Dynamic cerebral autoregulation reproducibility is affected by physiological variability
Journal
Frontiers in Physiology
Journal Volume
10
Journal Issue
JUL
Date Issued
2019
Author(s)
Sanders M.L.
Elting J.W.J.
Panerai R.B.
Aries M.
Bor-Seng-Shu E.
Caicedo A.
Chacon M.
Gommer E.D.
Van Huffel S.
Jara J.L.
Kostoglou K.
Mahdi A.
Marmarelis V.Z.
Mitsis G.D.
M?ller M.
Nikolic D.
Nogueira R.C.
Payne S.J.
Puppo C.
Shin D.C.
Simpson D.M.
Tarumi T.
Yelicich B.
Zhang R.
Claassen J.A.H.R.
Abstract
Parameters describing dynamic cerebral autoregulation (DCA) have limited reproducibility. In an international, multi-center study, we evaluated the influence of multiple analytical methods on the reproducibility of DCA. Fourteen participating centers analyzed repeated measurements from 75 healthy subjects, consisting of 5 min of spontaneous fluctuations in blood pressure and cerebral blood flow velocity signals, based on their usual methods of analysis. DCA methods were grouped into three broad categories, depending on output types: (1) transfer function analysis (TFA); (2) autoregulation index (ARI); and (3) correlation coefficient. Only TFA gain in the low frequency (LF) band showed good reproducibility in approximately half of the estimates of gain, defined as an intraclass correlation coefficient (ICC) of > 0.6. None of the other DCA metrics had good reproducibility. For TFA-like and ARI-like methods, ICCs were lower than values obtained with surrogate data (p < 0.05). For TFA-like methods, ICCs were lower for the very LF band (gain 0.38 ± 0.057, phase 0.17 ± 0.13) than for LF band (gain 0.59 ± 0.078, phase 0.39 ± 0.11, p ? 0.001 for both gain and phase). For ARI-like methods, the mean ICC was 0.30 ± 0.12 and for the correlation methods 0.24 ± 0.23. Based on comparisons with ICC estimates obtained from surrogate data, we conclude that physiological variability or non-stationarity is likely to be the main reason for the poor reproducibility of DCA parameters. Copyright ? 2019 Sanders, Elting, Panerai, Aries, Bor-Seng-Shu, Caicedo, Chacon, Gommer, Van Huffel, Jara, Kostoglou, Mahdi, Marmarelis, Mitsis, M?ller, Nikolic, Nogueira, Payne, Puppo, Shin, Simpson, Tarumi, Yelicich, Zhang and Claassen.
Subjects
adult
analytic method
Article
autoregulation
autoregulation index
blood flow velocity
blood pressure fluctuation
brain blood flow
correlation coefficient
dynamic cerebral autoregulation
end tidal carbon dioxide tension
female
Fourier transformation
hemodynamic parameters
human
human experiment
male
mean arterial pressure
middle aged
mild cognitive impairment
normal human
physiological process
reproducibility
transfer function analysis
SDGs
Type
journal article