The effect of exercise intensity and cardiorespiratory fitness on the kinetic response of middle cerebral artery blood velocity during exercise in healthy adults

Competing influences of arterial pressure and carbon dioxide on the dynamic cerebrovascular response to step transitions in exercise intensity

Recent investigations of middle cerebral artery blood velocity (MCAv) kinetics at the onset of exercise have not accounted for potential dynamic changes in arterial partial pressure of carbon dioxide ([Formula: see text]) during the transient phase of exercise transitions when modeling MCAv kinetics, despite [Formula: see text] having known effects on cerebrovascular tone. The purpose of our study was to determine the independent effects of mean arterial pressure (MAP) and estimated [Formula: see text] ([Formula: see text]) on mean MCAv during repeated moderate-intensity exercise transitions. We hypothesized that cerebral autoregulation would minimize the effect of sustained exercise-induced changes in MAP on mean MCAv and that dynamic changes in [Formula: see text] would contribute to changes in mean MCAv. Eighteen young healthy adults (7 women, age: 28 ± 5 yr) performed three exercise transitions from 25 W to 90% of the ventilatory threshold in sequence with 5-min stages. Mean MCAv increased (P < 0.001) from 25 W (60.5 ± 14.0 cm·s-1) to 90% of the ventilatory threshold (68.8 ± 15.1 cm·s-1). MAP at the level of the middle cerebral artery (MAPMCA) (Δ = 14 ± 8 mmHg, P < 0.001) and [Formula: see text] (Δ = 2.7 ± 1.8 mmHg, P < 0.001) also increased with exercise intensity. Autoregressive moving average (ARMA) analysis isolated the independent effects of dynamic changes in MAPMCA and [Formula: see text] on MCAv, with low prediction error (mean absolute error = 1.12 ± 0.25 cm·s-1). Calculated steady states of the ARMA step responses were 0.13 ± 0.15 cm·s-1·mmHg-1 for Δmean MCAv/ΔMAPMCA and 1.95 ± 0.83 cm·s-1·mmHg-1 for Δmean MCAv/Δ[Formula: see text]. These data demonstrate that the combination of dynamic changes in MAP and [Formula: see text] largely explains the MCAv response during transitions in exercise intensity.NEW & NOTEWORTHY Time-series analysis of moderate-intensity exercise transitions suggested that cerebral autoregulation buffered the effect of sustained changes in mean arterial pressure on middle cerebral artery blood velocity (MCAv) and that changes in estimated arterial partial pressure of carbon dioxide ([Formula: see text]) contributed to the dynamic changes in MCAv during exercise transitions. Therefore, changes in [Formula: see text] at the onset of exercise are central to modeling dynamic MCAv responses and understanding the benefits of exercise on cerebral blood flow.

Middle cerebral artery blood velocity and end-tidal carbon dioxide responses to moderate intensity cycling in children, adolescents, and adults

This study investigated the middle cerebral artery blood velocity (MCAv) response to constant work-rate moderate-intensity cycling exercise in 21 children (9.3 ± 0.8 yr), 17 adolescents (12.3 ± 0.4 yr), and 20 young adults (23.6 ± 2.4 yr). Participants completed an incremental ramp test to exhaustion on a cycle ergometer to determine maximal oxygen uptake and gas exchange threshold (GET) before completing three 6-min transitions at a moderate intensity (90% GET) on separate visits. On each visit, bilateral MCAv was measured by transcranial Doppler ultrasonography and breath-by-breath end-tidal carbon dioxide ([Formula: see text]) via a metabolic cart. Data were ensemble-averaged for each participant and analyzed using a monoexponential model. Absolute MCAv was significantly higher throughout exercise in children and adolescents compared with adults (P < 0.001). Children had a significantly lower relative increase in MCAv from baseline (∼12%) compared with adolescents (∼20%) and adults (∼18%, P < 0.040). All adolescents and adults had a monoexponential rise in MCAv and [Formula: see text], but this was observed in only eight children. Children and adolescents had a significantly faster MCAv time constant (τ, 12 ± 6 and 14 ± 8 s, respectively) compared with adults (27 ± 9 s, P < 0.001). MCAv τ was positively associated with faster [Formula: see text] τ in adolescents (r = 0.70, P = 0.002) but not in children (r = -0.20, P = 0.640). Time- and amplitude-based response parameters of MCAv kinetics were significantly associated with [Formula: see text] kinetics in adults (r = 0.50-0.74, P ≤ 0.025), but not in children (r = -0.19 to -0.48, P > 0.227). These findings suggest that the transition from childhood to adulthood impacts the MCAv response to exercise and the relationships between [Formula: see text] and MCAv kinetics during exercise.NEW & NOTEWORTHY This is the first study to find that children have smaller increases in Δ%MCAv (∼12%) during moderate-intensity exercise compared with adolescents and adults (∼18%-20%). Furthermore, MCAv kinetics were significantly faster in children and adolescents, compared with adults. MCAv kinetic responses were significantly and positively associated with [Formula: see text] kinetics in adults, but not in children. These novel data also suggest that the regulatory role of [Formula: see text] on MCAv during exercise begins to strengthen during adolescence.

Agreement between left and right middle cerebral artery blood velocity responses to incremental and constant work-rate exercise in healthy males and females

Objective.To quantify the agreement between left and right middle cerebral artery blood velocity (MCAv) responses to incremental and constant work-rate exercise in adults.ApproachSeventeen healthy adults (23.8 ± 2.4 years, 9 females) completed a ramp incremental test to exhaustion on a cycle ergometer, three 6-minute transitions at a moderate-intensity, and three at a heavy-intensity, all on separate days. Bilateral MCAv was measured throughout using transcranial Doppler ultrasonography, with left and right MCAv data analysed separately. Data were analysed at baseline, gas exchange threshold, respiratory compensation point and exhaustion during ramp incremental exercise. MCAv responses to constant work-rate exercise were analysed using a mono-exponential model, to determine time- and amplitude-based kinetic response parameters.Main ResultsLeft and right MCAv responses to incremental and constant work-rate exercise were significantly, strongly and positively correlated (r≥ 0.61,P< 0.01). Coefficient of variation (left versus right) ranged from 7.3%-20.7%, 6.4%-26.2% and 5.9%-22.5% for ramp, moderate and heavy-intensity exercise, respectively. The relative change in MCAv from baseline was higher in the right compared to left MCAv during ramp, moderate and heavy-intensity exercise (allP< 0.05), but the effect sizes were small (d≤ 0.4). Small mean left-right differences were present during ramp incremental exercise at all time-points (<6 cm s-1; <4%), and for all kinetic parameters during moderate and heavy-intensity exercise (<3 cm s-1, <3%, <4 s).SignificanceThese findings demonstrate similarities between left and right MCAv responses to incremental and constant-work rate exercise in adults on a group-level, but also highlight individual variation in the agreement between left and right MCAv exercise responses.

Sex Differences in Resilience and Resistance to Brain Pathology and Dysfunction Moderated by Cerebrovascular Response to Exercise and Genetic Risk for Alzheimer's Disease

Sex as a biological variable appears to contribute to the multifactorial etiology of Alzheimer's disease. We tested sex-based interactions between cerebrovascular function and APOE4 genotype on resistance and resilience to brain pathology and cognitive executive dysfunction in cognitively-normal older adults. Female APOE4 carriers had higher amyloid-β deposition yet achieved similar cognitive performance to males and female noncarriers. Further, female APOE4 carriers with robust cerebrovascular responses to exercise possessed lower amyloid-β. These results suggest a unique cognitive resilience and identify cerebrovascular function as a key mechanism for resistance to age-related brain pathology in females with high genetic vulnerability to Alzheimer's disease.