Cerebral autoregulation in the acute and subacute phase of ischemic stroke patients submitted to thrombolysis

• Grant number: 13/25953-0
• Support Opportunities: Regular Research Grants
• Start date: December 01, 2014
• End date: November 30, 2017
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Ricardo de Carvalho Nogueira
• Grantee: Ricardo de Carvalho Nogueira
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: EDSON BOR-SENG-SHU ; Manoel Jacobsen Teixeira

Abstract

Cerebral autoregulation (CA) is a physiologic mechanism where by constriction or dilatation of cerebral microcirculation the cerebral blood flow (CBF) is kept constant, in spite of fluctuations of arterial blood pressure (ABP), thus protecting the brain from hypo or hyper perfusion. Intactness of CA can be estimated from the relationship between spontaneous fluctuations or changes in BP and CBF, and graded according to the Tiecks Autoregulation Index. Several methods can be used to measure CBF; Transcranial Doppler (TCD) ultrasound is one of the most commonly implemented techniques that is frequently used for research studies, mostly due to its non-invasive and portable nature as well as temporal and spatial resolution. There are two methods for estimating CA; static and dynamic, though research studies frequently implement the dynamic method because it can be applied without the use of drugs or invasive stimuli to alter the arterial BP (ABP), and can be applied to critical care patients through the analysis of spontaneous fluctuations of ABP. The importance of measuring CA has become to the forefront through years of research, which has found the presence of significant impairment of CA in the acute phase of stroke. Furthermore, it is believed that this impairment can affect the penumbra zone, and the study of CA could impact their treatment options. Until now, thrombolytic therapy is the only approved treatment in the acute phase of stroke, and management of ABP during and after treatment is directly related to the cerebral haemorrhagic complications due to the treatment impacting neurological outcome. Thus, the eventual CA impairment during and after the thrombolytic therapy could also impact neurological outcome. (AU)

Scientific publications

(4)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

NOGUEIRA, R. C.; PANERAI, R. B.; TEIXEIRA, M. J.; ROBINSON, T. G.; BOR-SENG-SHU, E.. Cerebral Hemodynamic Effects of Cheyne-Stokes Respiration in a Patient with Stroke. JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v. 26, n. 5, p. E80-E82, MAY 2017. (13/25953-0)

NOGUEIRA, RICARDO C.; BOR-SENG-SHU, EDSON; SAEED, NAZIA P.; TEIXEIRA, MANOEL J.; PANERAI, RONNEY B.; ROBINSON, THOMPSON G.. Meta-analysis of Vascular Imaging Features to Predict Outcome Following Intravenous rtPA for Acute Ischemic Stroke. FRONTIERS IN NEUROLOGY, v. 7, MAY 18 2016. (13/25953-0)

LLWYD, OSIAN; SALINET, ANGELA S. M.; PANERAI, RONNEY B.; LAM, MAN Y.; SAEED, NAZIA P.; BRODIE, FIONA; BOR-SENG-SHU, EDSON; ROBINSON, THOMPSON G.; NOGUEIRA, RICARDO C.. Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype. CEREBROVASCULAR DISEASES EXTRA, v. 8, n. 2, p. 80-89, 2018. (13/25953-0, 14/04955-8)

NOGUEIRA, RICARDO C.; LAM, MAN Y.; LLWYD, OSIAN; SALINET, ANGELA S. M.; BOR-SENG-SHU, EDSON; PANERAI, RONNEY B.; ROBINSON, THOMPSON G.. Cerebral autoregulation and response to intravenous thrombolysis for acute ischemic stroke. SCIENTIFIC REPORTS, v. 10, n. 1, JUN 29 2020. (13/25953-0)