Middle Cerebral Artery Blood Flow Velocity in Healthy Persons During Wakefulness and Sleep: A Transcranial Doppler Study

Dw, Droste; Berger, W.; Schüler, Elke; Jk, Krauss

doi:10.1093/sleep/16.7.603

Cited by 23 publications

(11 citation statements)

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“…The association of BWEs with B-waves in patients with NPH who were not improving after shunting has been demonstrated 65 , 66 . Moreover, rhythmic oscillations of ICP associated with fluctuations in the TCD signal have been detected during sleep, and their variations in accordance with the sleep stage have been demonstrated 66 . Specifically, there is an increase of BWEs during the REM phase.…”

Section: Discussionmentioning

confidence: 98%

“…65,66 Moreover, rhythmic oscillations of ICP associated with fluctuations in the TCD signal have been detected during sleep, and their variations in accordance with the sleep stage have been demonstrated. 66 Specifically, there is an increase of BWEs during the REM phase. In our study, even though we performed a nocturnal monitoring and observed changes of the measured parameters in the presence of B-waves, we could not specify in which sleep stage they were occurring and we could not prove if their appearance was related to a specific sleep stage.…”

Section: Noninvasive Optical Techniques To Study Pathological Alterat...mentioning

confidence: 89%

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Transcranial optical monitoring for detecting intracranial pressure alterations in children with benign external hydrocephalus: a proof-of-concept study

et al. 2022

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Significance: Benign external hydrocephalus (BEH) is considered a self-limiting pathology with a good prognosis. However, some children present a pathological intracranial pressure (ICP) characterized by quantitative and qualitative alterations (the so-called B-waves) that can lead to neurological sequelae.Aim: Our purpose was to evaluate whether there were cerebral hemodynamic changes associated with ICP B-waves that could be evaluated with noninvasive neuromonitoring.Approach: We recruited eleven patients (median age 16 months, range 7 to 55 months) with BEH and an unfavorable evolution requiring ICP monitoring. Bedside, nocturnal monitoring using near-infrared time-resolved and diffuse correlation spectroscopies synchronized to the clinical monitoring was performed.Results: By focusing on the timing of different ICP patterns that were identified manually by clinicians, we detected significant tissue oxygen saturation (StO 2 ) changes (p ¼ 0.002) and blood flow index (BFI) variability (p ¼ 0.005) between regular and high-amplitude B-wave patterns. A blinded analysis looking for analogs of ICP patterns in BFI time traces achieved 90% sensitivity in identifying B-waves and 76% specificity in detecting the regular patterns. Conclusions:We revealed the presence of StO 2 and BFI variations-detectable with optical techniques-during ICP B-waves in BEH children. Finally, the feasibility of detecting ICP B-waves in hemodynamic time traces obtained noninvasively was shown.

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Section: Discussionmentioning

confidence: 98%

Section: Noninvasive Optical Techniques To Study Pathological Alterat...mentioning

confidence: 89%

Transcranial optical monitoring for detecting intracranial pressure alterations in children with benign external hydrocephalus: a proof-of-concept study

et al. 2022

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“…Cerebral Blood Flow CBF in the rat is increased in the active nocturnal phase of the cycle 138,139 and significantly lower in the rest phase in awake animals although its dependence on activity versus endogenous rhythms is less clear. In humans, limited studies demonstrate a similar pattern of reduced blood flow and blood flow velocity during the night (Figure 1), 140,141 with a ≈20% reduction at its nadir from its peak, similar to changes in blood pressure. CBF is more reduced in patients with obstructive sleep apnea 142 and rises during rapid eye movement sleep, 143,144 indicative of the importance of diurnal arousal versus endogenous circadian rhythms.…”

Section: Circadian and Diurnal Rhythms In Cerebrovascular Functionmentioning

confidence: 71%

Circadian and Diurnal Regulation of Cerebral Blood Flow

Webb,

Klerman,

Mandeville

2024

Circulation Research

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Circadian and diurnal variation in cerebral blood flow directly contributes to the diurnal variation in the risk of stroke, either through factors that trigger stroke or due to impaired compensatory mechanisms. Cerebral blood flow results from the integration of systemic hemodynamics, including heart rate, cardiac output, and blood pressure, with cerebrovascular regulatory mechanisms, including cerebrovascular reactivity, autoregulation, and neurovascular coupling. We review the evidence for the circadian and diurnal variation in each of these mechanisms and their integration, from the detailed evidence for mechanisms underlying the nocturnal nadir and morning surge in blood pressure to identifying limited available evidence for circadian and diurnal variation in cerebrovascular compensatory mechanisms. We, thus, identify key systemic hemodynamic factors related to the diurnal variation in the risk of stroke but particularly identify the need for further research focused on cerebrovascular regulatory mechanisms.

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“…CBF and CBF velocity peak in the active phase (Figure 3), that is, in humans at around midday, and are reduced during rest, that is, in humans at night. 151 Of note, the regulation of CBF velocity shows a similar daily rhythm in patients with acute stroke compared with healthy subjects. 152 Although strongly dependent on activity, the 24-hour rhythm of CBF persists under a constant routine protocol suggesting an endogenous circadian regulation.…”

Section: Cerebral Blood Flowmentioning

confidence: 97%

“…250 Although the underlying biology has not been fully identified, one potential explanation is the diurnal rhythm of CBF, which has its lowest point around midnight, both in healthy individuals and patients with stroke. 151,152 Stronger CBF after endovascular treatment in the morning might lead to improved reperfusion and thus better clinical outcomes compared with patients that are treated in the evening hours, which are followed by a trough of CBF and thus potentially lower reperfusion. Further, the diurnal variability of CBF might explain differences in initial infarct progression before endovascular treatment: those with evening or night onset have highest infarct progression, coinciding with lowest CBF.…”

Section: Circadian Regulation Of Neurovascular Disease Outcomesmentioning

confidence: 99%

Circadian Biology and the Neurovascular Unit

Li,

Tiedt,

Lawrence

et al. 2024

Circulation Research

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Mammalian physiology and cellular function are subject to significant oscillations over the course of every 24-hour day. It is likely that these daily rhythms will affect function as well as mechanisms of disease in the central nervous system. In this review, we attempt to survey and synthesize emerging studies that investigate how circadian biology may influence the neurovascular unit. We examine how circadian clocks may operate in neural, glial, and vascular compartments, review how circadian mechanisms regulate cell-cell signaling, assess interactions with aging and vascular comorbidities, and finally ask whether and how circadian effects and disruptions in rhythms may influence the risk and progression of pathophysiology in cerebrovascular disease. Overcoming identified challenges and leveraging opportunities for future research might support the development of novel circadian-based treatments for stroke.

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Middle Cerebral Artery Blood Flow Velocity in Healthy Persons During Wakefulness and Sleep: A Transcranial Doppler Study

Cited by 23 publications

References 0 publications

Transcranial optical monitoring for detecting intracranial pressure alterations in children with benign external hydrocephalus: a proof-of-concept study

Transcranial optical monitoring for detecting intracranial pressure alterations in children with benign external hydrocephalus: a proof-of-concept study

Circadian and Diurnal Regulation of Cerebral Blood Flow

Circadian Biology and the Neurovascular Unit

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