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Updated: Apr 22, 2026
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
The longitudinal evolution of cerebral blood flow regulation after acute ischaemic stroke
Angela S M Salinet1, Ronney B Panerai2, Thompson G Robinson2
1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Insights
Cerebral blood flow regulation, including cerebral autoregulation and neurovascular coupling, initially worsens after acute stroke but recovers over three months. These findings are crucial for timing interventions and understanding rehabilitation impacts in stroke recovery.
Area of Science:
- Neuroscience
- Cardiovascular Research
- Neurology
Background:
- Acute ischemic stroke significantly impairs cerebral blood flow (CBF) regulation.
- Longitudinal changes in CBF regulatory mechanisms post-stroke are not well-documented.
- Key mechanisms assessed include cerebral autoregulation (CA) and neurovascular coupling (NVC).
Purpose of the Study:
- To longitudinally assess changes in CA and NVC over three months following acute ischemic stroke.
- To compare CBF regulation in stroke patients with healthy controls.
- To inform the timing of blood pressure interventions and rehabilitation strategies.
Main Methods:
- CBF velocity (CBFv), blood pressure (BP), and end-tidal CO2 were recorded.
- Assessments were conducted within 72 hours of stroke onset, and at 2 weeks, 1 month, and 3 months post-stroke.
- Passive arm movement was used to evaluate NVC, while CA was assessed through BP and CBFv fluctuations.
Main Results:
- Stroke patients showed significantly lower CBFv in the affected hemisphere within 72 hours compared to controls.
- Cerebral autoregulation (CA) index was most reduced at 2 weeks post-stroke.
- Neurovascular coupling (NVC) response to passive movement was decreased bilaterally, especially in the affected hemisphere.
- Both CA and NVC returned to control levels by the 3-month follow-up.
Conclusions:
- Cerebral autoregulation (CA) and neurovascular coupling (NVC) mechanisms initially deteriorate after stroke but recover over time.
- Findings support guiding the timing of blood pressure interventions and understanding rehabilitation effects.
- Further research in larger, diverse stroke populations is needed to explore stroke subtype influences.
Background:
Acute stroke is known to impair cerebral blood flow (CBF) regulation, but the longitudinal changes of these effects have been poorly reported. The main CBF regulatory mechanisms [cerebral autoregulation (CA) and neurovascular coupling (NVC)] were assessed over 3 months after acute ischaemic stroke.
Methods:
Recordings of CBF velocity (CBFv), blood pressure (BP), and end-tidal CO2 were performed during 5 min baseline and 1 min passive movement of the elbow. Stroke patients were assessed <72 h of stroke onset, and at 2 weeks, 1 and 3 months after stroke.
Results:
Fifteen acute stroke subjects underwent all 4 sessions and were compared to 22 control subjects. Baseline recordings revealed a significantly lower CBFv in the affected hemisphere within 72 h after stroke compared to controls (p = 0.02) and a reduction in CA index most marked at 2 weeks (p = 0.009). CBFv rise in response to passive arm movement was decreased bilaterally after stroke, particularly in the affected hemisphere (p < 0.01). Both alterations in CA and NVC returned to control levels during recovery.
Conclusion:
The major novel finding of this study was that both CA and NVC regulatory mechanisms deteriorated initially following stroke onset, but returned to control levels during the recovery period. These findings are relevant to guide the timing of interventions to manipulate BP and potentially for the impact of intensive rehabilitation strategies that may precipitate acute physiological perturbations but require further exploration in a larger population that better reflects the heterogeneity of stroke. Further, they will also enable the potential influence of stroke subtype to be investigated.
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