Impaired cerebral autoregulation is associated with brain atrophy and worse functional status in chronic ischemic stroke

• Published in: PloS one 2012-10, Vol.7 (10), p.e46794-e46794
• Main Authors: Aoi, Mikio C, Hu, Kun, Lo, Men-Tzung, Selim, Magdy, Olufsen, Mette S, Novak, Vera
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adults; Aged; Arterial Pressure; Atrophy; Blood; Blood flow; Blood Flow Velocity; Blood pressure; Brain; Brain - blood supply; Brain - pathology; Brain - physiopathology; Brain Ischemia - complications; Brain Ischemia - physiopathology; Brain research; Cardiology; Cerebral blood flow; Cerebral ischemia; Cerebrovascular Circulation; Chronic Disease; Diabetes; Engineering; Family medical history; Female; Flow velocity; Functional magnetic resonance imaging; Gait; Homeostasis; Humans; Hypertension; Infarction, Middle Cerebral Artery - pathology; Infarction, Middle Cerebral Artery - physiopathology; Ischemia; Lobes; Logistic Models; Magnetic Resonance Imaging; Male; Medicine; Middle Aged; Neurology; NMR; Nuclear magnetic resonance; Older people; Perfusion; Perfusion (Physiology); Physiology; Retrospective Studies; Stroke; Stroke - complications; Stroke - physiopathology; Studies; Substantia grisea; Temporal lobe; Temporal Lobe - blood supply; Temporal Lobe - pathology; Temporal Lobe - physiopathology; Territory; Transplants & implants; Veins & arteries
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0046794

Dynamic cerebral autoregulation (dCA) is impaired following stroke. However, the relationship between dCA, brain atrophy, and functional outcomes following stroke remains unclear. In this study, we aimed to determine whether impairment of dCA is associated with atrophy in specific regions or globally, thereby affecting daily functions in stroke patients.We performed a retrospective analysis of 33 subjects with chronic infarctions in the middle cerebral artery territory, and 109 age-matched non-stroke subjects. dCA was assessed via the phase relationship between arterial blood pressure and cerebral blood flow velocity. Brain tissue volumes were quantified from MRI. Functional status was assessed by gait speed, instrumental activities of daily living (IADL), modified Rankin Scale, and NIH Stroke Score.Compared to the non-stroke group, stroke subjects showed degraded dCA bilaterally, and showed gray matter atrophy in the frontal, parietal and temporal lobes ipsilateral to infarct. In stroke subjects, better dCA was associated with less temporal lobe gray matter atrophy on the infracted side ([Formula: see text] = 0.029), faster gait speed ([Formula: see text] = 0.018) and lower IADL score ([Formula: see text]0.002). Our results indicate that better dynamic cerebral perfusion regulation is associated with less atrophy and better long-term functional status in older adults with chronic ischemic infarctions.