Dynamic cerebral autoregulation following acute ischaemic stroke: Comparison of transcranial Doppler and magnetic resonance imaging techniques.
journal contributionposted on 25.04.2018, 11:22 by Ronney B. Panerai, José L. Jara, Nazia P. Saeed, Mark A. Horsfield, Thompson G . Robinson
Novel MRI-based dynamic cerebral autoregulation (dCA) assessment enables the estimation of both global and spatially discriminated autoregulation index values. Before exploring this technique for the evaluation of focal dCA in acute ischaemic stroke (AIS) patients, it is necessary to compare global dCA estimates made using both TCD and MRI. Both techniques were used to study 11 AIS patients within 48 h of symptom onset, and nine healthy controls. dCA was assessed by the rate of return of CBFV (Rturn) following a sudden drop induced by the thigh cuff manoeuvre. No significant between-hemisphere differences were seen in controls using either the TCD or MRI technique. Inter-hemisphere averaged Rturn values were not different between TCD (1.89 ± 0.67%/s) and MRI (2.07 ± 0.60%/s) either. In patients, there were no differences between the affected and unaffected hemispheres whether assessed by TCD (Rturn 0.67 ± 0.72 vs. 0.98 ± 1.09%/s) or MRI (0.55 ± 1.51 vs. 1.63 ± 0.63%/s). Rturn for both TCD and MRI was impaired in AIS patients compared to controls in both unaffected and affected hemispheres (ANOVA, p = 0.00005). These findings pave the way for wider use of MRI for dCA assessment in health and disease.
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Stroke Association of the United Kingdom. NPS also received funding from the NIHR BRU for Cardiovascular Sciences. JLJ was partially funded by the University of Santiago de Chile and Becas Chile.
CitationJournal of Cerebral Blood Flow and Metabolism, 2016, 36 (12), pp. 2194-2202
Author affiliation/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences
VersionAM (Accepted Manuscript)
Published inJournal of Cerebral Blood Flow and Metabolism
PublisherSAGE Publications (UK and US) for International Society for Cerebral Blood Flow and Metabolism
Acute ischaemic strokecerebral autoregulationmagnetic resonance imagingthigh cufftranscranial Doppler ultrasoundAdultBlood Flow VelocityBlood PressureBrain IschemiaCase-Control StudiesCerebrovascular CirculationFemaleHomeostasisHumansMagnetic Resonance ImagingMaleMiddle AgedStrokeUltrasonography, Doppler, Transcranial