Abstract
The brain is a vital organ that relies on a constant and adequate supply of blood to match oxygen and glucose delivery with the local metabolic demands of active neurones. It is well established that cerebral blood flow is altered in response to both neural activity and humoral stimuli. Thus, augmented neural activation (e.g. visual stimulation) leads to locally increased cerebral blood flow via functional hyperaemia, whereas humoral stimuli (i.e. alterations in arterial PO2 and PCO2) produce global increases in cerebral blood flow. Perhaps not surprisingly, cerebrovascular responses to neural activity and humoral stimuli may not be highly correlated because they reflect different physiological mechanisms for vasodilation. Exquisite regulation of cerebral blood flow is particularly important under hypoxic conditions when cerebral PO2 can be reduced substantially. Indeed, cerebrovascular reactivity to hypoxia determines the capacity of cerebral vessels to respond and compensate for a reduced oxygen supply. This reactivity is dynamic, changing with prolonged exposure to hypoxic environments, and in patients and healthy individuals exposed to chronic intermittent periods of hypoxia. More recently, a number of animal studies have provided evidence that glial cells (i.e. astrocytes) play an important role in regulating cerebral blood flow under normoxic and hypoxic conditions. This review aims to summarize our current understanding of cerebral blood flow control during hypoxia in humans and put into context the underlying neurovascular mechanisms that may contribute to this regulation.
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Acknowledgments
This work was conducted by CD Steinback as a postdoctoral fellow under the supervision of MJ Poulin. The authors would like to thank Andrew Beaudin, Dr. Margaret Davenport, and Dr. Matriam Pun for their critical review of the manuscript. The Laboratory for Human Cerebrovascular Physiology is funded by the Canadian Institutes of Health Research (CIHR; Grant IDs MOP-93568 and MOP-93717), the Natural Sciences and Engineering Research Council of Canada (NSERC; Grant ID 311904-2009), and the Canadian Stroke Network (Grand ID 22329). CD Steinback was supported by Alberta Innovates – Health Solutions (AIHS) and NSERC Postdoctoral Fellowships. MJ Poulin is funded by an AIHS Senior Medical Scholarship and holds the Brenda Strafford Foundation Chair in Alzheimer Research.
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Steinback, C.D., Poulin, M.J. (2016). Influence of Hypoxia on Cerebral Blood Flow Regulation in Humans. In: Roach, R., Hackett, P., Wagner, P. (eds) Hypoxia. Advances in Experimental Medicine and Biology, vol 903. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7678-9_9
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