Impaired Dynamic Cerebral Autoregulation in Patients With Cerebral Venous Sinus Thrombosis: Evaluation Using Transcranial Doppler and Silent Reading Stimulation

Songwei Chen; Hongxiu Chen; Jiangang Duan; Liuping Cui; Ran Liu; Yingqi Xing

doi:10.1016/j.ultrasmedbio.2023.07.009

Impaired Dynamic Cerebral Autoregulation in Patients With Cerebral Venous Sinus Thrombosis: Evaluation Using Transcranial Doppler and Silent Reading Stimulation

Ultrasound Med Biol. 2023 Oct;49(10):2221-2226. doi: 10.1016/j.ultrasmedbio.2023.07.009. Epub 2023 Aug 1.

Authors

Songwei Chen¹, Hongxiu Chen¹, Jiangang Duan², Liuping Cui¹, Ran Liu¹, Yingqi Xing³

Affiliations

¹ Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
² Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China.
³ Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China. Electronic address: xingyq2009@sina.com.

PMID: 37532632
DOI: 10.1016/j.ultrasmedbio.2023.07.009

Abstract

Objective: Cerebral venous sinus thrombosis (CVST) may impair dynamic cerebral autoregulation (dCA) of the middle cerebral artery (MCA). However, most studies have focused on dCA of the MCA; a few studies are based on the posterior cerebral artery (PCA) during silent reading and neurovascular coupling (NVC). This study explored the effects of CVST on dCA of the MCA and PCA during silent reading and NVC.

Methods: From January 2021 to August 2022, 60 CVST patients and 30 controls were enrolled in this study. Non-invasive continuous beat-to-beat blood pressure, cerebral blood flow velocity and other associated information on the MCA and PCA during silent reading were collected using a transcranial Doppler. NVC assessment was performed by opening and closing the eyes periodically based on voice prompts, and eye-opening visual stimulation was achieved by silently reading Chinese tourism materials. Visual stimulation signals can selectively activate Brodmann's areas 17, 18, and 19 of the occipital when reading silently with open eyes, prompting them to release neurotransmitters and dilate PCA. dCA was determined by transfer function analysis.

Results: In dCA of the PCA during silent reading, the CVST group's very low frequency phase was lower than that of the control group (p = 0.047). In NVC, the difference in the indexes of the cerebrovascular conductance and visually evoked flow response of the CVST group were lower than those of the control group (p = 0.017 and p = 0.019, respectively).

Conclusion: Compared with the control group, dCA and NVC of the PCA during silent reading were impaired in CVST patients.

Keywords: Cerebral autoregulation; Doppler; Neurovascular coupling; Silent reading; Sinus thrombosis; Transcranial; Transfer function analysis; Ultrasound.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Flow Velocity / physiology
Cerebrovascular Circulation / physiology
Homeostasis / physiology
Humans
Reading*
Sinus Thrombosis, Intracranial* / diagnostic imaging
Ultrasonography, Doppler, Transcranial