The Relationship between Cerebral Blood Flow Velocity Fluctuations and Sleep State in Normal Newborns

Ferrarri, F; Kelsall, AW; Rennie, Janet M.; Evans, David H.

doi:10.1203/00006450-199401000-00012

Cited by 33 publications

(26 citation statements)

References 14 publications

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“…The similar mean CBFV in quiet and REM sleep has been reported previously [2,8], but the greater amplitude of variability in REM as compared with QS observed in the present study is of interest. REM sleep constitutes the majority of the ultradian sleep cycle of the neonate [17], With increasing maturation, the duration of REM periods shorten, and there is a decline in the amount of REM sleep [18,19], Contrary to our findings in preterm in fants, a significantly greater amplitude of CV in CBFV in QS as compared with REM sleep has been reported in healthy term infants recently [20], As observed in our study, these authors also found that the mean CBFV was similar in the two sleep states. The different findings are most likely related to differences in methodology and in mean gestational age in the two study populations (32 vs 38.5 weeks).…”

Section: Discussioncontrasting

confidence: 56%

Influence of Sleep State and Respiratory Pattern on Cyclical Fluctuations of Cerebral Blood Flow Velocity in Healthy Preterm Infants

Rehan

Fajardo²,

Haider³

et al. 1996

Neonatology

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To examine the influence of sleep state, respiratory pattern, and ventilation on cyclical fluctuations (CF) in cerebral blood flow (CBF) velocity (CBFV), we studied 21 ‘healthy’ preterm infants: birth weight 1,790 ± 162 g (SEM), study weight 1,960 ± 165 g, gestational age 32 ± 1 weeks, postnatal age 20 ± 4 (range 8–57) days. The CBFV was measured using on-line pulsed Doppler ultrasound by insonating the middle cerebral artery. Breathing was measured using a flow through system. The sleep state was monitored according to conventional criteria. Three hundred and seventy-five epochs of 1 min each were analyzed; 207 during quiet sleep (QS) and 168 during rapid eye movement (REM) sleep. CFs in CBFV were detected in all babies. The frequency of CF ranged from 0.5 to 6 cycles/min. The proportion of epochs showing CF was similar during both sleep states (56% QS vs. 59% REM; p = NS). Although the mean CBFV (cm/s) was similar in these two sleep states, the mean coefficient of variation, a measure of CF amplitude, was significantly higher during REM as compared with QS (6 ± 0.5 vs. 4.3 ± 0.2%; p < 0.05). Similarly, the mean CBFVs were similar with various respiratory patterns, but the coefficient of variation was significantly higher in periodic and apneic patterns as compared with regular and irregular respiratory patterns (5.6 ± 0.6% periodic, 5.6 ± 0.3% apneic, 3.6 ± 0.3% regular, and 4.1 ± 0.5% irregular; p < 0.05). The amplitude of CF was associated with the variability of the heart rate (p < 0.05), but not with the variability of the respiratory measurements. These findings suggest: (1) REM sleep is associated with a greater CBF variability than QS, and (2) periodic and apneic breathing are associated with a greater CBF variability than regular or irregular breathing. We speculate that sleep state and respiratory pattern do not determine but modulate the CBF. Our data suggest that in studies involving interpretation of CBFV data using the Doppler technique, breathing patterns should be taken into account in addition to sleep state.

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Section: Discussioncontrasting

confidence: 56%

Influence of Sleep State and Respiratory Pattern on Cyclical Fluctuations of Cerebral Blood Flow Velocity in Healthy Preterm Infants

Rehan

Fajardo²,

Haider³

et al. 1996

Neonatology

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“…However no difference in the median cerebral BFV was observed in different sleep states. 28 Several investigations of the renal BFV and RI in children, including a small group of infants during the first year of life, have been performed in cross-sectional studies. 7,[15][16][17] We showed a steady increase of the renal BFV in the same group of healthy infants during the first months of life.…”

Section: -14mentioning

confidence: 99%

Developmental Changes in Cerebral and Visceral Blood Flow Velocity in Healthy Neonates and Infants

Ilves

Lintrop

Talvik

et al. 2008

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to evaluate the changes in Doppler blood flow velocity (BFV) in cerebral and visceral arteries during infancy. Methods. The BFV was measured in 37 healthy term neonates in the anterior cerebral artery (ACA), middle cerebral artery (MCA), basilar artery, internal carotid artery (ICA), celiac artery (CA), superior mesenteric artery (SMA), and renal artery (RA). Results. The mean BFV increased and the resistive index decreased (P < .05) in all cerebral arteries, SMA, and CA by the age of 12 to 23.9 hours and in the RA by the age of 24 to 35.9 hours compared with 2 to 11.9 hours. A further significant increase (P < .05) of the mean BFV occurred in all arteries except the ICA and CA by the age of 72 to 120 hours compared with 12 to 23.9 hours. By the age of 21 to 59 days, the mean BVF doubled in all investigated arteries compared with 2 to 11.9 hours, with a further significant increase (P < .05) by the age of 150 to 240 days in cerebral and renal arteries. There was no correlation between the mean blood pressure (BP) and mean BFV in the ACA and MCA. However, there was a positive correlation (r ≥ 0.5; P < .05) between the BP and BFV in the RA and SMA at the age of 12 to 23.9 hours. Conclusions. A significant increase in the cerebral and visceral BFV occurs normally throughout infancy, with the visceral BFV affected by BP changes during the first day of life. Key words: cerebral blood flow velocity; neonate; sonography; visceral blood flow velocity. oppler sonography is a noninvasive method that allows repeated and safe assessment of hemodynamics in neonatal units. Several studies have shown that a pulsed Doppler technique can be used to examine the pattern of blood flow velocity (BFV) in major vessels of the brain 1 as well as visceral organs 2 in neonates with good reproducibility. Several studies have followed the BFV in different cerebral 3-6 and visceral 7-11 arteries during cardiovascular adaptation of the neonate within the first week of life. These studies typically evaluated a single organ. A few cross-sectional studies have followed the changes of the cerebral BFV in neonates up to the first 20 days of life 12 and infants older than 30 days. 13,14 Cross-sectional studies of the BFV in renal arteries have also been performed in infants older than 30 days. 7,[15][16][17] To our knowledge there have been no studies looking at the normal preprandial splanchic BFV in infants older than 1 month.

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“…A wide range of methods have been developed to assess cerebral blood flow control, based on transcranial Doppler measurements of blood flow and recordings of blood pressure [24], but none has proven entirely satisfactory for routine clinical application in neonates. One reason for this difficulty is that cerebral blood flow control involves complex mechanisms, which are affected by many factors [4], [25]- [27]. The current work further demonstrates that spontaneous EEG activity is significantly correlated with CBFV, and this may need to be considered in mathematical models of blood flow control.…”

Section: Discussionmentioning

confidence: 81%

“…Blood flow to the brain changes, for example, with sleep [3], [4], during epileptic seizures [5], [6], and with sensory stimulation [7]. In previous work [8], we investigated the correlation between cerebral blood flow velocity (CBFV), as measured by transcranial Doppler ultrasound, and spontaneous electroencephalogram (EEG) activity during quiet sleep in newborn babies [Tracé Alternant (TA) EEG pattern].…”

mentioning

confidence: 99%

Estimation of Coherence Between Blood Flow and Spontaneous EEG Activity in Neonates

Simpson

Rosas

Infantosi

2005

IEEE Trans. Biomed. Eng.

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Abstract-Blood flow to the brain responds to changes in neuronal activity and, thus, metabolic demand. In earlier work, we observed correlation between cerebral blood flow and spontaneous electroencephalogram (EEG) activity in neonates. Using coherence, we now found that during Tracé Alternant EEG activity in quiet sleep of normal term neonates, this correlation is strongest at frequencies around 0.1 Hz, reaching statistical significance (p 0 05) in six of the nine subjects studied (p 0 07 in eight subjects). Due to noise, artifact, and spontaneous changes in the subjects' EEG patterns, the signals investigated included epochs of missing samples. We, therefore, developed a novel algorithm for the estimation of coherence in such data and applied a Monte Carlo (surrogate data) method for its statistical analysis. This process provides a test for the statistical significance of the maximum coherence within a selected frequency band. In addition to permitting further insight into the mechanisms of cerebral blood flow control, these algorithms are potentially of great benefit in a wide range of biomedical applications, where interrupted (gapped) recordings are often a problem.

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The Relationship between Cerebral Blood Flow Velocity Fluctuations and Sleep State in Normal Newborns

Cited by 33 publications

References 14 publications

Influence of Sleep State and Respiratory Pattern on Cyclical Fluctuations of Cerebral Blood Flow Velocity in Healthy Preterm Infants

Influence of Sleep State and Respiratory Pattern on Cyclical Fluctuations of Cerebral Blood Flow Velocity in Healthy Preterm Infants

Developmental Changes in Cerebral and Visceral Blood Flow Velocity in Healthy Neonates and Infants

Estimation of Coherence Between Blood Flow and Spontaneous EEG Activity in Neonates

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