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Updated: Dec 11, 2025
Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
Published on: March 15, 2021
Cerebral Hemodynamic Changes to Transcranial Doppler in Asymptomatic Patients with Fabry's Disease
Carla Vagli1, Francesco Fisicaro2, Luisa Vinciguerra3
1Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy.
Insights
Asymptomatic Fabry's disease (FD) patients show altered posterior circulation blood flow velocity. Transcranial Doppler sonography (TCD) may detect preclinical neurovascular changes in FD, aiding management.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Fabry disease (FD) presents a spectrum of clinical manifestations, including cerebrovascular disease, predominantly in the posterior circulation.
- Limited and contradictory research exists on cerebral blood flow (CBF) velocity in asymptomatic FD (aFD) using transcranial Doppler sonography (TCD).
Purpose of the Study:
- To evaluate TCD findings in aFD subjects.
- To identify potential preclinical changes in CBF velocity within the posterior circulation of aFD patients.
Main Methods:
- 30 aFD subjects and 28 healthy controls were assessed.
- Transcranial Doppler sonography (TCD) measured blood flow velocity and resistance indices in the middle cerebral artery (MCA) and basilar artery (BA).
- Cerebral vasomotor reactivity (CVR) was evaluated from the MCA.
Main Results:
- No significant differences in MCA blood flow velocity or CVR were observed between aFD subjects and controls.
- aFD subjects exhibited higher mean blood flow velocity and lower resistance index in the basilar artery (BA) compared to controls.
- No correlation was found between BA-derived TCD parameters and lyso-globotriaosylceramide levels.
Conclusions:
- Asymptomatic FD patients demonstrate altered CBF velocity in the posterior circulation.
- TCD may enable preclinical detection of neurovascular involvement in FD.
- Early identification can facilitate management and prevention of cerebrovascular complications.
Background:
Patients with Fabry's disease (FD) may be asymptomatic or show a spectrum of clinical manifestations, including cerebrovascular disease, mainly affecting posterior circulation. Few and conflicting studies on cerebral blood flow (CBF) velocity by transcranial Doppler sonography (TCD) in asymptomatic FD (aFD) subjects have been published. Our study aims to assess TCD in aFD subjects to identify any preclinical CBF change.
Methods:
A total of 30 aFD subjects were consecutively recruited and compared to 28 healthy controls. Brain magnetic resonance imaging was normal in all participants. TCD was used to study blood flow velocity and indices of resistance of intracranial arteries from the middle cerebral artery (MCA), bilaterally, and from the basilar artery (BA). Cerebral vasomotor reactivity (CVR) was also evaluated from MCA.
Results:
No difference was found between groups for MCA parameters of CBF velocity and CVR. Compared to controls, a higher mean blood flow velocity and a lower resistance index from BA were observed in FD subjects. No correlation was found between any BA-derived TCD parameter and the level of lyso-globotriaosylceramide.
Conclusions:
aFD subjects show evidence of altered CBF velocity in posterior circulation. Preclinical detection of neurovascular involvement in FD might allow appropriate management and prevention of future cerebrovascular complications and disability.
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