The role of the autonomic nervous system in cerebral blood flow regulation in stroke: A review

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical Pub Date : 2023-05-01 DOI:10.1016/j.autneu.2023.103082

Alex Mankoo , Sankanika Roy , Aaron Davies , Ronney B. Panerai , Thompson G. Robinson , Patrice Brassard , Lucy C. Beishon , Jatinder S. Minhas

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引用次数: 3

Abstract

Stroke is a pathophysiological condition which results in alterations in cerebral blood flow (CBF). The mechanism by which the brain maintains adequate CBF in presence of fluctuating cerebral perfusion pressure (CPP) is known as cerebral autoregulation (CA). Disturbances in CA may be influenced by a number of physiological pathways including the autonomic nervous system (ANS). The cerebrovascular system is innervated by adrenergic and cholinergic nerve fibers. The role of the ANS in regulating CBF is widely disputed owing to several factors including the complexity of the ANS and cerebrovascular interactions, limitations to measurements, variation in methods to assess the ANS in relation to CBF as well as experimental approaches that can or cannot provide insight into the sympathetic control of CBF. CA is known to be impaired in stroke however the number of studies investigating the mechanisms by which this occurs are limited. This literature review will focus on highlighting the assessment of the ANS and CBF via indices derived from the analyses of heart rate variability (HRV), and baroreflex sensitivity (BRS), and providing a summary of both clinical and animal model studies investigating the role of the ANS in influencing CA in stroke. Understanding the mechanisms by which the ANS influences CBF in stroke patients may provide the foundation for novel therapeutic approaches to improve functional outcomes in stroke patients.

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自主神经系统在脑卒中脑血流调节中的作用:综述

中风是一种导致脑血流改变的病理生理状况。大脑在脑灌注压(CPP)波动的情况下维持足够的CBF的机制被称为脑自动调节(CA)。CA的紊乱可能受到许多生理途径的影响，包括自主神经系统(ANS)。脑血管系统受肾上腺素能和胆碱能神经纤维支配。由于几个因素，包括ANS和脑血管相互作用的复杂性、测量的局限性、评估ANS与CBF相关的方法的变化以及能够或不能提供交感神经控制CBF的实验方法，ANS在调节CBF中的作用受到广泛争议。已知CA在中风中受损，但调查其发生机制的研究数量有限。本文献综述将重点介绍通过心率变异性(HRV)和压反射敏感性(BRS)分析得出的指标来评估ANS和CBF，并总结临床和动物模型研究，探讨ANS在卒中中影响CA的作用。了解ANS影响脑卒中患者脑血流的机制可能为改善脑卒中患者功能预后的新治疗方法提供基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Autonomic Neuroscience-Basic & Clinical 医学-神经科学

CiteScore

5.80

自引率

7.40%

发文量

审稿时长

66 days

期刊介绍： This is an international journal with broad coverage of all aspects of the autonomic nervous system in man and animals. The main areas of interest include the innervation of blood vessels and viscera, autonomic ganglia, efferent and afferent autonomic pathways, and autonomic nuclei and pathways in the central nervous system. The Editors will consider papers that deal with any aspect of the autonomic nervous system, including structure, physiology, pharmacology, biochemistry, development, evolution, ageing, behavioural aspects, integrative role and influence on emotional and physical states of the body. Interdisciplinary studies will be encouraged. Studies dealing with human pathology will be also welcome.