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Yi Yang - One of the best experts on this subject based on the ideXlab platform.
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Venous sinus stenting improves cerebral Autoregulation in a patient with venous sinus stenosis: a case report
BMC Neurology, 2020Co-Authors: Meiyan Jia, Zhen-ni Guo, Hang Jin, Xin Sun, Xiu-li Yan, Mingchao Shi, Yi YangAbstract:Venous sinus stenosis (VSS) is a type of cerebral venous vascular disease. Cerebral Autoregulation is an indicator of cerebral arterial function. The cerebral circulatory system is composed of the venous system and arterial system. Impaired venous function may affect arterial function. Thus, cerebral venous stenosis may influence cerebral Autoregulation. In this case, a 50-year-old woman with transient blindness and headache was admitted to the hospital. The patient was diagnosed with VSS. A stent was placed at the stenosis. The stent released the intravenous pressure and remitted the patient’s symptoms. Measurements of dynamic cerebral Autoregulation (dCA) were performed at 3 time points: before stenting, after stenting, and 3 months later. The dCA gradually improved after stenting. VSS may have an influence on cerebral Autoregulation, and effective treatment improves cerebral Autoregulation in patients with VSS.
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Temporal Course of Cerebral Autoregulation in Patients With Narcolepsy Type 1: Two Case Reports.
Frontiers in Neurology, 2019Co-Authors: Zhen-ni Guo, Yingkai Zhao, Xin Sun, Zan Wang, Xiu-li Yan, Ran Zhang, Yi YangAbstract:Cerebral Autoregulation is the mechanism of maintaining constant cerebral blood flow despite the changes in arterial blood pressure. In the present two cases, cerebral Autoregulation was impaired in patients with narcolepsy type 1, and both venlafaxine and fluoxetine may have the potential function to improve the impaired cerebral Autoregulation. A relationship may exist between impaired cerebral Autoregulation and neurological symptoms in patients with narcolepsy type 1.
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Temporal Course of Cerebral Autoregulation in Patients With Narcolepsy Type 1: Two Case Reports
Frontiers Media S.A., 2019Co-Authors: Zhen-ni Guo, Yingkai Zhao, Xin Sun, Yi Yang, Zan Wang, Xiu-li Yan, Ran ZhangAbstract:Cerebral Autoregulation is the mechanism by which constant cerebral blood flow is maintained despite changes in arterial blood pressure. In the two presented cases, cerebral Autoregulation was impaired in patients with narcolepsy type 1, and both venlafaxine and fluoxetine may have the potential to improve the impaired cerebral Autoregulation. A relationship may exist between impaired cerebral Autoregulation and neurological symptoms in patients with narcolepsy type 1
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Antioxidant Melatonin: Potential Functions in Improving Cerebral Autoregulation After Subarachnoid Hemorrhage
Frontiers in Physiology, 2018Co-Authors: Zhen-ni Guo, Hang Jin, Huijie Sun, Yingkai Zhao, Jia Liu, Xin Sun, Yi YangAbstract:Subarachnoid hemorrhage (SAH) is a subtype of stroke with high mortality and morbidity. Impaired cerebral Autoregulation following SAH has been reported owing to effects on sympathetic control, endothelial function, myogenic response, and cerebral metabolism. Impaired cerebral Autoregulation is associated with early brain injury, cerebral vasospasm/delayed cerebral ischemia, and SAH prognosis. However, few drugs have been reported to improve cerebral Autoregulation after SAH. Melatonin is a powerful antioxidant that is effective (easily crosses the blood brain barrier) and safe (tolerated in large doses without toxicity). Theoretically, melatonin may impact the control mechanisms of cerebral Autoregulation via antioxidative effects, protection of endothelial cell integrity, suppression of sympathetic nerve activity, increase in nitric oxide bioavailability, mediation of the myogenic response, and amelioration of hypoxemia. Furthermore, melatonin may have a comprehensive effect on cerebral Autoregulation. This review discusses the potential effects of melatonin on cerebral Autoregulation following SAH, in terms of the association between pharmacological activities and the mechanisms of cerebral Autoregulation.
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The Role of Nitric Oxide and Sympathetic Control in Cerebral Autoregulation in the Setting of Subarachnoid Hemorrhage and Traumatic Brain Injury
Molecular Neurobiology, 2015Co-Authors: Zhen-ni Guo, Jia Liu, Anwen Shao, Lu-sha Tong, Weiyi Sun, Yi YangAbstract:Cerebral Autoregulation is defined as the mechanism by which constant cerebral blood flow is maintained despite changes of arterial blood pressure, and arterial blood pressure represents the principle aspect of cerebral Autoregulation. The impairment of cerebral Autoregulation is reported to be involved in several diseases. However, the concept, mechanisms, and pathological dysfunction of cerebral Autoregulation are beyond full comprehension. Nitric oxide control and sympathetic control are main contributors to cerebral Autoregulation. Although impaired cerebral Autoregulation after nitric oxide inhibition or sympathetic ganglia blockade is reported, managing the inhibition or blockade can have negative consequences and needs further exploration. Additionally, impaired cerebral Autoregulation following subarachnoid hemorrhage and traumatic brain injury has been proven by several descriptive studies, although without corresponding explanations. As the most important mechanisms of cerebral Autoregulation, the changes of nitric oxide and sympathetic stimulation play significant roles in these insults. Therefore, the in-depth researches of nitric oxide and sympathetic nerve in cerebral Autoregulation may help to develop new therapeutic targets.
Ronney B. Panerai - One of the best experts on this subject based on the ideXlab platform.
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increased blood pressure variability upon standing up improves reproducibility of cerebral Autoregulation indices
Medical Engineering & Physics, 2017Co-Authors: Adam Mahdi, Ronney B. Panerai, Dragana Nikolic, Anthony A Birch, Mette S Olufsen, David M Simpson, Stephen J PayneAbstract:Abstract Dynamic cerebral Autoregulation, that is the transient response of cerebral blood flow to changes in arterial blood pressure, is currently assessed using a variety of different time series methods and data collection protocols. In the continuing absence of a gold standard for the study of cerebral Autoregulation it is unclear to what extent does the assessment depend on the choice of a computational method and protocol. We use continuous measurements of blood pressure and cerebral blood flow velocity in the middle cerebral artery from the cohorts of 18 normotensive subjects performing sit-to-stand manoeuvre. We estimate cerebral Autoregulation using a wide variety of black-box approaches (including the following six Autoregulation indices ARI, Mx, Sx, Dx, FIR and ARX) and compare them in the context of reproducibility and variability. For all Autoregulation indices, considered here, the intra-class correlation was greater during the standing protocol, however, it was significantly greater (Fisher’s Z -test) for Mx ( p p p
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transfer function analysis of dynamic cerebral Autoregulation a white paper from the international cerebral Autoregulation research network
Journal of Cerebral Blood Flow and Metabolism, 2016Co-Authors: Jurgen A.h.r. Claassen, Aisha Meelvan Den S S Abeelen, D. M. Simpson, Ronney B. PaneraiAbstract:Cerebral Autoregulation is the intrinsic ability of the brain to maintain adequate cerebral perfusion in the presence of blood pressure changes. A large number of methods to assess the quality of cerebral Autoregulation have been proposed over the last 30 years. However, no single method has been universally accepted as a gold standard. Therefore, the choice of which method to employ to quantify cerebral Autoregulation remains a matter of personal choice. Nevertheless, given the concept that cerebral Autoregulation represents the dynamic relationship between blood pressure (stimulus or input) and cerebral blood flow (response or output), transfer function analysis became the most popular approach adopted in studies based on spontaneous fluctuations of blood pressure. Despite its sound theoretical background, the literature shows considerable variation in implementation of transfer function analysis in practice, which has limited comparisons between studies and hindered progress towards clinical application. Therefore, the purpose of the present white paper is to improve standardisation of parameters and settings adopted for application of transfer function analysis in studies of dynamic cerebral Autoregulation. The development of these recommendations was initiated by (but not confined to) the Cerebral Autoregulation Research Network
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Transfer function analysis of dynamic cerebral Autoregulation: A white paper from the International Cerebral Autoregulation Research Network.
Journal of Cerebral Blood Flow & Metabolism, 2016Co-Authors: Jurgen A.h.r. Claassen, Aisha Meelvan Den S S Abeelen, D. M. Simpson, Ronney B. PaneraiAbstract:Cerebral Autoregulation is the intrinsic ability of the brain to maintain adequate cerebral perfusion in the presence of blood pressure changes. A large number of methods to assess the quality of cerebral Autoregulation have been proposed over the last 30 years. However, no single method has been universally accepted as a gold standard. Therefore, the choice of which method to employ to quantify cerebral Autoregulation remains a matter of personal choice. Nevertheless, given the concept that cerebral Autoregulation represents the dynamic relationship between blood pressure (stimulus or input) and cerebral blood flow (response or output), transfer function analysis became the most popular approach adopted in studies based on spontaneous fluctuations of blood pressure. Despite its sound theoretical background, the literature shows considerable variation in implementation of transfer function analysis in practice, which has limited comparisons between studies and hindered progress towards clinical application. Therefore, the purpose of the present white paper is to improve standardisation of parameters and settings adopted for application of transfer function analysis in studies of dynamic cerebral Autoregulation. The development of these recommendations was initiated by (but not confined to) theCerebral Autoregulation Research Network(CARNet -www.car-net.org).
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Cerebral Autoregulation in pregnancies complicated by diabetes and overweight
Diabetes and Vascular Disease Research, 2015Co-Authors: Teelkien R. Van Veen, Ronney B. Panerai, Sina Haeri, Paul P. Van Den Berg, Gerda G. Zeeman, Michael A. BelfortAbstract:Aim: The aim of this study was to estimate the impact of diabetes and obesity on cerebral Autoregulation in pregnancy. Methods: Cerebral Autoregulation was evaluated in women with gestational diabetes, type 2 diabetes mellitus and/or overweight (body mass index ⩾ 25 kg m −2 ) and compared to a cohort of euglycaemic pregnant women. The Autoregulation index was calculated using simultaneously recorded cerebral blood flow velocity in the middle cerebral artery and blood pressure. Autoregulation index values of 0 and 9 indicate absent and perfect Autoregulation, respectively. Results: Autoregulation index in women with either diabetes (n = 33, 6.6 ± 1.1) or overweight (n = 21, 6.7 ± 0.6) was not significantly different to that in control patients (n = 23, 6.6 ± 0.8, p = 0.96). Conclusion: Cerebral Autoregulation is not impaired in pregnant women who have non-vasculopathic diabetes or overweight. This suggests that the increased risk of pre-eclampsia in diabetic and overweight women is not associated with early impaired cerebral Autoregulation.
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Cerebral Autoregulation in normal pregnancy and preeclampsia
Obstetrics & Gynecology, 2013Co-Authors: Teelkien R. Van Veen, Ronney B. Panerai, Sina Haeri, Gerda G. Zeeman, Michael A. Belfort, Annemiek C. GriffioenAbstract:OBJECTIVE: To test the hypothesis that preeclampsia is associated with impaired dynamic cerebral Autoregulation. METHODS: In a prospective cohort analysis, cerebral blood flow velocity of the middle cerebral artery (determined by transcranial Doppler), blood pressure (determined by noninvasive arterial volume clamping), and end-tidal carbon dioxide were simultaneously collected during a 7-minute period of rest. The Autoregulation index was calculated. Values of 0 and 9 indicated absent and perfect Autoregulation, respectively. Student t test was used, with P RESULTS: Women with preeclampsia (before treatment, n=20) and their normotensive counterparts (n=20) did not differ with respect to baseline characteristics, except for earlier gestational age at delivery (36 3/7 [24 4/7-40 2/7] compared with 39 2/7 [32 0/7-41 0/7]; P CONCLUSION: Women with preeclampsia have impaired dynamic cerebral Autoregulation. The fact that blood pressure does not correlate with Autoregulation functionality may explain why cerebral complications such as eclampsia can occur without sudden or excessive elevation in blood pressure.
Zhen-ni Guo - One of the best experts on this subject based on the ideXlab platform.
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Venous sinus stenting improves cerebral Autoregulation in a patient with venous sinus stenosis: a case report
BMC Neurology, 2020Co-Authors: Meiyan Jia, Zhen-ni Guo, Hang Jin, Xin Sun, Xiu-li Yan, Mingchao Shi, Yi YangAbstract:Venous sinus stenosis (VSS) is a type of cerebral venous vascular disease. Cerebral Autoregulation is an indicator of cerebral arterial function. The cerebral circulatory system is composed of the venous system and arterial system. Impaired venous function may affect arterial function. Thus, cerebral venous stenosis may influence cerebral Autoregulation. In this case, a 50-year-old woman with transient blindness and headache was admitted to the hospital. The patient was diagnosed with VSS. A stent was placed at the stenosis. The stent released the intravenous pressure and remitted the patient’s symptoms. Measurements of dynamic cerebral Autoregulation (dCA) were performed at 3 time points: before stenting, after stenting, and 3 months later. The dCA gradually improved after stenting. VSS may have an influence on cerebral Autoregulation, and effective treatment improves cerebral Autoregulation in patients with VSS.
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Temporal Course of Cerebral Autoregulation in Patients With Narcolepsy Type 1: Two Case Reports.
Frontiers in Neurology, 2019Co-Authors: Zhen-ni Guo, Yingkai Zhao, Xin Sun, Zan Wang, Xiu-li Yan, Ran Zhang, Yi YangAbstract:Cerebral Autoregulation is the mechanism of maintaining constant cerebral blood flow despite the changes in arterial blood pressure. In the present two cases, cerebral Autoregulation was impaired in patients with narcolepsy type 1, and both venlafaxine and fluoxetine may have the potential function to improve the impaired cerebral Autoregulation. A relationship may exist between impaired cerebral Autoregulation and neurological symptoms in patients with narcolepsy type 1.
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Temporal Course of Cerebral Autoregulation in Patients With Narcolepsy Type 1: Two Case Reports
Frontiers Media S.A., 2019Co-Authors: Zhen-ni Guo, Yingkai Zhao, Xin Sun, Yi Yang, Zan Wang, Xiu-li Yan, Ran ZhangAbstract:Cerebral Autoregulation is the mechanism by which constant cerebral blood flow is maintained despite changes in arterial blood pressure. In the two presented cases, cerebral Autoregulation was impaired in patients with narcolepsy type 1, and both venlafaxine and fluoxetine may have the potential to improve the impaired cerebral Autoregulation. A relationship may exist between impaired cerebral Autoregulation and neurological symptoms in patients with narcolepsy type 1
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Antioxidant Melatonin: Potential Functions in Improving Cerebral Autoregulation After Subarachnoid Hemorrhage
Frontiers in Physiology, 2018Co-Authors: Zhen-ni Guo, Hang Jin, Huijie Sun, Yingkai Zhao, Jia Liu, Xin Sun, Yi YangAbstract:Subarachnoid hemorrhage (SAH) is a subtype of stroke with high mortality and morbidity. Impaired cerebral Autoregulation following SAH has been reported owing to effects on sympathetic control, endothelial function, myogenic response, and cerebral metabolism. Impaired cerebral Autoregulation is associated with early brain injury, cerebral vasospasm/delayed cerebral ischemia, and SAH prognosis. However, few drugs have been reported to improve cerebral Autoregulation after SAH. Melatonin is a powerful antioxidant that is effective (easily crosses the blood brain barrier) and safe (tolerated in large doses without toxicity). Theoretically, melatonin may impact the control mechanisms of cerebral Autoregulation via antioxidative effects, protection of endothelial cell integrity, suppression of sympathetic nerve activity, increase in nitric oxide bioavailability, mediation of the myogenic response, and amelioration of hypoxemia. Furthermore, melatonin may have a comprehensive effect on cerebral Autoregulation. This review discusses the potential effects of melatonin on cerebral Autoregulation following SAH, in terms of the association between pharmacological activities and the mechanisms of cerebral Autoregulation.
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The Role of Nitric Oxide and Sympathetic Control in Cerebral Autoregulation in the Setting of Subarachnoid Hemorrhage and Traumatic Brain Injury
Molecular Neurobiology, 2015Co-Authors: Zhen-ni Guo, Jia Liu, Anwen Shao, Lu-sha Tong, Weiyi Sun, Yi YangAbstract:Cerebral Autoregulation is defined as the mechanism by which constant cerebral blood flow is maintained despite changes of arterial blood pressure, and arterial blood pressure represents the principle aspect of cerebral Autoregulation. The impairment of cerebral Autoregulation is reported to be involved in several diseases. However, the concept, mechanisms, and pathological dysfunction of cerebral Autoregulation are beyond full comprehension. Nitric oxide control and sympathetic control are main contributors to cerebral Autoregulation. Although impaired cerebral Autoregulation after nitric oxide inhibition or sympathetic ganglia blockade is reported, managing the inhibition or blockade can have negative consequences and needs further exploration. Additionally, impaired cerebral Autoregulation following subarachnoid hemorrhage and traumatic brain injury has been proven by several descriptive studies, although without corresponding explanations. As the most important mechanisms of cerebral Autoregulation, the changes of nitric oxide and sympathetic stimulation play significant roles in these insults. Therefore, the in-depth researches of nitric oxide and sympathetic nerve in cerebral Autoregulation may help to develop new therapeutic targets.
Arthur M. Lam - One of the best experts on this subject based on the ideXlab platform.
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Hemispheric differences in cerebral Autoregulation in children with moderate and severe traumatic brain injury.
Neurocritical Care, 2007Co-Authors: Monica S. Vavilala, Nuj Tontisirin, Yuthana Udomphorn, William M. Armstead, Jerry J. Zimmerman, Randall M. Chesnut, Arthur M. LamAbstract:Introduction To examine hemispheric differences in cerebral Autoregulation in children with traumatic brain injury (TBI). After IRB approval and consent, subjects underwent static cerebral Autoregulation testing during the first 9 days after PICU admission. Cerebral Autoregulation was quantified using the autoregulatory index (ARI).
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Hyperemia and impaired cerebral Autoregulation in a surgical patient with diabetic ketoacidosis.
Canadian Journal of Anesthesia Journal canadien d'anesthésie, 2005Co-Authors: Monica S. Vavilala, Michael J. Souter, Arthur M. LamAbstract:Purpose: We describe cerebral hyperemia and impaired cerebral Autoregulation documented with transcranial Doppler (TCD) ultrasonography in an adult patient with diabetic ketoacidosis (DKA) and sepsis presenting for surgery. Clinical features: Middle cerebral artery flow velocity was increased relative to PaCO 2 (Vmca 52 cm·sec –1 ; PaCO 2 22 mmHg) and the autoregulatory index (ARI) was 0 prior to surgery. Twenty hours after admission and treatment, cerebral hyperemia resolved (Vmca 52 cm·sec –1 ; PaCO 2 35 mmHg) and cerebral Autoregulation returned to normal (ARI 0.91). Conclusion: To our knowledge, this is the first description of impaired cerebral Autoregulation in adult DKA. Our observations suggest a relationship between cerebral hyperemia and impaired cerebral Autoregulation in DKA.
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Graded hypercapnia and cerebral Autoregulation during sevoflurane or propofol anesthesia.
Anesthesiology, 2000Co-Authors: Timothy J. Mcculloch, Elizabeth Visco, Arthur M. LamAbstract:BackgroundHypercapnia abolishes cerebral Autoregulation, but little is known about the interaction between hypercapnia and Autoregulation during general anesthesia. With normocapnia, sevoflurane (up to 1.5 minimum alveolar concentration) and propofol do not impair cerebral Autoregulation. This study
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Cerebral Autoregulation following minor head injury
Journal of Neurosurgery, 1997Co-Authors: Elisabeth Junger, Arthur M. Lam, David W. Newell, Gerald A. Grant, Anthony M. Avellino, Saadi Ghatan, Colleen M. Douville, Rune Aaslid, H. R. WinnAbstract:The purpose of this study was to determine whether patients with minor head injury experience impairments in cerebral Autoregulation. Twenty-nine patients with minor head injuries defined by Glasgow Coma Scale (GCS) scores of 13 to 15 underwent testing of dynamic cerebral Autoregulation within 48 hours of their injury using continuous transcranial Doppler velocity recordings and blood pressure recordings. Twenty-nine age-matched normal volunteers underwent Autoregulation testing in the same manner to establish comparison values. The function of the autoregulatory response was assessed by the cerebral blood flow velocity response to induced rapid brief changes in arterial blood pressure and measured as the Autoregulation index (ARI). Eight (28%) of the 29 patients with minor head injury demonstrated poorly functioning or absent cerebral Autoregulation versus none of the controls, and this difference was highly significant (p = 0.008). A significant correlation between lower blood pressure and worse Autoregulation was found by regression analysis in head-injured patients (r = 0.6, p < 0.001); however, lower blood pressure did not account for the autoregulatory impairment in all patients. Within this group of head-injured patients there was no correlation between ARI and initial GCS or 1-month Glasgow Outcome Scale scores. This study indicates that a significant number of patients with minor head injury may have impaired cerebral Autoregulation and may be at increased risk for secondary ischemic neuronal damage.
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Impaired cerebral Autoregulation after mild brain injury.
Surgical Neurology, 1997Co-Authors: Stephan P. Strebel, Arthur M. Lam, Basil F. Matta, David W. NewellAbstract:BACKGROUND Severe head injury may impair cerebral Autoregulation, which can increase the risk of secondary neuronal injury. The likelihood of impairment in Autoregulation is assumed to be low with mild head injury. We report here the absence of cerebral Autoregulation in a patient who suffered a concussion from an automobile accident 6 days earlier. METHODS The patient participated in a clinical study approved by the institutional human subjects review committee, investigating the dose-effect relationship of anesthetics on cerebral Autoregulation. The patient was scheduled to undergo repair of a knee injury suffered during a motor vehicle accident, during which she had a concussion. The screening evaluation revealed no evidence of neurologic disease. The test was to be performed three times in each patient: baseline Autoregulation measurements during stable fentanyl-nitrous oxide anesthesia, second and third measurements during low dose and high dose of the anesthetic to which the patient was assigned. Autoregulation was tested by increasing the mean systemic blood pressure from 80 mm Hg-100 mm Hg using a phenylephrine infusion while simultaneously recording flow velocity from a middle cerebral artery using transcranial Doppler ultrasonography. RESULTS Static Autoregulation testing during baseline testing demonstrated complete absence of this homeostatic mechanism and the study was canceled. Repeated testing in the recovery unit after the patient awoke showed identical results. CONCLUSIONS Trivial mild head injury may result in loss of cerebral Autoregulation. A clinical study of a larger series to document the incidence is warranted.
Jurgen A.h.r. Claassen - One of the best experts on this subject based on the ideXlab platform.
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transfer function analysis of dynamic cerebral Autoregulation a white paper from the international cerebral Autoregulation research network
Journal of Cerebral Blood Flow and Metabolism, 2016Co-Authors: Jurgen A.h.r. Claassen, Aisha Meelvan Den S S Abeelen, D. M. Simpson, Ronney B. PaneraiAbstract:Cerebral Autoregulation is the intrinsic ability of the brain to maintain adequate cerebral perfusion in the presence of blood pressure changes. A large number of methods to assess the quality of cerebral Autoregulation have been proposed over the last 30 years. However, no single method has been universally accepted as a gold standard. Therefore, the choice of which method to employ to quantify cerebral Autoregulation remains a matter of personal choice. Nevertheless, given the concept that cerebral Autoregulation represents the dynamic relationship between blood pressure (stimulus or input) and cerebral blood flow (response or output), transfer function analysis became the most popular approach adopted in studies based on spontaneous fluctuations of blood pressure. Despite its sound theoretical background, the literature shows considerable variation in implementation of transfer function analysis in practice, which has limited comparisons between studies and hindered progress towards clinical application. Therefore, the purpose of the present white paper is to improve standardisation of parameters and settings adopted for application of transfer function analysis in studies of dynamic cerebral Autoregulation. The development of these recommendations was initiated by (but not confined to) the Cerebral Autoregulation Research Network
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Transfer function analysis of dynamic cerebral Autoregulation: A white paper from the International Cerebral Autoregulation Research Network.
Journal of Cerebral Blood Flow & Metabolism, 2016Co-Authors: Jurgen A.h.r. Claassen, Aisha Meelvan Den S S Abeelen, D. M. Simpson, Ronney B. PaneraiAbstract:Cerebral Autoregulation is the intrinsic ability of the brain to maintain adequate cerebral perfusion in the presence of blood pressure changes. A large number of methods to assess the quality of cerebral Autoregulation have been proposed over the last 30 years. However, no single method has been universally accepted as a gold standard. Therefore, the choice of which method to employ to quantify cerebral Autoregulation remains a matter of personal choice. Nevertheless, given the concept that cerebral Autoregulation represents the dynamic relationship between blood pressure (stimulus or input) and cerebral blood flow (response or output), transfer function analysis became the most popular approach adopted in studies based on spontaneous fluctuations of blood pressure. Despite its sound theoretical background, the literature shows considerable variation in implementation of transfer function analysis in practice, which has limited comparisons between studies and hindered progress towards clinical application. Therefore, the purpose of the present white paper is to improve standardisation of parameters and settings adopted for application of transfer function analysis in studies of dynamic cerebral Autoregulation. The development of these recommendations was initiated by (but not confined to) theCerebral Autoregulation Research Network(CARNet -www.car-net.org).