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Zhong J, Li G, Lv Z, Chen J, Wang C, Shao A, Gong Z, Wang J, Liu S, Luo J, Yang S, Wu S, Ning L, Wang Z, Li J, Wu Y. Neuromodulation of Cerebral Blood Flow: A Physiological Mechanism and Methodological Review of Neurovascular Coupling. Bioengineering (Basel) 2025; 12:442. [PMID: 40428061 PMCID: PMC12108752 DOI: 10.3390/bioengineering12050442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2025] [Revised: 04/20/2025] [Accepted: 04/21/2025] [Indexed: 05/29/2025] Open
Abstract
Neurovascular coupling (NVC) refers to the dynamic regulation of cerebral blood flow via neuronal activity, a mechanism crucial for maintaining normal brain function. This review elucidates the intricate physiological mechanisms underlying NVC, emphasizing the coordinated roles of neurons, glial cells, and vascular cells in mediating activity-induced changes in blood flow. We examine how NVC is impaired in neurological disorders such as Alzheimer's disease and stroke, where the dysfunction of this coupling contributes to neurodegeneration and neurological deficits. A broad range of techniques for assessing NVC is discussed-encompassing the established modalities like transcranial Doppler, near-infrared spectroscopy, and functional magnetic resonance imaging (fMRI), as well as emerging technologies such as functional ultrasound imaging and miniaturized endoscopy that enable high-resolution monitoring in deep brain regions. We also highlight the computational modeling approaches for simulating NVC dynamics and identify the novel biomarkers of NVC dysfunction with potential utility in early diagnosis. Finally, emerging translational applications-including neuromodulation techniques and targeted pharmacological interventions-are explored as means to restore normal neurovascular function. These advancements underscore the clinical significance of NVC research, paving the way for improved diagnostic tools and therapeutic strategies in neurological disorders.
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Affiliation(s)
- Jiawen Zhong
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Gen Li
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Zexiang Lv
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Jingbo Chen
- Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, China;
| | - Chunyan Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Ansheng Shao
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Zhiwei Gong
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Junjie Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Siqiao Liu
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Jun Luo
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Shuping Yang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Sibei Wu
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Lin Ning
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Zhinong Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Jiahao Li
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Yu Wu
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
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Flück D, Beaudin AE, Steinback CD, Kumarpillai G, Shobha N, McCreary CR, Peca S, Smith EE, Poulin MJ. Effects of aging on the association between cerebrovascular responses to visual stimulation, hypercapnia and arterial stiffness. Front Physiol 2014; 5:49. [PMID: 24600398 PMCID: PMC3928624 DOI: 10.3389/fphys.2014.00049] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/26/2014] [Indexed: 02/04/2023] Open
Abstract
Aging is associated with decreased vascular compliance and diminished neurovascular- and hypercapnia-evoked cerebral blood flow (CBF) responses. However, the interplay between arterial stiffness and reduced CBF responses is poorly understood. It was hypothesized that increased cerebral arterial stiffness is associated with reduced evoked responses to both, a flashing checkerboard visual stimulation (i.e., neurovascular coupling), and hypercapnia. To test this hypothesis, 20 older (64 ± 8 year; mean ± SD) and 10 young (30 ± 5 year) subjects underwent a visual stimulation (VS) and a hypercapnic test. Blood velocity through the posterior (PCA) and middle cerebral (MCA) arteries was measured concurrently using transcranial Doppler ultrasound (TCD). Cerebral and systemic vascular stiffness were calculated from the cerebral blood velocity and systemic blood pressure waveforms, respectively. Cerebrovascular (MCA: young = 76 ± 15%, older = 98 ± 19%, p = 0.004; PCA: young = 80 ± 16%, older = 106 ± 17%, p < 0.001) and systemic (young = 59 ± 9% and older = 80 ± 9%, p < 0.001) augmentation indices (AI) were higher in the older group. CBF responses to VS (PCA: p < 0.026) and hypercapnia (PCA: p = 0.018; MCA: p = 0.042) were lower in the older group. A curvilinear model fitted to cerebral AI and age showed AI increases until ~60 years of age, after which the increase levels off (PCA: R (2) = 0.45, p < 0.001; MCA: R (2) = 0.31, p < 0.001). Finally, MCA, but not PCA, hypercapnic reactivity was inversely related to cerebral AI (MCA: R (2) = 0.28, p = 0.002; PCA: R (2) = 0.10, p = 0.104). A similar inverse relationship was not observed with the PCA blood flow response to VS (R (2) = 0.06, p = 0.174). In conclusion, older subjects had reduced neurovascular- and hypercapnia-mediated CBF responses. Furthermore, lower hypercapnia-mediated blood flow responses through the MCA were associated with increased vascular stiffness. These findings suggest the reduced hypercapnia-evoked CBF responses through the MCA, in older individuals may be secondary to vascular stiffening.
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Affiliation(s)
- Daniela Flück
- Department of Biology, Institute of Human Movement Sciences and Sport, ETH Zurich Zurich, Switzerland ; Department of Physiology and Pharmacology, Faculty of Medicine, University of Calgary Calgary, AB, Canada
| | - Andrew E Beaudin
- Department of Physiology and Pharmacology, Faculty of Medicine, University of Calgary Calgary, AB, Canada
| | - Craig D Steinback
- Department of Physiology and Pharmacology, Faculty of Medicine, University of Calgary Calgary, AB, Canada
| | - Gopukumar Kumarpillai
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary Calgary, AB, Canada
| | - Nandavar Shobha
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary Calgary, AB, Canada
| | - Cheryl R McCreary
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Department of Radiology, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services Calgary, AB, Canada
| | - Stefano Peca
- Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services Calgary, AB, Canada
| | - Eric E Smith
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services Calgary, AB, Canada
| | - Marc J Poulin
- Department of Physiology and Pharmacology, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary Calgary, AB, Canada ; Faculty of Kinesiology, University of Calgary Calgary, AB, Canada ; The Libin Cardiovascular Institute of Alberta, Faculty of Medicine, University of Calgary Calgary, AB, Canada
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Bedeković MR, Lovrenčić-Huzjan A, Puretić MB, Demarin V. Prolonged mean reaction time in posterior cerebral artery during visual stimulation in patients with severe carotid stenosis. Clin Physiol Funct Imaging 2011; 31:282-7. [PMID: 21672135 DOI: 10.1111/j.1475-097x.2011.01013.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
While the mean increase in flow velocities in posterior cerebral artery (PCA) as a response to visual stimuli is well documented, the data on the reaction time as a measurement of the vasomotor response of the posterior part of the circle of Willis are still sparse. The aim was to assess the visual evoked response in PCA during white light stimulation by means of functional transcranial doppler in patients with severe internal carotid artery (ICA) stenosis, to introduce a real-time haemodynamic changes as a measurement of the effect of severe carotid disease on the posterior circulation. The measurements were taken in 49 right-handed patients with severe ICA stenosis or occlusion and 30 healthy volunteers, simultaneously in left and right PCA using 2-MHz probes, successively in the dark and during the white light stimulation, during three consecutive repetitive periods of 1 min each. Mean values of mean blood flow velocities (MBFV) and mean reaction time (MRT) with and without visual stimuli were analysed. Linear regression analysis showed no statistically significant correlation between the age, MBFV and a degree of left and right carotid stenosis, and MRT in left and right PCA either in the group of healthy subjects or in the group of patients with severe carotid stenosis, in both test conditions. MRT could be an indicator of compromised cerebral circulation in the presence of haemodynamic significant carotid stenosis as well as an additional and independent haemodynamic parameter of the cerebral visual evoked response.
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Affiliation(s)
- Marina Roje Bedeković
- University Department of Neurology, Sestre milosrdnice University Hospital, Zagreb, Croatia.
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