit, H.M. de; Rikkert, Marcel G M Olde; Claassen, Jurgen A.H.R.

doi:10.1111/j.1552-6569.2010.00517.x

Cited by 13 publications

(20 citation statements)

References 35 publications

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“…Oxygenation of the frontal cortex was measured using the validated technique of NIRS (Smielewski et al 1995;Brady et al 2007). Changes in the concentration of oxygenated and deoxygenated haemoglobin (O 2 Hb and HHb, respectively) in the cerebral cortex were measured (Mehagnoul-Schipper et al 2000;van Beek et al 2012). The basic principle of NIRS is that near-infrared light penetrates the skull and brain and is absorbed by the chromophores O 2 Hb and HHb, which have different absorption spectra.…”

Section: Instrumentationmentioning

confidence: 99%

“…This data segmentation is based on a trade-off between a reduction in spectral variance and keeping sufficient spectral resolution. Each Hanning-windowed segment was fast Fourier transformed and the periodograms were averaged to calculate the autospectrum of MAP, CBFV and O 2 Hb (Zhang et al 1998;van Beek et al 2012). The spectral power of oscillations was calculated as the area under the curve of the power spectrum density plots.…”

Section: Data Processingmentioning

confidence: 99%

“…Unfortunately, most studies investigated either the dynamic cerebral autoregulation (Narayanan et al 2001;Sorond et al 2005;Claassen et al 2009;van Beek et al 2010a) or the cerebrovascular CO 2 reactivity (Ringelstein et al 1988;Bakker et al 2004;Claassen et al 2007;Dineen et al 2011;van Beek et al 2011), but the studies did not examine both aspects of the cerebrovascular system simultaneously.…”

Section: Introductionmentioning

confidence: 99%

“…The addition of near-infrared spectroscopy (NIRS) can be used to measure concentrations of oxygenated and deoxygenated haemoglobin and provide estimates of cortical brain tissue oxygenation (Reinhard et al 2006). Thus, by using Finapres and transcranial Doppler sonography concomitantly with near-infrared spectroscopy, it is possible to determine two different but dependent dynamic relationships, namely the relationship between blood pressure and cerebral blood flow on the one hand and the relationship between cerebral blood flow and cerebral cortical oxygenation on the other (van Beek et al 2010b(van Beek et al , 2012.…”

Section: Introductionmentioning

confidence: 99%

“…Dynamic cerebral autoregulation and cerebrovascular CO 2 reactivity are both directly related to the oxygenation of the brain tissue and therefore to human brain function (van Beek et al 2010b(van Beek et al , 2012. The majority of studies of dynamic cerebral autoregulation and cerebrovascular CO 2 reactivity have used transcranial Doppler ultrasound (TCD) to obtain continuous measurements of cerebral blood flow velocity (CBFV), together with continuous blood pressure measurements (Finapres).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of dynamic cerebral autoregulation and cerebrovascular CO₂ reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation

Oudegeest-Sander

Beek

Abbink

et al. 2014

Experimental Physiology

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New Findings r What is the central question in this study?It is unknown to what extent increasing age influences the dynamic adaptations of cerebral blood flow velocity and cortical oxygenation in response to changes in blood pressure (cerebral autoregulation) and to changes in carbon dioxide (cerebrovascular CO 2 reactivity). r What is the main finding and its importance?We have shown that ageing up to 86 years is associated with an overall preservation of dynamic cerebral autoregulation and cerebrovascular CO 2 reactivity, leading to a sufficiency of cerebral cortical oxygenation during daily life activities, despite the decrease in absolute cerebral blood flow velocity and increase in cerebrovascular resistance with advancing age.With ageing, cerebral blood flow velocity (CBFV) decreases; however, to what extent dynamic cerebral autoregulation and cerebrovascular CO 2 reactivity are influenced by ageing is unknown. The aim was to examine the dynamic responses of CBFV and cortical oxygenation to changes in blood pressure (BP) and arterial CO 2 across different ages. Fifty-eight participants in three age groups were included, as follows: young (n = 20, 24 ± 2 years old), elderly (n = 20, 66 ± 1 years old), and older elderly (n = 18, 78 ± 3 years old). The CBFV was measured using transcranial Doppler ultrasound, simultaneously with oxyhaemoglobin (O 2 Hb) using near-infrared spectroscopy and beat-to-beat BP measurements using Finapres. Postural manoeuvres were performed to induce haemodynamic fluctuations. Cerebrovascular CO 2 reactivity was tested with hyperventilation and CO 2 inhalation. With age, CBFV decreased (young 59 ± 12 cm s −1 , elderly 48 ± 7 cm s −1 and older elderly 42 ± 9 cm s −1 , P < 0.05) and cerebrovascular resistance increased (1.46 ± 0.58, 1.81 ± 0.36 and 1.98 ± 0.52 mmHg cm −1 s −1 , respectively, P < 0.05). Normalized gain (autoregulatory damping) increased with age for BP-CBFV (0.88 ± 0.18, 1.31 ± 0.30 and 1.06 ± 0.34, respectively, P < 0.05) and CBFV-O 2 Hb (0.10 ± 0.09, 0.12 ± 0.04 and 0.17 ± 0.08, respectively, P < 0.05) during the repeated sit-stand manoeuvre at 0.05 Hz. Even though the absolute changes in CBFV and cerebrovascular resistance index during the cerebrovascular CO 2 reactivity were higher in the young group, the percentage changes in CBFV, cerebrovascular resistance index and O 2 Hb were similar in all age groups. In conclusion, there was no decline in dynamic cerebral autoregulation and cerebrovascular CO 2 reactivity with increasing age up to 86 years. Despite the decrease in cerebral blood flow * M. H. Oudegeest-Sander and A. H. E. A. van Beek contributed equally to this work.

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Section: Instrumentationmentioning

confidence: 99%

Section: Data Processingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Assessment of dynamic cerebral autoregulation and cerebrovascular CO₂ reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation

Oudegeest-Sander

Beek

Abbink

et al. 2014

Experimental Physiology

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Fine tuning breath‐hold‐based cerebrovascular reactivity analysis models

et al. 2016

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IntroductionWe elaborate on existing analysis methods for breath‐hold (BH)‐derived cerebrovascular reactivity (CVR) measurements and describe novel insights and models toward more exact CVR interpretation.MethodsFive blood‐oxygen‐level‐dependent (BOLD) fMRI datasets of neurovascular patients with unilateral hemispheric hemodynamic impairment were used to test various BH CVR analysis methods. Temporal lag (phase), percent BOLD signal change (CVR), and explained variance (coherence) maps were calculated using three different sine models and two novel “Optimal Signal” model‐free methods based on the unaffected hemisphere and the sagittal sinus fMRI signal time series, respectively.ResultsAll models showed significant differences in CVR and coherence between the affected—hemodynamic impaired—and unaffected hemisphere. Voxel‐wise phase determination significantly increases CVR (0.60 ± 0.18 vs. 0.82 ± 0.27; P < 0.05). Incorporating different durations of breath hold and resting period in one sine model (two‐task) did increase coherence in the unaffected hemisphere, as well as eliminating negative phase commonly obtained by one‐task frequency models. The novel model‐free “optimal signal” methods both explained the BOLD MR data similar to the two task sine model.ConclusionsOur CVR analysis demonstrates an improved CVR and coherence after implementation of voxel‐wise phase and frequency adjustment. The novel “optimal signal” methods provide a robust and feasible alternative to the sine models, as both are model‐free and independent of compliance. Here, the sagittal sinus model may be advantageous, as it is independent of hemispheric CVR impairment.

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Effects of Thoracic Pressure Changes on MRI Signals in the Brain

Bandettini

Harper

et al. 2015

J Cereb Blood Flow Metab

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Cerebrovascular stressors, such as breath holding or CO2 inhalation, cause global magnetic resonance imaging (MRI) signal changes. In this study, we show that intrathoracic pressure changes cause rapid MRI signal alterations that have similar spatial patterns to the changes associated with breath holding or CO2 inhalation. Nine subjects performed the Valsalva maneuver during functional MRI data collection. Expiratory pressures ranged from 10 to 40 mm Hg. Breath holds ending on either inhalation or exhalation were also collected. The maximal and minimal functional MRI (fMRI) signal scaled with thoracic pressure load, and the overall amplitude of responses to the Valsalva varied, depending on brain tissue. Additionally, a Valsalva effort as short as 5 seconds yielded signal changes similar in spatial distribution and magnitude to a 20-second breath hold, suggesting potential applications of the Valsalva maneuver for calibrated fMRI experiments.

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Incorrect Performance of the Breath Hold Method in the Old Underestimates Cerebrovascular Reactivity and Goes Unnoticed Without Concomitant Blood Pressure and End-Tidal CO2 Registration

Cited by 13 publications

References 35 publications

Assessment of dynamic cerebral autoregulation and cerebrovascular CO₂ reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation

Assessment of dynamic cerebral autoregulation and cerebrovascular CO₂ reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation

Fine tuning breath‐hold‐based cerebrovascular reactivity analysis models

Effects of Thoracic Pressure Changes on MRI Signals in the Brain

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Incorrect Performance of the Breath Hold Method in the Old Underestimates Cerebrovascular Reactivity and Goes Unnoticed Without Concomitant Blood Pressure and End-Tidal CO2 Registration

Cited by 13 publications

References 35 publications

Assessment of dynamic cerebral autoregulation and cerebrovascular CO2 reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation

Assessment of dynamic cerebral autoregulation and cerebrovascular CO2 reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation

Fine tuning breath‐hold‐based cerebrovascular reactivity analysis models

Effects of Thoracic Pressure Changes on MRI Signals in the Brain

Contact Info

Product

Resources

About

Assessment of dynamic cerebral autoregulation and cerebrovascular CO₂ reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation

Assessment of dynamic cerebral autoregulation and cerebrovascular CO₂ reactivity in ageing by measurements of cerebral blood flow and cortical oxygenation