Utility of transcranial Doppler ultrasound for the integrative assessment of cerebrovascular function

• Published in: Journal of neuroscience methods 2011-03, Vol.196 (2), p.221-237
• Main Authors: Willie, C.K., Colino, F.L., Bailey, D.M., Tzeng, Y.C., Binsted, G., Jones, L.W., Haykowsky, M.J., Bellapart, J., Ogoh, S., Smith, K.J., Smirl, J.D., Day, T.A., Lucas, S.J., Eller, L.K., Ainslie, P.N.
• Format: Article
• Language: English
• Subjects: Brain; Brain - blood supply; Brain - physiology; Brain injury; Carbon dioxide; Cerebral Arteries - diagnostic imaging; Cerebral Arteries - physiopathology; Cerebral blood flow; Cerebrovascular Circulation - physiology; Cerebrovascular Disorders - diagnosis; Cerebrovascular Disorders - physiopathology; Cerebrovascular physiology; Energy storage; Head; Humans; Integration; Models, Neurological; Nervous system; Neurovascular coupling; Oxygen; Reviews; Stroke; Transcranial Doppler ultrasound; Ultrasonography, Doppler, Transcranial - instrumentation; Ultrasonography, Doppler, Transcranial - methods; Ultrasound; Vascular reactivity
• ISSN: 0165-0270; 1872-678X
• DOI: 10.1016/j.jneumeth.2011.01.011

► There is much utility in the use of TCD to assess cerebrovascular function. ► TCD is an efficient tool to access blood velocities within the cerebral vessels. ► TCD is an effective method to assess cerebrovascular function. There is considerable utility in the use of transcranial Doppler ultrasound (TCD) to assess cerebrovascular function. The brain is unique in its high energy and oxygen demand but limited capacity for energy storage that necessitates an effective means of regional blood delivery. The relative low cost, ease-of-use, non-invasiveness, and excellent temporal resolution of TCD make it an ideal tool for the examination of cerebrovascular function in both research and clinical settings. TCD is an efficient tool to access blood velocities within the cerebral vessels, cerebral autoregulation, cerebrovascular reactivity to CO 2, and neurovascular coupling, in both physiological states and in pathological conditions such as stroke and head trauma. In this review, we provide: (1) an overview of TCD methodology with respect to other techniques; (2) a methodological synopsis of the cerebrovascular exam using TCD; (3) an overview of the physiological mechanisms involved in regulation of the cerebral blood flow; (4) the utility of TCD for assessment of cerebrovascular pathology; and (5) recommendations for the assessment of four critical and complimentary aspects of cerebrovascular function: intra-cranial blood flow velocity, cerebral autoregulation, cerebral reactivity, and neurovascular coupling. The integration of these regulatory mechanisms from an integrated systems perspective is discussed, and future research directions are explored.