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Impaired cerebral autoregulation and neurovascular coupling in middle cerebral artery stroke: Influence of severity?

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journal contribution
posted on 2020-04-07, 09:51 authored by Angela SM Salinet, Nathalia CC Silva, Juliana Caldas, Daniel S de Azevedo, Marcelo de-Lima-Oliveira, Ricardo C Nogueira, Adriana B Conforto, Manoel J Texeira, Thompson G Robinson, Ronney B Panerai, Edson Bor-Seng-Shu
We aimed to assess cerebral autoregulation (CA) and neurovascular coupling (NVC) in stroke patients of differing severity comparing responses to healthy controls and explore the association between CA and NVC with functional outcome. Patients admitted with middle cerebral artery (MCA) stroke and healthy controls were recruited. Stroke severity was defined by the National Institutes of Health Stroke Scale (NIHSS) scores: ≤4 mild, 5–15 moderate and ≥16 severe. Transcranial Doppler ultrasound and Finometer recorded MCA cerebral blood flow velocity (CBFv) and blood pressure, respectively, over 5 min baseline and 1 min passive movement of the elbow to calculate the autoregulation index (ARI) and CBFv amplitude responses to movement. All participants were followed up for three months. A total of 87 participants enrolled in the study, including 15 mild, 27 moderate and 13 severe stroke patients, and 32 control subjects. ARI was lower in the affected hemisphere (AH) of moderate and severe stroke groups. Decreased NVC was seen bilaterally in all stroke groups. CA and NVC correlated with stroke severity and functional outcome. CBFv regulation is significantly impaired in acute stroke, and further compromised with increasing stroke severity. Preserved CA and NVC in the acute period were associated with improved three-month functional outcome.

History

Citation

Salinet, A. S., Silva, N. C., Caldas, J., de Azevedo, D. S., de-Lima-Oliveira, M., Nogueira, R. C., … Bor-Seng-Shu, E. (2019). Impaired cerebral autoregulation and neurovascular coupling in middle cerebral artery stroke: Influence of severity? Journal of Cerebral Blood Flow & Metabolism, 39(11), 2277–2285. https://doi.org/10.1177/0271678X18794835

Version

  • AM (Accepted Manuscript)

Published in

JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM

Volume

39

Issue

11

Pagination

2277 - 2285 (9)

Publisher

SAGE PUBLICATIONS INC

issn

0271-678X

eissn

1559-7016

Acceptance date

2018-07-06

Copyright date

2018

Available date

2018-08-17

Publisher version

https://journals.sagepub.com/doi/full/10.1177/0271678X18794835

Spatial coverage

United States

Language

English