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Cerebrovascular autoregulation as a neuroimaging tool

Published online by Cambridge University Press:  24 June 2014

Jim Lagopoulos*
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia Mayne Clinical Research Imaging Center, Randwick, Australia Department of Neurology, Westmead Hospital, Westmead, Australia
Gin S. Malhi
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia Mayne Clinical Research Imaging Center, Randwick, Australia
Belinda Ivanovski
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia
Catherine M. Cahill
Affiliation:
School of Psychiatry, The University of New South Wales, Australia Mood Disorders Unit, Black Dog Institute, Sydney, Australia
Erhard W. Lang
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Yugan Mudaliar
Affiliation:
Intensive Care Unit, Westmead Hospital, Westmead, Australia
Nick Dorsch
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Alan Yam
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Jane Griffith
Affiliation:
Department of Neurosurgery, Westmead Hospital, Westmead, Australia
Jamin Mulvey
Affiliation:
Intensive Care Unit, Westmead Hospital, Westmead, Australia
*
Dr Jim Lagopoulos, Mayne Clinical Research Imaging Center, Prince of Wales Medical Research Institute, Barker Street, Randwick, NSW 2031 Australia. Tel: +61 2 93822998; Fax: +61 2 93828208; E-mail: jim.lagopoulos@unsw.edu.au

Abstract

Functional transcranial Doppler (fTCD) sonography provides a high temporal resolution measure of blood flow and has over the years proved to be a valuable tool in the clinical evaluation of patients with cerebrovascular disorders. More recently, due to advances in physics and computing, it has become possible to derive indices of cerebrovascular autoregulation (CA) as well as cerebrovascular pressure reactivity (CR), using non-invasive techniques. These indices provide a dynamic representation of the brain's regulatory blood flow mechanisms not only in pathological states but also in health. However, whilst the temporal resolution of these regulatory indices is very good, spatially, the localization of brain regions remains very poor, thus limiting its brain mapping capacity. Functional MRI, on the contrary, is a brain-imaging technique that operates on similar blood flow principles; however, unlike fTCD, it provides high spatial resolution. Because both fTCD and fMRI determine blood flow-dependant imaging parameters, the coupling of fTCD with fMRI may provide greater insight into brain function by virtue of the combined enhanced temporal and spatial resolution that each technique affords. This review summarizes the fTCD technique with particular emphasis on the CA and CR indices and their relationship in traumatic brain injury as well as in health.

Type
Review Article
Copyright
Copyright © 2006 Blackwell Munksgaard

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