Cerebral autoregulation and response to intravenous thrombolysis for acute ischemic stroke

We hypothesized that knowledge of cerebral autoregulation (CA) status during recanalization therapies could guide further studies aimed at neuroprotection targeting penumbral tissue, especially in patients that do not respond to therapy. Thus, we assessed CA status of patients with acute ischemic st...

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Bibliographic Details
Published in:Scientific reports 2020-06, Vol.10 (1), p.10554-10554, Article 10554
Main Authors: Nogueira, Ricardo C., Lam, Man Y., Llwyd, Osian, Salinet, Angela S. M., Bor-Seng-Shu, Edson, Panerai, Ronney B., Robinson, Thompson G.
Format: Article
Language:English
Subjects:
639/166/985
692/617/375/1370/534
Administration, Intravenous - methods
Aged
Aged, 80 and over
Blood flow
Blood Flow Velocity - drug effects
Blood pressure
Blood Pressure - drug effects
Brain Ischemia - drug therapy
Brain Ischemia - physiopathology
Cerebral blood flow
Cerebrovascular Circulation - drug effects
Cerebrovascular Circulation - physiology
Female
Fibrinolysis
Homeostasis - physiology
Humanities and Social Sciences
Humans
Infarction, Middle Cerebral Artery - drug therapy
Intravenous administration
Ischemia
Ischemic Stroke - drug therapy
Ischemic Stroke - metabolism
Ischemic Stroke - physiopathology
Male
Middle Aged
Middle Cerebral Artery - physiopathology
multidisciplinary
Neuroprotection
Science
Science (multidisciplinary)
Severity of Illness Index
Stroke
Stroke - drug therapy
Stroke - metabolism
Stroke - physiopathology
Thrombolysis
Thrombolytic Therapy - methods
Treatment Outcome
Ultrasonography, Doppler, Transcranial - methods
Ultrasound
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Summary:We hypothesized that knowledge of cerebral autoregulation (CA) status during recanalization therapies could guide further studies aimed at neuroprotection targeting penumbral tissue, especially in patients that do not respond to therapy. Thus, we assessed CA status of patients with acute ischemic stroke (AIS) during intravenous r-tPA therapy and associated CA with response to therapy. AIS patients eligible for intravenous r-tPA therapy were recruited. Cerebral blood flow velocities (transcranial Doppler) from middle cerebral artery and blood pressure (Finometer) were recorded to calculate the autoregulation index (ARI, as surrogate for CA). National Institute of Health Stroke Score was assessed and used to define responders to therapy (improvement of ≥ 4 points on NIHSS measured 24–48 h after therapy). CA was considered impaired if ARI 
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-67404-9