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Evaluation of Cerebral Blood Flow Autoregulation in the Rat Using Laser Doppler Flowmetry
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Impaired dynamic cerebral autoregulation in patients with cerebral amyloid angiopathy

Matthias Reinhard1, Leonie Lorenz2, Linda Sommerlade3

  • 1Department of Neurology and Neurophysiology, University Medical Center Freiburg, Germany; Department of Neurology and Clinical Neurophysiology, Medical Center Esslingen, Academic Teaching Hospital of the University of Tübingen, Germany.

Brain Research
|April 19, 2019
PubMed

Insights

Cerebral amyloid angiopathy (CAA) impairs dynamic cerebral autoregulation (CA), particularly in the posterior circulation. This impairment correlates with the severity of cerebral microbleeds in CAA patients.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Cerebral amyloid angiopathy (CAA) is a cerebrovascular disease that can affect cerebral pressure regulation.
  • Dynamic cerebral autoregulation (CA) is crucial for maintaining stable cerebral blood flow.

Purpose of the Study:

  • To investigate whether dynamic CA is impaired in the anterior and posterior circulation of patients with CAA.
  • To explore the relationship between CA impairment and microbleeds in CAA patients.

Main Methods:

  • 15 patients with CAA and 14 age-matched controls underwent transcranial Doppler (TCD) assessments.
  • Dynamic CA was evaluated in the middle cerebral artery (MCA) and posterior cerebral artery (PCA) using transfer function analysis during controlled hypotension.
  • MRI was used to identify CAA, microbleeds, and superficial cortical siderosis.

Main Results:

  • Patients with CAA exhibited significantly lower phase values in the PCA compared to controls, indicating impaired CA.
  • This impairment was more pronounced in patients with pure CAA (without other microbleeds) and in the posterior circulation.
  • Reduced CA phase in the MCA and PCA was associated with a higher number of microbleeds and superficial cortical siderosis.

Conclusions:

  • Dynamic cerebral autoregulation is demonstrably impaired in patients with cerebral amyloid angiopathy.
  • The extent of CA impairment is linked to the presence and severity of cerebral microbleeds and superficial cortical siderosis.

Keywords:
AutoregulationCerebral amyloid angiopathyCerebral blood flowTranscranial Doppler sonography

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