Journal
PHYSIOLOGICAL REPORTS
Volume 7, Issue 4, Pages -Publisher
WILEY
DOI: 10.14814/phy2.14001
Keywords
Body position; cerebrospinal fluid; cerebrovascular autoregulation; computer model; orthostasis
Categories
Funding
- Space Research Organization Netherlands (SRON) [MG052]
Ask authors/readers for more resources
Standing up elicits a host of cardiovascular changes which all affect the cerebral circulation. Lowered mean arterial blood pressure (ABP) at brain level, change in the cerebral venous outflow path, lowered end-tidal P-CO2 (PETCO2), and intracranial pressure (ICP) modify cerebral blood flow (CBF). The question we undertook to answer is whether gravity-induced blood pressure (BP) changes are compensated in CBF with the same dynamics as are spontaneous or induced ABP changes in a stable position. Twenty-two healthy subjects (18/4 m/f, 40 +/- 8 years) were subjected to 30 degrees and 70 degrees head-up tilt (HUT) and sinusoidal tilts (SinTilt, 0 degrees & 60 degrees around 30 degrees at 2.5-10 tilts/min). Additionally, at those three tilt levels, they performed paced breathing at 6-15 breaths/min to induce larger than spontaneous cardiovascular oscillations. We measured continuous finger BP and cerebral blood flow velocity (CBFv) in the middle cerebral artery by transcranial Doppler to compute transfer functions (TFs) from ABP- to CBFv oscillations. SinTilt induces the largest ABP oscillations at brain level with CBFv gains strikingly lower than for paced breathing or spontaneous variations. This would imply better autoregulation for dynamic gravitational changes. We demonstrate in a mathematical model that this difference is explained by ICP changes due to movement of cerebrospinal fluid (CSF) into and out of the spinal dural sack. Dynamic cerebrovascular autoregulation seems insensitive to how BP oscillations originate if the effect of ICP is factored in. CSF-movement in-and-out of the spinal dural space contributes importantly to orthostatic tolerance by its effect on cerebral perfusion pressure.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available