Directional sensitivity of the cerebral pressure-flow relationship during forced oscillations induced by oscillatory...

A directional sensitivity of the cerebral pressure-flow relationship has been described using repeated squat-stands. Oscillatory lower body negative pressure (OLBNP) is a reproducible method to characterize dynamic cerebral autoregulation (dCA). It could represent a safer method to examine the directional sensitivity of the cerebral pressure-flow relationship within clinical populations and/or during pharmaceutical administration. Therefore, examining the cerebral pressure-flow directional sensitivity during an OLBNP-induced cyclic physiological stress is crucial. We calculated changes in middle cerebral artery mean blood velocity (MCAv) per alterations to mean arterial pressure (MAP) to compute ratios adjusted for time intervals (ΔMCAv_T/ΔMAP_T) with respect to the minimum-to-maximum MCAv and MAP, for each OLBNP transition (0 to -90 Torr), during 0.05 Hz and 0.10 Hz OLBNP. We then compared averaged ΔMCAv_T/ΔMAP_T during OLBNP-induced MAP increases (INC) (ΔMCAv_T/$\Delta {\text{MAP}}_{\text{T}}^{\text{INC}}$) and decreases (DEC) (ΔMCAv_T/$\Delta {\text{MAP}}_{\text{T}}^{\text{DEC}}$). Nineteen healthy participants [9 females; 30 ± 6 years] were included. There were no differences in ΔMCAv_T/ΔMAP_T between INC and DEC at 0.05 Hz. ΔMCAv_T/$\Delta {\text{MAP}}_{\text{T}}^{\text{INC}}$ (1.06 ± 0.35 vs. 1.33 ± 0.60 cm⋅s^-1/mmHg; p = 0.0076) was lower than ΔMCAv_T/$\Delta {\text{MAP}}_{\text{T}}^{\text{DEC}}$ at 0.10 Hz. These results support OLBNP as a model to evaluate the directional sensitivity of the cerebral pressure-flow relationship.