Dynamic cerebrovascular regulation in patients with autonomic dysfunction: A transcranial Doppler study

A. Ching Chao, Han Hwa Hu, Kwong Kan Liao, Chang Ming Chern

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background. Regulation of cerebral blood flow during orthostatic stress has been a major research interest. The purpose of this study was to scan healthy volunteers and patients with orthostatic dizziness and autonomic dysfunction for differences in cerebral hemodynamic patterns during orthostasis. Methods. Thirteen patients with orthostatic dizziness and autonomic dysfunction and 9 healthy volunteers were recruited for monitoring of variations in intracranial hemodynamics with transcranial Doppler ultrasound during a 30-minute head-up tilt. Heart rate and blood pressure were monitored with surface electrocardiography and cuff sphygmomanometer, respectively. Cerebral blood flow velocity was continuously monitored using transcranial Doppler ultrasonography. Results. The baseline mean cerebral blood flow velocity was significantly lower in the patient group (p < 0.05). After tilting up, the extent of immediate decreases in systolic blood pressure and in the mean blood flow velocity were significantly more in the patients (p < 0.05). However, the mean blood flow velocity remained significantly more retarded for up to 90 seconds after the initial drop in the patient group, while the blood pressure showed no significant difference between the patients and controls. Conclusions. Impaired dynamic cerebrovascular regulation can be documented as a delayed recovery of cerebral blood flow velocity upon orthostatic challenges, which may help verify the status of cerebrovascular regulation in patients with autonomic dysfunction.

Original languageEnglish
Pages (from-to)339-345
Number of pages7
JournalJournal of the Chinese Medical Association
Volume66
Issue number6
Publication statusPublished - Jun 1 2003
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Blood Flow Velocity
Dizziness
Blood Pressure
Healthy Volunteers
Hemodynamics
Sphygmomanometers
Doppler Transcranial Ultrasonography
Doppler Ultrasonography
Electrocardiography
Heart Rate
Head
Research

Keywords

  • Autonomic dysfunction
  • Cerebrovascular regulation
  • Orthostatic dizziness
  • Tilt table
  • Transcranial Doppler ultrasound

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Dynamic cerebrovascular regulation in patients with autonomic dysfunction : A transcranial Doppler study. / Chao, A. Ching; Hu, Han Hwa; Liao, Kwong Kan; Chern, Chang Ming.

In: Journal of the Chinese Medical Association, Vol. 66, No. 6, 01.06.2003, p. 339-345.

Research output: Contribution to journalArticle

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AB - Background. Regulation of cerebral blood flow during orthostatic stress has been a major research interest. The purpose of this study was to scan healthy volunteers and patients with orthostatic dizziness and autonomic dysfunction for differences in cerebral hemodynamic patterns during orthostasis. Methods. Thirteen patients with orthostatic dizziness and autonomic dysfunction and 9 healthy volunteers were recruited for monitoring of variations in intracranial hemodynamics with transcranial Doppler ultrasound during a 30-minute head-up tilt. Heart rate and blood pressure were monitored with surface electrocardiography and cuff sphygmomanometer, respectively. Cerebral blood flow velocity was continuously monitored using transcranial Doppler ultrasonography. Results. The baseline mean cerebral blood flow velocity was significantly lower in the patient group (p < 0.05). After tilting up, the extent of immediate decreases in systolic blood pressure and in the mean blood flow velocity were significantly more in the patients (p < 0.05). However, the mean blood flow velocity remained significantly more retarded for up to 90 seconds after the initial drop in the patient group, while the blood pressure showed no significant difference between the patients and controls. Conclusions. Impaired dynamic cerebrovascular regulation can be documented as a delayed recovery of cerebral blood flow velocity upon orthostatic challenges, which may help verify the status of cerebrovascular regulation in patients with autonomic dysfunction.

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KW - Tilt table

KW - Transcranial Doppler ultrasound

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