The responsiveness of the cerebrovasculature to alterations in arterial content of carbon dioxide (PCO2) is a common functional test to assess brain health (i.e., CBF-CO2 responsiveness). The most common and simplest test to assess CBF-CO2 responsiveness is the inhalation of one concentration of CO2 via a Douglas bag open circuit (e.g., 5% CO2 in air). Across the studies using this approach a range of durations have been used to induce this stimulus-response, from 1 to 5 min. However, given the known kinetics of this response, a 1 min response test may represent something different to that of a 5 min test. Further, given the interaction between the ventilatory and vascular responses with the open-circuit technique, the ventilatory response may also affect the consistency between the different stimulus durations for the CBF-CO2 responsiveness measure. The purpose of this study was to examine whether 1, 2, 4 and 5 mins of CO2 stimulus gave the same CBF-CO2 responsiveness measure. Fourteen healthy volunteers were recruited. Following a full familiarisation visit, participants attended the laboratory for one experimental trial. Participants lay supine for ~20 min while being instrumented, following which they completed a 5 min resting baseline. In a randomised order, participants then completed four durations (1, 2, 4 and 5 minutes) of 5% CO2 (in air) inhalation via the open-circuit Douglas bag method, with 5 min recovery between. Bilateral middle cerebral artery velocity (MCAv, transcranial Doppler), mean arterial pressure (MAP, Finometer), ventilation (VE) and partial pressure of end-tidal carbon dioxide (PETCO2) were recorded continuously. CBF-CO2 responsiveness and ventilatory sensitivity to CO2 (VE-CO2) were calculated as change from baseline (relative and absolute, respectively) per mm Hg change in PETCO2. We compared values calculated from the final 30 s of each CO2-stimulus duration. A repeated-measures ANOVA (Bonferroni corrected) was used to test differences between durations. We observed no statistical difference (p=0.15) across the different durations of CO2-stimulus for CBF-CO2 responsiveness (bilateral Doppler data pooled (mean±SD): 2.4±1.2, 2.4±1.1, 2.3±1.1, 2.3±1.1 %ΔMCAv/mm Hg PETCO2, for 1, 2, 4 and 5 min respectively), despite observable differences in the MCAv-response profile between durations. For example, a steady-state profile typified the 4 and 5 min tests, whereas the 1 min test tended to peak in the final seconds of the stimulus. Further, while grouped CBF-CO2 responsiveness data appear consistent across durations, there was variation within individuals across the four stimulus durations; CoV ranging from 8 – 45% between individuals. In contrast, VE-CO2 sensitivity increased ~3-fold from the 1 min to the 4- and 5-min test durations (0.3±0.2, 0.6±0.3, 0.9±0.3, 1.0±0.4 L·min-1/mm Hg, for 1, 2, 4 and 5 min respectively; p<0.01).
Physiology 2015 (Cardiff, UK) (2015) Proc Physiol Soc 34, PC226
Poster Communications: Does the duration of stimulus alter the cerebral blood flow-to-carbon dioxide responsiveness measure?
C. V. Burley1, H. Sharman1, E. Lisk1, G. M. Balanos1, A. C. Phillips1, S. J. Lucas1,2
1. SportExR, University of Birmingham, Birmingham, United Kingdom. 2. Dept of Physiology, University of Otago, Dunedin, New Zealand.
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Where applicable, experiments conform with Society ethical requirements.