Evaluating the methods used for measuring cerebral blood flow at rest and during exercise in humans

  • Michael M. Tymko
  • Philip N. Ainslie
  • Kurt J. Smith
Invited Review

Abstract

The first accounts of measuring cerebral blood flow (CBF) in humans were made by Angelo Mosso in ~1880, who recorded brain pulsations in patients with skull defects. In 1890, Charles Roy and Charles Sherrington determined in animals that brain pulsations—assessed via a similar method used by Mosso—were altered during a variety of stimuli including sensory nerve stimulation, asphyxia, and pharmacological interventions. Between 1880 and 1944, measurements for CBF were typically relied on skull abnormalities in humans. Thereafter, Kety and Schmidt introduced a new methodological approach in 1945 that involved nitrous oxide dilution combined with serial arterial and jugular venous blood sampling. Less than a decade later (1950’s), several research groups employed the Kety-Schmidt technique to assess the effects of exercise on global CBF and metabolism; these studies demonstrated an uncoupling of CBF and metabolism during exercise, which was contrary to early hypotheses. However, there were several limitations to this technique related to low temporal resolution and the inability to measure regional CBF. These limitations were overcome in the 1960’s when transcranial Doppler ultrasound (TCD) was developed as a method to measure beat-by-beat cerebral blood velocity. Between 1990 and 2010, TCD further progressed our understanding of CBF regulation and allowed for insight into other mechanistic factors, independent of local metabolism, involved in regulating CBF during exercise. Recently, it was discovered that TCD may not be accurate under several physiological conditions. Other measures of indexing CBF such as Duplex ultrasound and magnetic resonance imaging, although not without some limitations, may be more applicable for future investigations.

Keywords

Kety-Schmidt technique Transcranial Doppler ultrasound Duplex ultrasound Cerebral blood flow Exercise 

Abbreviations

ACAv

Anterior cerebral artery

ACAv

Anterior cerebral artery blood velocity

BOLD

Blood oxygenation level dependent

CBF

Cerebral blood flow

CBV

Cerebral blood velocity

CCA

Common carotid artery

CMR

Cerebral metabolic rate

ECA

External carotid artery

gCBF

Global cerebral blood flow

ICA

Internal carotid artery

ICAv

Internal carotid artery blood velocity

MCA

Middle cerebral artery

MCAv

Middle cerebral artery blood velocity

MRI

Magnetic resonance imaging

PaCO2

Partial pressure of arterial carbon dioxide

PCA

Posterior cerebral artery

PCAv

Posterior cerebral artery blood velocity

PETCO2

Partial pressure of end-tidal carbon dioxide

PET

Positron emission tomography

TCD

Transcranial Doppler ultrasound.

VA

Vertebral artery

Notes

Acknowledgements

This work was funded by the natural sciences and engineering research council (NSERC), and by a Canada research chair (CRC).

Author contributions

All authors contributed to drafting and critically revising the article for important intellectual content. All authors approved the final version of the manuscript and all persons designated as authors qualify for authorship, and all those who qualify for authorship are listed.

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, Faculty of Health and Social DevelopmentUniversity of British ColumbiaKelownaCanada
  2. 2.School of Sports Science, Exercise and HealthThe University of Western AustraliaCrawleyAustralia

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