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Updated: Jan 29, 2026

Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
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Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow

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Transcranial Doppler findings in antiphospholipid syndrome

I F Ricarte1, L A Dutra1,2, O G P Barsottini1

  • 11 Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.

Lupus
|February 14, 2019
PubMed

Insights

Transcranial Doppler (TCD) revealed higher right-to-left shunts (RLS) in antiphospholipid syndrome (APS) patients. Microembolic signals (MESs) were more frequent in systemic lupus erythematosus (SLE) patients, suggesting anticoagulant therapy may prevent MESs.

Area of Science:

  • Neurology
  • Cardiology
  • Rheumatology

Background:

  • Transcranial Doppler (TCD) assesses cerebral hemodynamics, right-to-left shunts (RLS), and microembolic signals (MESs).
  • MESs in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are linked to increased stroke risk.
  • TCD may aid stroke risk stratification in SLE and APS patients.

Purpose of the Study:

  • To evaluate TCD-derived cerebral mean blood flow velocities.
  • To assess the presence of MESs and RLS in patients with APS and SLE.
  • To compare these parameters between patient groups and healthy controls.

Main Methods:

  • Evaluated 22 primary APS, 24 secondary APS (SAPS), 27 SLE without APS, and 21 healthy controls.
  • Utilized TCD for cerebral mean blood flow velocities and breath-holding index calculation.
  • Monitored middle cerebral arteries for MESs and investigated RLS using agitated saline.

Main Results:

  • No significant differences in mean blood flow velocities were observed.
  • MESs were more frequent in SLE patients (17.4%) than in APS (0-4.3%) or controls (0%) (p=0.03).
  • Higher RLS frequency was found in APS patients (63.6%) compared to controls (38.1%) (p=0.05).

Conclusions:

  • APS patients exhibit a higher frequency of RLS, underscoring the need for cardiac evaluation in stroke patients with APS.
  • The increased MESs in SLE patients may indicate a protective effect of anticoagulant therapy, which is more common in APS.
  • TCD is a valuable tool for assessing cerebral hemodynamics and identifying stroke risk factors in SLE and APS.
Abstract

Keywords:
Transcranial Dopplerantiphospholipid syndromecerebral blood flowmicroembolic signalsright-to-left shuntsystemic lupus erythematosus

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