Cerebral blood flow in conscious rats and implications for therapeutic interventions

Cerebral blood flow (CBF) often becomes compromised in patients suffering from cardiovascular diseases, increasing the risk of neurodegenerative disease and vascular dementia. There is an urgent need for treatments to address cardiovascular risk without compromising brain perfusion, yet the impact of many existing treatments on CBF are not well understood. An exclusive focus on arterial blood pressure (BP) control against a background of cerebral vascular damage may miss an opportunity to restore cerebral haemodynamic regulation and mitigate risk to cognitive function. This Symposium Review focuses on the possibility and promise of assessing and optimising CBF during treatment for cardiovascular diseases. This is especially relevant given the new interest in pathways that protect brain health via cerebrospinal fluid exchange, such as the glymphatic system. Insights into the fundamental mechanisms connecting vascular motility and brain health can be gleaned from conscious, high-fidelity measurements of CBF. We believe that CBF monitoring is crucial in the development of novel compounds, or re-evaluation of current drugs.