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Assessing Cerebral Autoregulation via Oscillatory Lower Body Negative Pressure and Projection Pursuit Regression
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Assessment of cerebral autoregulation in stroke: A systematic review and meta-analysis of studies at rest

Kannakorn Intharakham1, Lucy Beishon1, Ronney B Panerai1,2

  • 1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|August 22, 2019
PubMed

Insights

Dynamic cerebral autoregulation (dCA) is impaired in stroke. Meta-analyses show reduced phase and autoregulation index (ARI) in acute ischemic stroke (AIS) patients compared to controls, but results for intracerebral hemorrhage (ICH) are limited.

Area of Science:

  • Neuroscience
  • Cerebrovascular Medicine
  • Medical Statistics

Background:

  • Dynamic cerebral autoregulation (dCA) is crucial for maintaining stable cerebral blood flow.
  • Impaired dCA is linked to cerebrovascular diseases, but assessment metrics lack consistency.
  • Transfer function analysis (TFA) is a common method for evaluating dCA.

Purpose of the Study:

  • To systematically review and meta-analyze the assessment of dCA in ischemic and hemorrhagic stroke.
  • To evaluate the consistency and significance of TFA-derived parameters (gain, phase, ARI) in stroke patients.

Main Methods:

  • Systematic review and meta-analysis of 33 articles assessing dCA using TFA.
  • Pooled data from 1233 patients across 12 acute ischemic stroke (AIS) and 2 intracerebral hemorrhage (ICH) studies.
  • Meta-analyses performed on TFA gain, phase, and autoregulation index (ARI).

Main Results:

  • In AIS, TFA phase was significantly reduced in both hemispheres compared to controls (P < 0.0001).
  • The ARI was significantly reduced in both hemispheres for AIS patients (P < 0.005).
  • TFA gain results were inconsistent for AIS; ICH gain was higher in the unaffected hemisphere (P = 0.01).

Conclusions:

  • Meta-analyses confirm significant differences in phase and ARI for AIS patients versus controls.
  • Limited studies and diverse units for gain in ICH hinder definitive conclusions.
  • Standardized assessment of dCA using TFA is needed for stroke patients.

Keywords:
Cerebral blood flowdynamic cerebral autoregulationintracranial hemorrhageischemic stroketransfer function analysis

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