Loading…
Cerebral autoregulatory performance and the cerebrovascular response to head‐of‐bed positioning in acute ischaemic stroke
Background and purpose Cerebrovascular responses to head‐of‐bed positioning in patients with acute ischaemic stroke are heterogeneous, questioning the applicability of general recommendations on head positioning. Cerebral autoregulation is impaired to various extents after acute stroke, although it...
Saved in:
| Published in: | European journal of neurology 2018-11, Vol.25 (11), p.1365-e117 |
|---|---|
| Main Authors: | , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c4437-568c4ac05b8eba507b559449350287ea97b08c01f85fa6b24a8b17885e4b30003 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c4437-568c4ac05b8eba507b559449350287ea97b08c01f85fa6b24a8b17885e4b30003 |
| container_end_page | e117 |
| container_issue | 11 |
| container_start_page | 1365 |
| container_title | European journal of neurology |
| container_volume | 25 |
| creator | Truijen, J. Rasmussen, L. S. Kim, Y. S. Stam, J. Stok, W. J. Pott, F. C. Lieshout, J. J. |
| description | Background and purpose
Cerebrovascular responses to head‐of‐bed positioning in patients with acute ischaemic stroke are heterogeneous, questioning the applicability of general recommendations on head positioning. Cerebral autoregulation is impaired to various extents after acute stroke, although it is unknown whether this affects cerebral perfusion during posture change. We aimed to elucidate whether the cerebrovascular response to head position manipulation depends on autoregulatory performance in patients with ischaemic stroke.
Methods
The responses of bilateral transcranial Doppler ultrasound‐determined cerebral blood flow velocity (CBFV) and local cerebral blood volume (CBV), assessed by near‐infrared spectroscopy of total hemoglobin tissue concentration ([total Hb]), to head‐of‐bed lowering from 30° to 0° were determined in 39 patients with acute ischaemic stroke and 17 reference subjects from two centers. Cerebrovascular autoregulatory performance was expressed as the phase difference of the arterial pressure‐to‐CBFV transfer function.
Results
Following head‐of‐bed lowering, CBV increased in the reference subjects only ([total Hb]: + 2.1 ± 2.0 vs. + 0.4 ± 2.6 μM; P < 0.05), whereas CBFV did not change in either group. CBV increased upon head‐of‐bed lowering in the hemispheres of patients with autoregulatory performance |
| doi_str_mv | 10.1111/ene.13737 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6220945</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2117683985</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4437-568c4ac05b8eba507b559449350287ea97b08c01f85fa6b24a8b17885e4b30003</originalsourceid><addsrcrecordid>eNp1kU9rFDEYhwex2Fo9-AUk4EUP0-bvJHMRyrLVQqkXPYck-85u6kwyJjOVPQh-hH5GP4nZbltUMIe8gTw8vD9-VfWK4BNSzikEOCFMMvmkOiK8UTVhjDwtbyZILQgmh9XznK8xxlRS_Kw6pG3LBObkqPqxgAQ2mR6ZeYoJ1nNvytyiEVIX02CCA2TCCk0bQO6OjTcmu4IllCCPMWRAU0QbMKtfP29jVy4LKzTG7Ccfgw9r5AMybp4A-ew2BgbvUJ5S_AovqoPO9Ble3s_j6sv58vPiY3356cPF4uyydpwzWYtGOW4cFlaBNQJLK0TL-S4DVRJMKy1WDpNOic40lnKjLJFKCeCWldTsuHq_946zHWDlIEwlsh6TH0za6mi8_vsn-I1exxvdUIpbLorg7b0gxW8z5EkPJQv0vQkQ56wpFkpgQRpS0Df_oNdxTqHE05QQ2SjWqp3w3Z5yKeacoHtchmC9K1WXUvVdqYV9_ef2j-RDiwU43QPffQ_b_5v08mq5V_4GC2qvzg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2117683985</pqid></control><display><type>article</type><title>Cerebral autoregulatory performance and the cerebrovascular response to head‐of‐bed positioning in acute ischaemic stroke</title><source>Wiley</source><creator>Truijen, J. ; Rasmussen, L. S. ; Kim, Y. S. ; Stam, J. ; Stok, W. J. ; Pott, F. C. ; Lieshout, J. J.</creator><creatorcontrib>Truijen, J. ; Rasmussen, L. S. ; Kim, Y. S. ; Stam, J. ; Stok, W. J. ; Pott, F. C. ; Lieshout, J. J.</creatorcontrib><description>Background and purpose
Cerebrovascular responses to head‐of‐bed positioning in patients with acute ischaemic stroke are heterogeneous, questioning the applicability of general recommendations on head positioning. Cerebral autoregulation is impaired to various extents after acute stroke, although it is unknown whether this affects cerebral perfusion during posture change. We aimed to elucidate whether the cerebrovascular response to head position manipulation depends on autoregulatory performance in patients with ischaemic stroke.
Methods
The responses of bilateral transcranial Doppler ultrasound‐determined cerebral blood flow velocity (CBFV) and local cerebral blood volume (CBV), assessed by near‐infrared spectroscopy of total hemoglobin tissue concentration ([total Hb]), to head‐of‐bed lowering from 30° to 0° were determined in 39 patients with acute ischaemic stroke and 17 reference subjects from two centers. Cerebrovascular autoregulatory performance was expressed as the phase difference of the arterial pressure‐to‐CBFV transfer function.
Results
Following head‐of‐bed lowering, CBV increased in the reference subjects only ([total Hb]: + 2.1 ± 2.0 vs. + 0.4 ± 2.6 μM; P < 0.05), whereas CBFV did not change in either group. CBV increased upon head‐of‐bed lowering in the hemispheres of patients with autoregulatory performance <50th percentile compared with a decrease in the hemispheres of patients with better autoregulatory performance ([total Hb]: +1.0 ± 1.3 vs. −0.5 ± 1.0 μM; P < 0.05). The CBV response was inversely related to autoregulatory performance (r = −0.68; P < 0.001) in the patients, whereas no such relation was observed for CBFV.
Conclusion
This study is the first to provide evidence that cerebral autoregulatory performance in patients with acute ischaemic stroke affects the cerebrovascular response to changes in the position of the head.</description><identifier>ISSN: 1351-5101</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.13737</identifier><identifier>PMID: 29935041</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Blood flow ; Blood pressure ; Blood volume ; Cerebral blood flow ; cerebral infarction ; Cerebrovascular system ; Doppler effect ; Flow velocity ; Hemispheres ; Hemodynamics ; Hemoglobin ; Infrared spectroscopy ; near‐infrared spectroscopy ; Original ; patient positioning ; Patients ; Perfusion ; Posture ; Stroke ; transcranial Doppler ultrasonography ; Transfer functions ; Ultrasound</subject><ispartof>European journal of neurology, 2018-11, Vol.25 (11), p.1365-e117</ispartof><rights>2018 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.</rights><rights>Copyright © 2018 European Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4437-568c4ac05b8eba507b559449350287ea97b08c01f85fa6b24a8b17885e4b30003</citedby><cites>FETCH-LOGICAL-c4437-568c4ac05b8eba507b559449350287ea97b08c01f85fa6b24a8b17885e4b30003</cites><orcidid>0000-0002-3290-9919 ; 0000-0002-3646-2122</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fene.13737$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fene.13737$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,315,786,790,891,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29935041$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Truijen, J.</creatorcontrib><creatorcontrib>Rasmussen, L. S.</creatorcontrib><creatorcontrib>Kim, Y. S.</creatorcontrib><creatorcontrib>Stam, J.</creatorcontrib><creatorcontrib>Stok, W. J.</creatorcontrib><creatorcontrib>Pott, F. C.</creatorcontrib><creatorcontrib>Lieshout, J. J.</creatorcontrib><title>Cerebral autoregulatory performance and the cerebrovascular response to head‐of‐bed positioning in acute ischaemic stroke</title><title>European journal of neurology</title><addtitle>Eur J Neurol</addtitle><description>Background and purpose
Cerebrovascular responses to head‐of‐bed positioning in patients with acute ischaemic stroke are heterogeneous, questioning the applicability of general recommendations on head positioning. Cerebral autoregulation is impaired to various extents after acute stroke, although it is unknown whether this affects cerebral perfusion during posture change. We aimed to elucidate whether the cerebrovascular response to head position manipulation depends on autoregulatory performance in patients with ischaemic stroke.
Methods
The responses of bilateral transcranial Doppler ultrasound‐determined cerebral blood flow velocity (CBFV) and local cerebral blood volume (CBV), assessed by near‐infrared spectroscopy of total hemoglobin tissue concentration ([total Hb]), to head‐of‐bed lowering from 30° to 0° were determined in 39 patients with acute ischaemic stroke and 17 reference subjects from two centers. Cerebrovascular autoregulatory performance was expressed as the phase difference of the arterial pressure‐to‐CBFV transfer function.
Results
Following head‐of‐bed lowering, CBV increased in the reference subjects only ([total Hb]: + 2.1 ± 2.0 vs. + 0.4 ± 2.6 μM; P < 0.05), whereas CBFV did not change in either group. CBV increased upon head‐of‐bed lowering in the hemispheres of patients with autoregulatory performance <50th percentile compared with a decrease in the hemispheres of patients with better autoregulatory performance ([total Hb]: +1.0 ± 1.3 vs. −0.5 ± 1.0 μM; P < 0.05). The CBV response was inversely related to autoregulatory performance (r = −0.68; P < 0.001) in the patients, whereas no such relation was observed for CBFV.
Conclusion
This study is the first to provide evidence that cerebral autoregulatory performance in patients with acute ischaemic stroke affects the cerebrovascular response to changes in the position of the head.</description><subject>Blood flow</subject><subject>Blood pressure</subject><subject>Blood volume</subject><subject>Cerebral blood flow</subject><subject>cerebral infarction</subject><subject>Cerebrovascular system</subject><subject>Doppler effect</subject><subject>Flow velocity</subject><subject>Hemispheres</subject><subject>Hemodynamics</subject><subject>Hemoglobin</subject><subject>Infrared spectroscopy</subject><subject>near‐infrared spectroscopy</subject><subject>Original</subject><subject>patient positioning</subject><subject>Patients</subject><subject>Perfusion</subject><subject>Posture</subject><subject>Stroke</subject><subject>transcranial Doppler ultrasonography</subject><subject>Transfer functions</subject><subject>Ultrasound</subject><issn>1351-5101</issn><issn>1468-1331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kU9rFDEYhwex2Fo9-AUk4EUP0-bvJHMRyrLVQqkXPYck-85u6kwyJjOVPQh-hH5GP4nZbltUMIe8gTw8vD9-VfWK4BNSzikEOCFMMvmkOiK8UTVhjDwtbyZILQgmh9XznK8xxlRS_Kw6pG3LBObkqPqxgAQ2mR6ZeYoJ1nNvytyiEVIX02CCA2TCCk0bQO6OjTcmu4IllCCPMWRAU0QbMKtfP29jVy4LKzTG7Ccfgw9r5AMybp4A-ew2BgbvUJ5S_AovqoPO9Ble3s_j6sv58vPiY3356cPF4uyydpwzWYtGOW4cFlaBNQJLK0TL-S4DVRJMKy1WDpNOic40lnKjLJFKCeCWldTsuHq_946zHWDlIEwlsh6TH0za6mi8_vsn-I1exxvdUIpbLorg7b0gxW8z5EkPJQv0vQkQ56wpFkpgQRpS0Df_oNdxTqHE05QQ2SjWqp3w3Z5yKeacoHtchmC9K1WXUvVdqYV9_ef2j-RDiwU43QPffQ_b_5v08mq5V_4GC2qvzg</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Truijen, J.</creator><creator>Rasmussen, L. S.</creator><creator>Kim, Y. S.</creator><creator>Stam, J.</creator><creator>Stok, W. J.</creator><creator>Pott, F. C.</creator><creator>Lieshout, J. J.</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3290-9919</orcidid><orcidid>https://orcid.org/0000-0002-3646-2122</orcidid></search><sort><creationdate>201811</creationdate><title>Cerebral autoregulatory performance and the cerebrovascular response to head‐of‐bed positioning in acute ischaemic stroke</title><author>Truijen, J. ; Rasmussen, L. S. ; Kim, Y. S. ; Stam, J. ; Stok, W. J. ; Pott, F. C. ; Lieshout, J. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4437-568c4ac05b8eba507b559449350287ea97b08c01f85fa6b24a8b17885e4b30003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Blood flow</topic><topic>Blood pressure</topic><topic>Blood volume</topic><topic>Cerebral blood flow</topic><topic>cerebral infarction</topic><topic>Cerebrovascular system</topic><topic>Doppler effect</topic><topic>Flow velocity</topic><topic>Hemispheres</topic><topic>Hemodynamics</topic><topic>Hemoglobin</topic><topic>Infrared spectroscopy</topic><topic>near‐infrared spectroscopy</topic><topic>Original</topic><topic>patient positioning</topic><topic>Patients</topic><topic>Perfusion</topic><topic>Posture</topic><topic>Stroke</topic><topic>transcranial Doppler ultrasonography</topic><topic>Transfer functions</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Truijen, J.</creatorcontrib><creatorcontrib>Rasmussen, L. S.</creatorcontrib><creatorcontrib>Kim, Y. S.</creatorcontrib><creatorcontrib>Stam, J.</creatorcontrib><creatorcontrib>Stok, W. J.</creatorcontrib><creatorcontrib>Pott, F. C.</creatorcontrib><creatorcontrib>Lieshout, J. J.</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Truijen, J.</au><au>Rasmussen, L. S.</au><au>Kim, Y. S.</au><au>Stam, J.</au><au>Stok, W. J.</au><au>Pott, F. C.</au><au>Lieshout, J. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral autoregulatory performance and the cerebrovascular response to head‐of‐bed positioning in acute ischaemic stroke</atitle><jtitle>European journal of neurology</jtitle><addtitle>Eur J Neurol</addtitle><date>2018-11</date><risdate>2018</risdate><volume>25</volume><issue>11</issue><spage>1365</spage><epage>e117</epage><pages>1365-e117</pages><issn>1351-5101</issn><eissn>1468-1331</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Background and purpose
Cerebrovascular responses to head‐of‐bed positioning in patients with acute ischaemic stroke are heterogeneous, questioning the applicability of general recommendations on head positioning. Cerebral autoregulation is impaired to various extents after acute stroke, although it is unknown whether this affects cerebral perfusion during posture change. We aimed to elucidate whether the cerebrovascular response to head position manipulation depends on autoregulatory performance in patients with ischaemic stroke.
Methods
The responses of bilateral transcranial Doppler ultrasound‐determined cerebral blood flow velocity (CBFV) and local cerebral blood volume (CBV), assessed by near‐infrared spectroscopy of total hemoglobin tissue concentration ([total Hb]), to head‐of‐bed lowering from 30° to 0° were determined in 39 patients with acute ischaemic stroke and 17 reference subjects from two centers. Cerebrovascular autoregulatory performance was expressed as the phase difference of the arterial pressure‐to‐CBFV transfer function.
Results
Following head‐of‐bed lowering, CBV increased in the reference subjects only ([total Hb]: + 2.1 ± 2.0 vs. + 0.4 ± 2.6 μM; P < 0.05), whereas CBFV did not change in either group. CBV increased upon head‐of‐bed lowering in the hemispheres of patients with autoregulatory performance <50th percentile compared with a decrease in the hemispheres of patients with better autoregulatory performance ([total Hb]: +1.0 ± 1.3 vs. −0.5 ± 1.0 μM; P < 0.05). The CBV response was inversely related to autoregulatory performance (r = −0.68; P < 0.001) in the patients, whereas no such relation was observed for CBFV.
Conclusion
This study is the first to provide evidence that cerebral autoregulatory performance in patients with acute ischaemic stroke affects the cerebrovascular response to changes in the position of the head.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>29935041</pmid><doi>10.1111/ene.13737</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3290-9919</orcidid><orcidid>https://orcid.org/0000-0002-3646-2122</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1351-5101 |
| ispartof | European journal of neurology, 2018-11, Vol.25 (11), p.1365-e117 |
| issn | 1351-5101 1468-1331 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6220945 |
| source | Wiley |
| subjects | Blood flow Blood pressure Blood volume Cerebral blood flow cerebral infarction Cerebrovascular system Doppler effect Flow velocity Hemispheres Hemodynamics Hemoglobin Infrared spectroscopy near‐infrared spectroscopy Original patient positioning Patients Perfusion Posture Stroke transcranial Doppler ultrasonography Transfer functions Ultrasound |
| title | Cerebral autoregulatory performance and the cerebrovascular response to head‐of‐bed positioning in acute ischaemic stroke |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-21T23%3A07%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cerebral%20autoregulatory%20performance%20and%20the%20cerebrovascular%20response%20to%20head%E2%80%90of%E2%80%90bed%20positioning%20in%20acute%20ischaemic%20stroke&rft.jtitle=European%20journal%20of%20neurology&rft.au=Truijen,%20J.&rft.date=2018-11&rft.volume=25&rft.issue=11&rft.spage=1365&rft.epage=e117&rft.pages=1365-e117&rft.issn=1351-5101&rft.eissn=1468-1331&rft_id=info:doi/10.1111/ene.13737&rft_dat=%3Cproquest_pubme%3E2117683985%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4437-568c4ac05b8eba507b559449350287ea97b08c01f85fa6b24a8b17885e4b30003%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2117683985&rft_id=info:pmid/29935041&rfr_iscdi=true |