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Al-Shama RFM, Uleman JF, Pereira M, Claassen JAHR, Dresler M. Cerebral blood flow in sleep: A systematic review and meta-analysis. Sleep Med Rev 2024; 77:101977. [PMID: 39096646 DOI: 10.1016/j.smrv.2024.101977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 08/05/2024]
Abstract
Sleep plays an essential role in physiology, allowing the brain and body to restore itself. Despite its critical role, our understanding of the underlying processes in the sleeping human brain is still limited. Sleep comprises several distinct stages with varying depths and temporal compositions. Cerebral blood flow (CBF), which delivers essential nutrients and oxygen to the brain, varies across brain regions throughout these sleep stages, reflecting changes in neuronal function and regulation. This systematic review and meta-analysis assesses global and regional CBF across sleep stages. We included, appraised, and summarized all 38 published sleep studies on CBF in healthy humans that were not or only slightly (<24 h) sleep deprived. Our main findings are that CBF varies with sleep stage and depth, being generally lowest in NREM sleep and highest in REM sleep. These changes appear to stem from sleep stage-specific regional brain activities that serve particular functions, such as alterations in consciousness and emotional processing.
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Affiliation(s)
- Rushd F M Al-Shama
- Department of Clinical and Experimental Cardiology and Cardiothoracic Surgery, Heart Center, University of Amsterdam, Amsterdam UMC location AMC, Amsterdam, the Netherlands.
| | - Jeroen F Uleman
- Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mariana Pereira
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jurgen A H R Claassen
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
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2
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Inamasu J, Akiyama T, Akaji K, Inaba M, Nishimoto M, Kojima A, Terao S, Hayashi T, Mizutani K, Toda M. Aneurysmal subarachnoid hemorrhage occurring during sleep: Clinical characteristics and risk factors. J Stroke Cerebrovasc Dis 2024; 33:107591. [PMID: 38266691 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Aneurysmal subarachnoid hemorrhage (aSAH) is known to be triggered by several specific human activities. Sleep, by contrast, has not been considered a triggering activity for aSAH, and clinical characteristics of patients who sustain aSAH during sleep have rarely been reported in the literature. METHODS This is a retrospective analysis on the data acquired through a multicenter aSAH registry. Between January 2019 and December 2021, a total of 732 aSAH patients had been registered into our database. After excluding 109 patients whose activities at aSAH onset had been unidentifiable, the remaining 623 aSAH patients were dichotomized to 59 patients who sustained aSAH during sleep (Sleep group) and 564 patients who sustained aSAH during daytime activities (Awake group). Two-group comparison of demographic variables and multivariate logistic regression analysis were performed to clarify their clinical characteristics and identify potential risk factors. RESULTS The Sleep group exhibited significantly higher frequencies of diabetes (15.5 % vs. 6.4 %, p = 0.01) and antiplatelet use (13.8 % vs. 4.6 %, p=0.004) than the Awake group. Furthermore, multivariate logistic regression analysis showed that diabetes (OR, 3.051; 95 % CI, 1.281-7.268; p = 0.012) and antiplatelet use (OR, 3.640; 95 % CI, 1.422-9.316; p = 0.007) were correlated with aSAH occurring during sleep. There were no significant inter-group differences in the patient outcomes evaluated at discharge. CONCLUSION The current results indicate that risk factors may exist for aSAH occurring during sleep. Further investigations on how comorbidities such as diabetes, antiplatelet use and sleep apnea affect human hemodynamic and hemostatic parameters during sleep is warranted to better understand those relationships.
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Affiliation(s)
- Joji Inamasu
- Department of Neurosurgery, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi, Utsunomiya 321-0974, Japan.
| | - Takenori Akiyama
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazunori Akaji
- Department of Neurosurgery, Mihara Memorial Hospital, Isesaki, Japan
| | - Makoto Inaba
- Department of Neurosurgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Masaaki Nishimoto
- Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Atsuhiro Kojima
- Department of Neurosurgery, Saitama City Hospital, Saitama, Japan
| | - Satoshi Terao
- Department of Neurosurgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Takuro Hayashi
- Department of Neurosurgery, NHO Tokyo Medical Center, Tokyo, Japan
| | - Katsuhiro Mizutani
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Toda
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
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3
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Chen P, Wang W, Ban W, Zhang K, Dai Y, Yang Z, You Y. Deciphering Post-Stroke Sleep Disorders: Unveiling Neurological Mechanisms in the Realm of Brain Science. Brain Sci 2024; 14:307. [PMID: 38671959 PMCID: PMC11047862 DOI: 10.3390/brainsci14040307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/28/2024] Open
Abstract
Sleep disorders are the most widespread mental disorders after stroke and hurt survivors' functional prognosis, response to restoration, and quality of life. This review will address an overview of the progress of research on the biological mechanisms associated with stroke-complicating sleep disorders. Extensive research has investigated the negative impact of stroke on sleep. However, a bidirectional association between sleep disorders and stroke exists; while stroke elevates the risk of sleep disorders, these disorders also independently contribute as a risk factor for stroke. This review aims to elucidate the mechanisms of stroke-induced sleep disorders. Possible influences were examined, including functional changes in brain regions, cerebrovascular hemodynamics, neurological deficits, sleep ion regulation, neurotransmitters, and inflammation. The results provide valuable insights into the mechanisms of stroke complicating sleep disorders.
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Affiliation(s)
- Pinqiu Chen
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (P.C.)
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Wenyan Wang
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (P.C.)
| | - Weikang Ban
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Kecan Zhang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Yanan Dai
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Zhihong Yang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Yuyang You
- School of Automation, Beijing Institute of Technology, Beijing 100081, China
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4
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Licastro E, Pignataro G, Iliff JJ, Xiang Y, Lo EH, Hayakawa K, Esposito E. Glymphatic and lymphatic communication with systemic responses during physiological and pathological conditions in the central nervous system. Commun Biol 2024; 7:229. [PMID: 38402351 PMCID: PMC10894274 DOI: 10.1038/s42003-024-05911-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024] Open
Abstract
Crosstalk between central nervous system (CNS) and systemic responses is important in many pathological conditions, including stroke, neurodegeneration, schizophrenia, epilepsy, etc. Accumulating evidence suggest that signals for central-systemic crosstalk may utilize glymphatic and lymphatic pathways. The glymphatic system is functionally connected to the meningeal lymphatic system, and together these pathways may be involved in the distribution of soluble proteins and clearance of metabolites and waste products from the CNS. Lymphatic vessels in the dura and meninges transport cerebrospinal fluid, in part collected from the glymphatic system, to the cervical lymph nodes, where solutes coming from the brain (i.e., VEGFC, oligomeric α-syn, β-amyloid) might activate a systemic inflammatory response. There is also an element of time since the immune system is strongly regulated by circadian rhythms, and both glymphatic and lymphatic dynamics have been shown to change during the day and night. Understanding the mechanisms regulating the brain-cervical lymph node (CLN) signaling and how it might be affected by diurnal or circadian rhythms is fundamental to find specific targets and timing for therapeutic interventions.
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Affiliation(s)
- Ester Licastro
- Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University "Federico II", Naples, Italy
| | - Giuseppe Pignataro
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University "Federico II", Naples, Italy
| | - Jeffrey J Iliff
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Yanxiao Xiang
- Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Eng H Lo
- Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Consortium International pour la Recherche Circadienne sur l'AVC (CIRCA), Radcliffe Department of Medicine, University of Oxford, Headington, Oxford, UK
| | - Kazuhide Hayakawa
- Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
| | - Elga Esposito
- Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
- Consortium International pour la Recherche Circadienne sur l'AVC (CIRCA), Radcliffe Department of Medicine, University of Oxford, Headington, Oxford, UK.
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5
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Tichelman NL, Foerges AL, Elmenhorst EM, Lange D, Hennecke E, Baur DM, Beer S, Kroll T, Neumaier B, Bauer A, Landolt HP, Aeschbach D, Elmenhorst D. A genetic variation in the adenosine A2A receptor gene contributes to variability in oscillatory alpha power in wake and sleep EEG and A 1 adenosine receptor availability in the human brain. Neuroimage 2023; 280:120345. [PMID: 37625500 DOI: 10.1016/j.neuroimage.2023.120345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/25/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023] Open
Abstract
The EEG alpha rhythm (∼ 8-13 Hz) is one of the most salient human brain activity rhythms, modulated by the level of attention and vigilance and related to cerebral energy metabolism. Spectral power in the alpha range in wakefulness and sleep strongly varies among individuals based on genetic predisposition. Knowledge about the underlying genes is scarce, yet small studies indicated that the variant rs5751876 of the gene encoding A2A adenosine receptors (ADORA2A) may contribute to the inter-individual variation. The neuromodulator adenosine is directly linked to energy metabolism as product of adenosine tri-phosphate breakdown and acts as a sleep promoting molecule by activating A1 and A2A adenosine receptors. We performed sleep and positron emission tomography studies in 59 healthy carriers of different rs5751876 alleles, and quantified EEG oscillatory alpha power in wakefulness and sleep, as well as A1 adenosine receptor availability with 18F-CPFPX. Oscillatory alpha power was higher in homozygous C-allele carriers (n = 27, 11 females) compared to heterozygous and homozygous carriers of the T-allele (n(C/T) = 23, n(T/T) = 5, 13 females) (F(18,37) = 2.35, p = 0.014, Wilk's Λ = 0.487). Furthermore, a modulatory effect of ADORA2A genotype on A1 adenosine receptor binding potential was found across all considered brain regions (F(18,40) = 2.62, p = 0.006, Wilk's Λ = 0.459), which remained significant for circumscribed occipital region of calcarine fissures after correction for multiple comparisons. In female participants, a correlation between individual differences in oscillatory alpha power and A1 receptor availability was observed. In conclusion, we confirmed that a genetic variant of ADORA2A affects individual alpha power, while a direct modulatory effect via A1 adenosine receptors in females is suggested.
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Affiliation(s)
- Naemi L Tichelman
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Wilhelm-Johnen-Strasse, Jülich, North Rhine-Westphalia 52428, Germany
| | - Anna L Foerges
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Wilhelm-Johnen-Strasse, Jülich, North Rhine-Westphalia 52428, Germany; RWTH Aachen University, Department of Neurophysiology, Institute of Zoology (Bio-II), Worringerweg 3, Aachen, North Rhine-Westphalia 52074, Germany
| | - Eva-Maria Elmenhorst
- German Aerospace Center, Institute of Aerospace Medicine, Linder Höhe, Cologne, North Rhine-Westphalia 51147, Germany; Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, North Rhine-Westphalia 52074, Germany
| | - Denise Lange
- German Aerospace Center, Institute of Aerospace Medicine, Linder Höhe, Cologne, North Rhine-Westphalia 51147, Germany
| | - Eva Hennecke
- German Aerospace Center, Institute of Aerospace Medicine, Linder Höhe, Cologne, North Rhine-Westphalia 51147, Germany
| | - Diego M Baur
- University of Zurich, Institute of Pharmacology & Toxicology, Winterthurerstrasse 190, Zurich 8057, Switzerland and Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - Simone Beer
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Wilhelm-Johnen-Strasse, Jülich, North Rhine-Westphalia 52428, Germany
| | - Tina Kroll
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Wilhelm-Johnen-Strasse, Jülich, North Rhine-Westphalia 52428, Germany
| | - Bernd Neumaier
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-5), Wilhelm-Johnen-Strasse, Jülich, North Rhine-Westphalia 52428, Germany
| | - Andreas Bauer
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Wilhelm-Johnen-Strasse, Jülich, North Rhine-Westphalia 52428, Germany
| | - Hans-Peter Landolt
- University of Zurich, Institute of Pharmacology & Toxicology, Winterthurerstrasse 190, Zurich 8057, Switzerland and Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - Daniel Aeschbach
- German Aerospace Center, Institute of Aerospace Medicine, Linder Höhe, Cologne, North Rhine-Westphalia 51147, Germany; Harvard Medical School, Division of Sleep Medicine, Suite BL-438, 221 Longwood Avenue, Boston, Massachusetts 02115, United States of America; Rheinische Friedrich-Wilhelms-Universität Bonn, Institute of Experimental Epileptology and Cognition Research, University of Bonn Medical Center, Sigmund-Freud Str. 25, Bonn, North Rhine-Westphalia 53127, Germany
| | - David Elmenhorst
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Wilhelm-Johnen-Strasse, Jülich, North Rhine-Westphalia 52428, Germany; Rheinische Friedrich-Wilhelms-Universität Bonn, Division of Medical Psychology, Venusberg-Campus 1, Bonn, North Rhine-Westphalia 53127, Germany; University Hospital Cologne, Multimodal Neuroimaging Group, Department of Nuclear Medicine, Kerpener Strasse 62, Cologne, North Rhine-Westphalia 50937, Germany.
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6
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Mitchell JW, Gillette MU. Development of circadian neurovascular function and its implications. Front Neurosci 2023; 17:1196606. [PMID: 37732312 PMCID: PMC10507717 DOI: 10.3389/fnins.2023.1196606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
The neurovascular system forms the interface between the tissue of the central nervous system (CNS) and circulating blood. It plays a critical role in regulating movement of ions, small molecules, and cellular regulators into and out of brain tissue and in sustaining brain health. The neurovascular unit (NVU), the cells that form the structural and functional link between cells of the brain and the vasculature, maintains the blood-brain interface (BBI), controls cerebral blood flow, and surveils for injury. The neurovascular system is dynamic; it undergoes tight regulation of biochemical and cellular interactions to balance and support brain function. Development of an intrinsic circadian clock enables the NVU to anticipate rhythmic changes in brain activity and body physiology that occur over the day-night cycle. The development of circadian neurovascular function involves multiple cell types. We address the functional aspects of the circadian clock in the components of the NVU and their effects in regulating neurovascular physiology, including BBI permeability, cerebral blood flow, and inflammation. Disrupting the circadian clock impairs a number of physiological processes associated with the NVU, many of which are correlated with an increased risk of dysfunction and disease. Consequently, understanding the cell biology and physiology of the NVU is critical to diminishing consequences of impaired neurovascular function, including cerebral bleeding and neurodegeneration.
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Affiliation(s)
- Jennifer W. Mitchell
- Department of Cell and Developmental Biology, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Martha U. Gillette
- Department of Cell and Developmental Biology, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Carle-Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
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7
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Zhang D, Li X, Li B. Glymphatic System Dysfunction in Central Nervous System Diseases and Mood Disorders. Front Aging Neurosci 2022; 14:873697. [PMID: 35547631 PMCID: PMC9082304 DOI: 10.3389/fnagi.2022.873697] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/31/2022] [Indexed: 12/13/2022] Open
Abstract
The glymphatic system, a recently discovered macroscopic waste removal system in the brain, has many unknown aspects, especially its driving forces and relationship with sleep, and thus further explorations of the relationship between the glymphatic system and a variety of possible related diseases are urgently needed. Here, we focus on the progress in current research on the role of the glymphatic system in several common central nervous system diseases and mood disorders, discuss the structural and functional abnormalities of the glymphatic system which may occur before or during the pathophysiological progress and the possible underlying mechanisms. We emphasize the relationship between sleep and the glymphatic system under pathological conditions and summarize the common imaging techniques for the glymphatic system currently available. The perfection of the glymphatic system hypothesis and the exploration of the effects of aging and endocrine factors on the central and peripheral regulatory pathways through the glymphatic system still require exploration in the future.
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Affiliation(s)
- Dianjun Zhang
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, School of Forensic Medicine, China Medical University, Shenyang, China
- China Medical University Center of Forensic Investigation, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Xinyu Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, School of Forensic Medicine, China Medical University, Shenyang, China
- China Medical University Center of Forensic Investigation, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Baoman Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, School of Forensic Medicine, China Medical University, Shenyang, China
- China Medical University Center of Forensic Investigation, School of Forensic Medicine, China Medical University, Shenyang, China
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8
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Schaeffer S, Iadecola C. Revisiting the neurovascular unit. Nat Neurosci 2021; 24:1198-1209. [PMID: 34354283 PMCID: PMC9462551 DOI: 10.1038/s41593-021-00904-7] [Citation(s) in RCA: 245] [Impact Index Per Article: 81.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
The brain is supplied by an elaborate vascular network that originates extracranially and reaches deep into the brain. The concept of the neurovascular unit provides a useful framework to investigate how neuronal signals regulate nearby microvessels to support the metabolic needs of the brain, but it does not consider the role of larger cerebral arteries and systemic vasoactive signals. Furthermore, the recently emerged molecular heterogeneity of cerebrovascular cells indicates that there is no prototypical neurovascular unit replicated at all levels of the vascular network. Here, we examine the cellular and molecular diversity of the cerebrovascular tree and the relative contribution of systemic and brain-intrinsic factors to neurovascular function. Evidence supports the concept of a 'neurovascular complex' composed of segmentally diverse functional modules that implement coordinated vascular responses to central and peripheral signals to maintain homeostasis of the brain. This concept has major implications for neurovascular regulation in health and disease and for brain imaging.
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Abstract
Sleep is essential for healthy being and healthy functioning of human body as a whole, as well as each organ and system. Sleep disorders, such as sleep-disordered breathing, insomnia, sleep fragmentation, and sleep deprivation are associated with the deterioration in human body functioning and increased cardiovascular risks. However, owing to the complex regulation and heterogeneous state sleep per se can be associated with cardiovascular dysfunction in susceptible subjects. The understanding of sleep as a multidimensional concept is important for better prevention and treatment of cardiovascular diseases.
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Affiliation(s)
- Lyudmila Korostovtseva
- Sleep Laboratory, Research Department for Hypertension, Department for Cardiology, Almazov National Medical Research Centre, 2 Akkuratov Street, St Petersburg 197341, Russia.
| | - Mikhail Bochkarev
- Sleep Laboratory, Research Department for Hypertension, Almazov National Medical Research Centre, 2 Akkuratov Street, St Petersburg 197341, Russia
| | - Yurii Sviryaev
- Research Department for Hypertension, Almazov National Medical Research Centre, 2 Akkuratov Street, St Petersburg 197341, Russia
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10
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Ren H, Jiang X, Xu K, Chen C, Yuan Y, Dai C, Chen W. A Review of Cerebral Hemodynamics During Sleep Using Near-Infrared Spectroscopy. Front Neurol 2020; 11:524009. [PMID: 33329295 PMCID: PMC7710901 DOI: 10.3389/fneur.2020.524009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 10/26/2020] [Indexed: 11/13/2022] Open
Abstract
Investigating cerebral hemodynamic changes during regular sleep cycles and sleep disorders is fundamental to understanding the nature of physiological and pathological mechanisms in the regulation of cerebral oxygenation during sleep. Although sleep neuroimaging methods have been studied and have been well-reviewed, they have limitations in terms of technique and experimental design. Neurologists are convinced that Near-infrared spectroscopy (NIRS) provides essential information and can be used to assist the assessment of cerebral hemodynamics, and numerous studies regarding sleep have been carried out based on NIRS. Thus, a brief historical overview of the sleep studies using NIRS will be helpful for the biomedical students, academicians, and engineers to better understand NIRS from various perspectives. In this study, the existing literature on sleep studies is reviewed, and an overview of the NIRS applications is synthesized and provided. The paper first reviews the application scenarios, as well as the patterns of fluctuation of NIRS, which includes the investigation in regular sleep and sleep-disordered breathing. Various factors such as different sleep stages, populations, and degrees of severity were considered. Furthermore, the experimental design and signal processing, as well as the regulation mechanisms involved in regular and pathological sleep, are investigated and discussed. The strengths and weaknesses of the existing NIRS applications are addressed and presented, which can direct further NIRS analysis and utilization.
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Affiliation(s)
- Haoran Ren
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Xinyu Jiang
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Ke Xu
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Chen Chen
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Yafei Yuan
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Chenyun Dai
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Wei Chen
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention, Shanghai, China
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11
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Benveniste H, Elkin R, Heerdt PM, Koundal S, Xue Y, Lee H, Wardlaw J, Tannenbaum A. The glymphatic system and its role in cerebral homeostasis. J Appl Physiol (1985) 2020; 129:1330-1340. [PMID: 33002383 DOI: 10.1152/japplphysiol.00852.2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The brain's high bioenergetic state is paralleled by high metabolic waste production. Authentic lymphatic vasculature is lacking in brain parenchyma. Cerebrospinal fluid (CSF) flow has long been thought to facilitate central nervous system detoxification in place of lymphatics, but the exact processes involved in toxic waste clearance from the brain remain incompletely understood. Over the past 8 yr, novel data in animals and humans have begun to shed new light on these processes in the form of the "glymphatic system," a brain-wide perivascular transit passageway dedicated to CSF transport and interstitial fluid exchange that facilitates metabolic waste drainage from the brain. Here we will discuss glymphatic system anatomy and methods to visualize and quantify glymphatic system (GS) transport in the brain and also discuss physiological drivers of its function in normal brain and in neurodegeneration.
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Affiliation(s)
- Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | - Rena Elkin
- Departments of Computer Science and Applied Mathematics & Statistics, Stony Brook University, Stony Brook, New York
| | - Paul M Heerdt
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | - Sunil Koundal
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | - Yuechuan Xue
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | - Hedok Lee
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | - Joanna Wardlaw
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, Dementia Research Institute at the University of Edinburgh, Edinburgh, United Kingdom
| | - Allen Tannenbaum
- Departments of Computer Science and Applied Mathematics & Statistics, Stony Brook University, Stony Brook, New York
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Gorgoni M, D’Atri A, Scarpelli S, Ferrara M, De Gennaro L. The electroencephalographic features of the sleep onset process and their experimental manipulation with sleep deprivation and transcranial electrical stimulation protocols. Neurosci Biobehav Rev 2020; 114:25-37. [PMID: 32343983 DOI: 10.1016/j.neubiorev.2020.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/28/2020] [Accepted: 04/05/2020] [Indexed: 02/08/2023]
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13
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Benveniste H, Heerdt PM, Fontes M, Rothman DL, Volkow ND. Glymphatic System Function in Relation to Anesthesia and Sleep States. Anesth Analg 2019; 128:747-758. [PMID: 30883420 DOI: 10.1213/ane.0000000000004069] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The brain is one of the most metabolically active organs in the body. The brain's high energy demand associated with wakefulness persists during rapid eye movement sleep, and even during non-rapid eye movement sleep, cerebral oxygen consumption is only reduced by 20%. The active bioenergetic state parallels metabolic waste production at a higher rate than in other organs, and the lack of lymphatic vasculature in brain parenchyma is therefore a conundrum. A common assumption has been that with a tight blood-brain barrier restricting solute and fluid movements, a lymphatic system is superfluous in the central nervous system. Cerebrospinal fluid (CSF) flow has long been thought to facilitate central nervous system tissue "detoxification" in place of lymphatics. Nonetheless, while CSF production and transport have been studied for decades, the exact processes involved in toxic waste clearance remain poorly understood. Over the past 5 years, emerging data have begun to shed new light on these processes in the form of the "glymphatic system," a novel brain-wide perivascular transit passageway dedicated to CSF transport and metabolic waste drainage from the brain. Here, we review the key anatomical components and operational drivers of the brain's glymphatic system, with a focus on its unique functional dependence on the state of arousal and anesthetic regimens. We also discuss evidence for why clinical exploration of this novel system may in the future provide valuable insight into new strategies for preventing delirium and cognitive dysfunction in perioperative and critical care settings.
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Affiliation(s)
| | | | | | - Douglas L Rothman
- Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Nora D Volkow
- Laboratory for Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
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14
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Gorgoni M, Bartolacci C, D’Atri A, Scarpelli S, Marzano C, Moroni F, Ferrara M, De Gennaro L. The Spatiotemporal Pattern of the Human Electroencephalogram at Sleep Onset After a Period of Prolonged Wakefulness. Front Neurosci 2019; 13:312. [PMID: 31001079 PMCID: PMC6456684 DOI: 10.3389/fnins.2019.00312] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/19/2019] [Indexed: 02/05/2023] Open
Abstract
During the sleep onset (SO) process, the human electroencephalogram (EEG) is characterized by an orchestrated pattern of spatiotemporal changes. Sleep deprivation (SD) strongly affects both wake and sleep EEG, but a description of the topographical EEG power spectra and oscillatory activity during the wake-sleep transition after a period of prolonged wakefulness is still missing. The increased homeostatic sleep pressure should induce an earlier onset of sleep-related EEG oscillations. The aim of the present study was to assess the spatiotemporal EEG pattern at SO following SD. A dataset of a previous study was analyzed. We assessed the spatiotemporal EEG changes (19 cortical derivations) during the SO (5 min before vs. 5 min after the first epoch of Stage 2) of a recovery night after 40 h of SD in 39 healthy subjects, analyzing the EEG power spectra (fast Fourier transform) and the oscillatory activity [better oscillation (BOSC) detection method]. The spatiotemporal pattern of the EEG power spectra mostly confirmed the changes previously observed during the wake-sleep transition at baseline. The comparison between baseline and recovery showed a wide increase of the post- vs. pre-SO ratio during the recovery night in the frequency bins ≤10 Hz. We found a predominant alpha oscillatory rhythm in the pre-SO period, while after SO the theta oscillatory activity was prevalent. The oscillatory peaks showed a generalized increase in all frequency bands from delta to sigma with different predominance, while beta activity increased only in the fronto-central midline derivations. Overall, the analysis of the EEG power replicated the topographical pattern observed during a baseline night of sleep but with a stronger intensity of the SO-induced changes in the frequencies ≤10 Hz, and the detection of the rhythmic activity showed the rise of several oscillations at SO after SD that was not observed during the wake-sleep transition at baseline (e.g., alpha and frontal theta in correspondence of their frequency peaks). Beyond confirming the local nature of the EEG pattern at SO, our results show that SD has an impact on the spatiotemporal modulation of cortical activity during the falling-asleep process, inducing the earlier emergence of sleep-related EEG oscillations.
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Aurora D’Atri
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristina Marzano
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Moroni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
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15
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Clement P, Mutsaerts HJ, Václavů L, Ghariq E, Pizzini FB, Smits M, Acou M, Jovicich J, Vanninen R, Kononen M, Wiest R, Rostrup E, Bastos-Leite AJ, Larsson EM, Achten E. Variability of physiological brain perfusion in healthy subjects - A systematic review of modifiers. Considerations for multi-center ASL studies. J Cereb Blood Flow Metab 2018; 38:1418-1437. [PMID: 28393659 PMCID: PMC6120130 DOI: 10.1177/0271678x17702156] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Quantitative measurements of brain perfusion are influenced by perfusion-modifiers. Standardization of measurement conditions and correction for important modifiers is essential to improve accuracy and to facilitate the interpretation of perfusion-derived parameters. An extensive literature search was carried out for factors influencing quantitative measurements of perfusion in the human brain unrelated to medication use. A total of 58 perfusion modifiers were categorized into four groups. Several factors (e.g., caffeine, aging, and blood gases) were found to induce a considerable effect on brain perfusion that was consistent across different studies; for other factors, the modifying effect was found to be debatable, due to contradictory results or lack of evidence. Using the results of this review, we propose a standard operating procedure, based on practices already implemented in several research centers. Also, a theory of 'deep MRI physiotyping' is inferred from the combined knowledge of factors influencing brain perfusion as a strategy to reduce variance by taking both personal information and the presence or absence of perfusion modifiers into account. We hypothesize that this will allow to personalize the concept of normality, as well as to reach more rigorous and earlier diagnoses of brain disorders.
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Affiliation(s)
- Patricia Clement
- 1 Department of Radiology and nuclear medicine, Ghent University, Ghent, Belgium
| | - Henk-Jan Mutsaerts
- 2 Cognitive Neurology Research Unit, Sunnybrook Healthy Sciences Centre, Toronto, Canada.,3 Academic Medical Center, Amsterdam, the Netherlands
| | - Lena Václavů
- 3 Academic Medical Center, Amsterdam, the Netherlands
| | - Eidrees Ghariq
- 4 Leiden University Medical Center, Leiden, the Netherlands
| | | | | | - Marjan Acou
- 1 Department of Radiology and nuclear medicine, Ghent University, Ghent, Belgium
| | - Jorge Jovicich
- 7 Magnetic Resonance Imaging Laboratory Center for Mind/Brain Sciences, University of Trento, Mattarello, Italy
| | | | | | | | - Egill Rostrup
- 10 Department of Diagnostics, Glostrup Hospital, University of Copenhagen, Denmark
| | | | | | - Eric Achten
- 1 Department of Radiology and nuclear medicine, Ghent University, Ghent, Belgium
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16
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Golestani AM, Kwinta JB, Khatamian YB, Chen JJ. The Effect of Low-Frequency Physiological Correction on the Reproducibility and Specificity of Resting-State fMRI Metrics: Functional Connectivity, ALFF, and ReHo. Front Neurosci 2017; 11:546. [PMID: 29051724 PMCID: PMC5633680 DOI: 10.3389/fnins.2017.00546] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 09/19/2017] [Indexed: 01/08/2023] Open
Abstract
The resting-state fMRI (rs-fMRI) signal is affected by a variety of low-frequency physiological phenomena, including variations in cardiac-rate (CRV), respiratory-volume (RVT), and end-tidal CO2 (PETCO2). While these effects have become better understood in recent years, the impact that their correction has on the quality of rs-fMRI measurements has yet to be clarified. The objective of this paper is to investigate the effect of correcting for CRV, RVT and PETCO2 on the rs-fMRI measurements. Nine healthy subjects underwent a test-retest rs-fMRI acquisition using repetition times (TRs) of 2 s (long-TR) and 0.323 s (short-TR), and the data were processed using eight different physiological correction strategies. Subsequently, regional homogeneity (ReHo), amplitude of low-frequency fluctuation (ALFF), and resting-state connectivity of the motor and default-mode networks are calculated for each strategy. Reproducibility is calculated using intra-class correlation and the Dice Coefficient, while the accuracy of functional-connectivity measures is assessed through network separability, sensitivity and specificity. We found that: (1) the reproducibility of the rs-fMRI measures improved significantly after correction for PETCO2; (2) separability of functional networks increased after PETCO2 correction but was not affected by RVT and CRV correction; (3) the effect of physiological correction does not depend on the data sampling-rate; (4) the effect of physiological processes and correction strategies is network-specific. Our findings highlight limitations in our understanding of rs-fMRI quality measures, and underscore the importance of using multiple quality measures to determine the optimal physiological correction strategy.
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Affiliation(s)
- Ali M Golestani
- Rotman Research Institute at Baycrest Centre, University of Toronto, Toronto, ON, Canada
| | - Jonathan B Kwinta
- Rotman Research Institute at Baycrest Centre, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yasha B Khatamian
- Rotman Research Institute at Baycrest Centre, University of Toronto, Toronto, ON, Canada
| | - J Jean Chen
- Rotman Research Institute at Baycrest Centre, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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17
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Interpreting EEG alpha activity. Neurosci Biobehav Rev 2014; 44:94-110. [DOI: 10.1016/j.neubiorev.2013.05.007] [Citation(s) in RCA: 259] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 04/05/2013] [Accepted: 05/03/2013] [Indexed: 01/04/2023]
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18
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Marzano C, Moroni F, Gorgoni M, Nobili L, Ferrara M, De Gennaro L. How we fall asleep: regional and temporal differences in electroencephalographic synchronization at sleep onset. Sleep Med 2013; 14:1112-22. [PMID: 24051119 DOI: 10.1016/j.sleep.2013.05.021] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/15/2013] [Accepted: 05/21/2013] [Indexed: 02/05/2023]
Affiliation(s)
- Cristina Marzano
- Department of Psychology, University of Rome "Sapienza", Rome, Italy
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19
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Peng T, Niazy R, Payne SJ, Wise RG. The effects of respiratory CO2 fluctuations in the resting-state BOLD signal differ between eyes open and eyes closed. Magn Reson Imaging 2012; 31:336-45. [PMID: 22921940 DOI: 10.1016/j.mri.2012.06.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 06/24/2012] [Indexed: 11/16/2022]
Abstract
Resting fluctuations in arterial CO2 (a cerebral vasodilator) are believed to be an important source of low-frequency blood oxygenation level dependent (BOLD) signal fluctuations. In this study we focus on the two commonly used resting-states in functional magnetic resonance imaging experiments, eyes open and eyes closed, and quantify the degree to which measured spontaneous fluctuations in the partial pressure of end-tidal CO2 (Petco2) relate to BOLD signal time series. A significantly longer latency of BOLD signal changes following Petco2 fluctuations was found in the eyes closed condition compared to with eyes open, which may reveal different intrinsic vascular response delays in CO2 reactivity or an alteration in the net BOLD signal arising from Petco2 fluctuations and altered neural activity with eyes closed. By allowing a spatially varying time delay for the compensation of this temporal difference, a more spatially consistent CO2 correlation map can be obtained. Finally, Granger-causality analysis demonstrated a "causal" relationship between Petco2 and BOLD. The identified dominant Petco2→BOLD directional coupling supports the notion that Petco2 fluctuations are indeed a cause of resting BOLD variance in the majority of subjects.
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Affiliation(s)
- Tingying Peng
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
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20
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Calvo Vecino JM, Abad Gurumeta A, Garrido Reche E, Chao Novo K, Orts Castro A, Tomás Lachos J. [Transcranial Doppler ultrasound, bispectral index, and electroencephalographic monitoring of entropy during pediatric total intravenous anesthesia]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2010; 57:621-629. [PMID: 22283014 DOI: 10.1016/s0034-9356(10)70298-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVE Transcranial Doppler ultrasound is a noninvasive technique for monitoring the velocity of blood flow in the main intracranial arteries, particularly those in the circle of Willis. Our aim was to assess whether changes in cerebral arterial blood flow in anesthetized pediatric patients detected by pulsed Doppler ultrasound correlate with changes in the bispectral (BIS) index and electroencephalographic state and response entropy (ES and ER, respectively). MATERIAL AND METHODS Prospective, blinded observational study of 36 pediatric patients (age range, 5 to 11 years) under total intravenous anesthesia for minor surgical procedures. Propofol and fentanyl were used for induction; propofol and remifentanil in continuous perfusion and a single dose of cisatracurium were used for maintenance. In all patients we monitored hemodynamic and respiratory patterns, gases, temperature, and hypnosis (BIS, ES and ER) as well as cerebral blood flow estimated by pulsed Doppler ultrasound in the middle cerebral artery. Raw data were subjected to statistical smoothing. The resistance index, pulsatility index, mean velocity, and estimated baseline cerebral blood flow were calculated from the Doppler sonogram. We then studied the correlations between the Doppler-derived values and BIS, ES, ER, fraction of end-tidal carbon dioxide, and temperature. The variables were entered into logistic regression. RESULTS The pattern at induction indicated high resistance (low mean velocities and high pulsatility indexes) until the lowest BIS and ES values of 31 and 29, respectively, were reached. During maintenance, the Doppler sonogram pattern was slower (normalization of the pulsatility index, the resistance index, and mean velocity). Changes in flow and absolute entropy and BIS values were statistically correlated (Pearson's r values > or = 0.91); there was 95.6% agreement between Doppler values and BIS and agreement between BIS and ES values of 35-45. On awakening, flow velocities approached baseline values when BIS and ES rose to between 90 and 98. The estimated cerebral blood flow underwent fluctuations coinciding with an approximately concomitant increase or decrease in BIS (r > 0.95); the response of BIS was slightly delayed by no more than a minute but there was no corresponding response of entropy measurements. CONCLUSIONS We report Doppler ultrasound patterns during anesthesia with propofol. Systems for monitoring hypnosis could be considered indirect measurements of cerebral blood flow; BIS measurements are more sensitive to flow change. Transcranial Doppler ultrasound facilitates the observation of changes in blood flow that occur at different levels of hypnosis during anesthesia.
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Affiliation(s)
- J M Calvo Vecino
- Servicio de Anestesiología y Reanimación, Complejo Hospitalario de Vallecas, Hospital Infanta Leonor, Vallecas, Madrid.
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21
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Lee JH, Oh S, Jolesz FA, Park H, Yoo SS. Application of Independent Component Analysis for the Data Mining of Simultaneous Eeg–fMRI: Preliminary Experience on Sleep Onset. Int J Neurosci 2009; 119:1118-36. [DOI: 10.1080/00207450902854627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Tyvaert L, LeVan P, Grova C, Dubeau F, Gotman J. Effects of fluctuating physiological rhythms during prolonged EEG-fMRI studies. Clin Neurophysiol 2008; 119:2762-74. [PMID: 18977169 PMCID: PMC3792084 DOI: 10.1016/j.clinph.2008.07.284] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Revised: 07/25/2008] [Accepted: 07/30/2008] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We evaluated BOLD correlates of alertness fluctuations commonly seen during prolonged EEG-fMRI studies to better define the brain areas active at different phases of vigilance and to assess the contribution of these fluctuations to the BOLD signal. METHODS We evaluated BOLD changes specifically related to the main physiological EEG rhythms (alpha, beta, theta, delta, spindles) in 15 epilepsy patients with rare discharges (all the regressors were included in the same general linear model to improve specificity). RESULTS We found a consistent effect of spindles, alpha and theta. For alpha, BOLD was positively correlated in thalami and putamen, and negatively correlated in the occipital, parietal and frontal lobes. For theta, a negative correlation was found over the parietal, temporal and frontal lobes. Spindles were correlated with a positive BOLD in thalami and putamen. Rhythm regressors added as confounds in the fMRI analysis explained at least 5% of BOLD signal variance in 6.8+/-8.9% of gray matter voxels, a contribution which is of the order of typical changes in fMRI studies. CONCLUSION First, we found specific cerebral structures involved in each main EEG rhythm generation. Second, fluctuations of these rhythms following vigilance changes are responsible for noteworthy BOLD changes. SIGNIFICANCE Physiological EEG rhythms may be integrated to the analysis of EEG-fMRI in studies with fluctuation of alertness, to eliminate possible confounding factors.
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Affiliation(s)
- Louise Tyvaert
- EEG Department, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Que., Canada H3A 2B4
| | - Pierre LeVan
- EEG Department, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Que., Canada H3A 2B4
| | - Christophe Grova
- EEG Department, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Que., Canada H3A 2B4
| | - François Dubeau
- EEG Department, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Que., Canada H3A 2B4
| | - Jean Gotman
- EEG Department, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Que., Canada H3A 2B4
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23
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Intrinsic correlations of electroencephalography rhythms with cerebral hemodynamics during sleep transitions. Neuroimage 2008; 42:357-68. [PMID: 18514543 DOI: 10.1016/j.neuroimage.2008.03.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 02/14/2008] [Accepted: 03/28/2008] [Indexed: 11/21/2022] Open
Abstract
To examine the correlation between electroencephalography fluctuations (EEGF) and cerebral hemodynamics during sleep after eliminating influences from cardiovascular activity, we simultaneously measured EEGF, the cerebral hemoglobin concentration change, and mean arterial blood pressure (MAP) during the sleep of healthy human adults. The cerebral hemoglobin concentration change was measured at 88 positions covering the whole head, by optical topography. We extracted the intrinsic correlation between EEGF and the cerebral hemoglobin concentration change without MAP contributions through cross-correlation and partial correlation analyses considering time lags. We found that increases in the power of the alpha rhythm in EEGF were correlated with increases in oxygenated hemoglobin (oxy-Hb) and decreases in deoxygenated hemoglobin (deoxy-Hb) and that increases in the power of the sigma rhythm in EEGF were correlated with decreases in oxy-Hb and increases in deoxy-Hb. The former correlations tended to appear in the transition from sleep stage 2 to sleep stage 1, and the latter correlations tended to appear in the transition from sleep stage 1 to sleep stage 2. The former correlations were found in the inferior frontal and middle temporal gyri and the latter correlations were found in the superior frontal, middle frontal, and angular gyri.
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24
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Bangash MF, Xie A, Skatrud JB, Reichmuth KJ, Barczi SR, Morgan BJ. Cerebrovascular response to arousal from NREM and REM sleep. Sleep 2008; 31:321-7. [PMID: 18363307 PMCID: PMC2276740 DOI: 10.1093/sleep/31.3.321] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVE To determine the effect of arousal from sleep on cerebral blood flow velocity (CBFV) in relation to associated ventilatory and systemic hemodynamic changes. PARTICIPANTS Eleven healthy individuals (6 men, 5 women). MEASUREMENTS Pulsed Doppler ultrasonography was used to measure CBFV in the middle cerebral artery with simultaneous measurements of sleep state (EEG, EOG, and EMG), ventilation (inductance plethysmography), heart rate (ECG), and arterial pressure (finger plethysmography). Arousals were induced by auditory tones (range: 40-80 dB; duration: 0.5 sec). Cardiovascular responses were examined beat-by-beat for 30 sec before and 30 sec after auditory tones. RESULTS During NREM sleep, CBFV declined following arousals (-15% +/- 2%; group mean +/- SEM) with a nadir at 9 sec after the auditory tone, followed by a gradual return to baseline. Mean arterial pressure (MAP; +20% +/- 1%) and heart rate (HR; +17% +/- 2%) increased with peaks at 5 and 3 sec after the auditory tone, respectively. Minute ventilation (VE) was increased (+35% +/- 10%) for 2 breaths after the auditory tone. In contrast, during REM sleep, CBFV increased following arousals (+15% +/- 3%) with a peak at 3 sec. MAP (+17% +/- 2%) and HR (+15% +/- 2%) increased during arousals from REM sleep with peaks at 5 and 3 sec post tone. VE increased (+16% +/- 7%) in a smaller, more sustained manner during arousals from REM sleep. CONCLUSIONS Arousals from NREM sleep transiently reduce CBFV, whereas arousals from REM sleep transiently increase CBFV, despite qualitatively and quantitatively similar increases in MAP, HR, and VE in the two sleep states.
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Affiliation(s)
| | | | | | | | | | - Barbara J. Morgan
- Orthopedics and Rehabilitation, University of Wisconsin-Madison and the Middleton Veterans Administration Hospital, Madison, WI
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25
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Corfield DR, Meadows GE. Control of cerebral blood flow during sleep and the effects of hypoxia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2006; 588:65-73. [PMID: 17089880 DOI: 10.1007/978-0-387-34817-9_7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
During wakefulness, cerebral blood flow (CBF) is closely coupled to regional cerebral metabolism; however CBF is also strongly modulated by breathing, increasing in response to both hypercapnia and hypoxia. During stage III/IV non-rapid eye (NREM) sleep, cerebral metabolism and CBF decrease whilst the partial pressure of arterial CO2 increases due to a reduction in alveolar ventilation. The reduction in CBF during NREM sleep therefore occurs despite a relative state of hypercapnia. We have used transcranial Doppler ultrasound to determine middle cerebral artery velocity, as an index of CBF, and have determined that NREM sleep is associated with a reduction in the cerebrovascular response to hypercapnia. This reduction in reactivity would, at least in part, allow the observed reductions in CBF in this state. Similarly, we have observed that the CBF response to hypoxia is absent during stage III/IV NREM sleep. Nocturnal hypoxia and hypercapnia are major pathogenic factor associated with cardio-respiratory diseases. These marked changes in cerebrovascular control that occur during sleep suggest that the cerebral circulation may be particularly vulnerable to cardio-respiratory insults during this period.
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Affiliation(s)
- Douglas R Corfield
- Institute of Science and Technology in Medicine, School of Life Sciences, Keele University, Keele, UK.
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