Journal of Cerebral Blood Flow and Metabolism最新文献

{"title":"Cerebrovascular morphology: Insights into normal variations, aging effects and disease implications.","authors":"Aditi Deshpande, Lucy Q Zhang, Ramani Balu, Noushin Yahyavi-Firouz-Abadi, Neeraj Badjatia, Kaveh Laksari, Pouya Tahsili-Fahadan","doi":"10.1177/0271678X251328537","DOIUrl":"10.1177/0271678X251328537","url":null,"abstract":"<p><p>Cerebrovascular morphology plays a critical role in brain health, influencing cerebral blood flow (CBF) and contributing to the pathogenesis of various neurological diseases. This review examines the anatomical structure of the cerebrovascular network and its variations in healthy and diseased populations and highlights age-related changes and their implications in various neurological conditions. Normal variations, including the completeness and anatomical anomalies of the Circle of Willis and collateral circulation, are discussed in relation to their impact on CBF and susceptibility to ischemic events. Age-related changes in the cerebrovascular system, such as alterations in vessel geometry and density, are explored for their contributions to age-related neurological disorders, including Alzheimer's disease and vascular dementia. Advances in medical imaging and computational methods have enabled automatic quantitative assessment of cerebrovascular structures, facilitating the identification of pathological changes in both acute and chronic cerebrovascular disorders. Emerging technologies, including machine learning and computational fluid dynamics, offer new tools for predicting disease risk and patient outcomes based on vascular morphology. This review underscores the importance of understanding cerebrovascular remodeling for early diagnosis and the development of novel therapeutic approaches in brain diseases.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1249-1264"},"PeriodicalIF":4.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral assessment of neuropsychiatric outcomes in rodent stroke models.","authors":"Robert M Callaghan, Huiyuan Yang, Rachel D Moloney, Christian Waeber","doi":"10.1177/0271678X251317369","DOIUrl":"10.1177/0271678X251317369","url":null,"abstract":"<p><p>Stroke-associated mood disorders are less recognised than sensorimotor impairment, despite their high prevalence. Similarly, few experimental stroke studies assess non-sensorimotor functions. This study examined the prevalence and implementation of non-sensorimotor tests in three stroke-focused journals over the last twenty years. Of 965 experimental ischaemic stroke papers which used behavioural testing in rodents, 932 included sensorimotor testing, while 137 used non-sensorimotor tests (most commonly the Morris water maze, open field, Y-maze, and novel object recognition tests, but with a more diverse range of tests introduced in recent years). Cognition, anxiety and depression were assessed in 70%, 27% and 3% of these 137 papers. Non-sensorimotor deficits were typically observed after recovery of sensorimotor function. Potential confounding factors and challenges for data interpretation were identified in the most prevalent tests. More generally, experimental rigor (a priori power calculation, randomisation, blinding, and pre-defined inclusion/exclusion) improved over the years, but remained unsatisfactory with only 26% of studies providing some evidence of adequate statistical power. Furthermore, most studies focused on male animals, limiting external validity. This review confirms the disparity between sensorimotor and non-sensorimotor testing in experimental stroke but shows that the share of the studies including the latter is increasing. It is essential that research into the neuropsychiatric sequalae of stroke addresses methodological issues noted and continues to expand to improve patient outcomes post-stroke.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1232-1248"},"PeriodicalIF":4.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute, not delayed, treatment of aflibercept enhances vessel density in post-ischemic brain and promotes long-term stroke recovery in obese mice.","authors":"Hyunwoo Ju, Joseph Minker, Ina Pavlova, Sunghee Cho, Il-Doo Kim","doi":"10.1177/0271678X251330102","DOIUrl":"10.1177/0271678X251330102","url":null,"abstract":"<p><p>Vascular comorbidities complicate stroke pathophysiology, worsen outcomes, and delay recovery. Obesity, in particular, significantly increases stroke-induced brain edema, a fatal complication during infarction, which leads to worsened long-term recovery. Treatment of aflibercept, a VEGF-trap, has been shown to reduce stroke-induced brain edema and attenuate acute neurological deficits in obese mice. However, the effect of aflibercept on long-term stroke recovery is unknown. We found that treating obese stroke mice with aflibercept at 3 hours displayed significantly improved long-term motor and cognitive function. Notably, VEGFR2 expression was upregulated at 3- and 7-days post-stroke, indicating sustained VEGF signaling in obese subjects. Unlike acute treatment of aflibercept at 3 hours post-stroke, delayed treatment (3-day) worsened stroke recovery. While the improved long-term stroke recovery in mice treated aflibercept 3 hours is associated with the upregulated Pecam-1 and Angiopoietin-1 mRNAs and vessel densities in peri-infarct area at 3 months post-stroke, the delayed treatment led to a reduction in both angiogenic marker expression and vessel density. These findings highlight the importance of early intervention with VEGF signaling in obese mice to promote subsequent vascular remodeling during the stroke recovery phase and indicate a critical therapeutic window for VEGF inhibition to treat stroke in subjects with vascular comorbidities.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1402-1412"},"PeriodicalIF":4.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correcting <i>SUVR</i> bias by accounting for radiotracer clearance in tissue: A validation study with [¹⁸F]FE-PE2I PET in cross-sectional, test-retest and longitudinal cohorts.","authors":"Minyoung Oh, Praveen Honhar, Richard E Carson, Ansel T Hillmer, Andrea Varrone","doi":"10.1177/0271678X251322407","DOIUrl":"10.1177/0271678X251322407","url":null,"abstract":"<p><p>Quantification of dopamine transporter (DAT) with [¹⁸F]FE-PE2I PET is an important progression marker for Parkinson's disease (PD). This study aimed to validate a novel correction (<i>SUVR</i>c) for a less-biased estimate of <i>SUVR</i> by accounting for [¹⁸F]FE-PE2I clearance-rate, in independent cross-sectional (38 PD, 38 controls), test-retest (9 PD) and longitudinal cohorts (21 PD). <i>SUVR</i>c was calculated as <math><mfrac><mrow><mi>SUVR</mi></mrow><mrow><mn>1</mn><mi> </mi><mo>-</mo><mi> </mi><mfrac><mrow><msub><mrow><mi>β</mi></mrow><mrow><mi>ref</mi></mrow></msub></mrow><mrow><msub><mrow><mi>k</mi></mrow><mrow><mn>2</mn><mo>,</mo><mi>ref</mi></mrow></msub></mrow></mfrac><mi> </mi><mo>+</mo><msub><mrow><mi>β</mi></mrow><mrow><mi>tar</mi></mrow></msub><mfrac><mrow><mi>SUVR</mi></mrow><mrow><msub><mrow><mi>k</mi></mrow><mrow><mn>2</mn><mo>,</mo><mi>ref</mi></mrow></msub><msub><mrow><mi>R</mi></mrow><mrow><mn>1</mn></mrow></msub></mrow></mfrac></mrow></mfrac></math>. <i>β</i>_tar and <i>β</i>_ref are the clearance rates from the target and reference tissues. Bias relative to <i>DVR</i>, discriminative power, test-retest variability (TRV) and annual longitudinal change (ALC) were used to compare <i>SUVR</i>_50-80 min, <i>SUVR</i>c_50-80 min, <i>SUVR</i>_15-45 min and <i>DVR. SUVR</i>_50-80 min showed high bias across all regions (HC: mean: 48.31 ± 20.49% [range: 28.32-53.80%]; PD: 29.91 ± 13.95% [20.45-39.80%]) that was corrected by <i>SUVR</i>c_50-80 min (HC: -0.80 ± 12.72% [-9.69-11.64%]; PD: -0.13 ± 7.41% [-5.04-2.97%]), <i>p < </i>0.001 for both groups compared to mean bias of <i>SUVR</i>_50-80 min, similar to <i>SUVR</i>_15-45 min. For the striatum, Cohen's <i>d</i> was similar for all measures. TRV were 3.2 ± 2.5% (<i>DVR</i>), 6.4 ± 5.7% (<i>SUVR</i>_50-80 min), 6.8 ± 5.9% (<i>SUVR</i>c_50-80 min) and 3.9 ± 3.2% (<i>SUVR</i>_15-45 min). Higher TRV of <i>SUVR</i>c_50-80 min was due to TRV of 9.2 ± 5.1% [1.1-19.4] for β_tar. ALC was 4.5 ± 4.2% (<i>DVR</i>), 5.2 ± 6.5% (<i>SUVR</i>_50-80 min), 4.4 ± 4.1% (<i>SUVR</i>c_50-80 min) and 4.2 ± 4.1% (<i>SUVR</i>_15-45 min). <i>SUVR</i>c_50-80 min reduced bias compared to <i>SUVR</i>_50-80 min, as previously reported. <i>SUVR</i>c_50-80 min was sensitive to small changes of β_tar, with higher TRV compared to <i>DVR</i>, but with similar ALC, suggesting that it can reliably assess longitudinal DAT changes.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1357-1370"},"PeriodicalIF":4.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the protective vasodilatory effects of hypobaric hypoxia on the neurovascular coupling response.","authors":"Jack K Leacy, David P Burns, Nicholas G Jendzjowsky, Connor Braun, Brittney A Herrington, Richard Ja Wilson, Tyler D Vermeulen, Glen E Foster, Alexander J Rosenberg, Garen K Anderson, Caroline A Rickards, Eric F Lucking, Ken D O'Halloran, Trevor A Day","doi":"10.1177/0271678X251322348","DOIUrl":"10.1177/0271678X251322348","url":null,"abstract":"<p><p>Neurovascular coupling (NVC) is the link between local neuronal activity and regional cerebral blood flow. High altitude (HA) ascent induces acute hypoxic vasodilation of the cerebral vasculature, with associated changes in CO₂ and acid-base status. We aimed to characterise the effects of (a) acute removal of the HA-induced vasodilation and (b) rapid ascent to and residency at HA on NVC responses. In twelve healthy participants (7 M/5F), arterial blood gases and NVC were measured at baseline (1130 m) and on days two (<24 h at HA) and nine (post-acclimatisation) at 3800 m. Acute gas challenges were performed using end-tidal forcing, with (a) normoxia and isocapnic hypoxia at 1130 m and (b) poikilocapnic hypoxia and isocapnic hyperoxia on days two and nine at 3800 m. Posterior cerebral artery velocity (PCAv) was measured using transcranial Doppler ultrasound in each condition and time-point. NVC was assessed via a standardized 30 s intermittent strobe light visual stimulus (VS), and quantified as the peak and mean change from baseline in PCAv. No significant differences were observed for any NVC metric across all conditions and time points. Our results reveal remarkable stability of the NVC response following (a) acute removal of HA-induced hypoxic vasodilation and (b) rapid ascent to and residency at 3800 m.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1293-1309"},"PeriodicalIF":4.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral perfusion alterations in healthy young adults due to two genetic risk factors of Alzheimer's disease: APOE and MAPT.","authors":"Samuel K Bennett, Jianmin Zeng, Maria-Eleni Dounavi, Arshad Majid, Sheharyar S Baig, Matteo De Marco, Craig Ritchie, John T O'Brien, Li Su","doi":"10.1177/0271678X241310731","DOIUrl":"10.1177/0271678X241310731","url":null,"abstract":"<p><p>Functional brain changes such as altered cerebral blood flow occur long before the onset of clinical symptoms in Alzheimer's disease (AD) and other neurodegenerative disorders. While cerebral hypoperfusion occurs in established AD, middle-aged carriers of genetic risk factors for AD, including APOE ε4, display regional hyperperfusion due to hypothesised pleiotropic or compensatory effects, representing a possible early biomarker of AD and facilitating earlier AD diagnosis. However, it is not clear whether hyperperfusion already exists even earlier in life. Here, 160 young and cognitively healthy participants from the Chinese PREVENT cohort underwent 3 T arterial spin labelling and T1 MRI and genetic testing for APOE and MAPT rs242557 status. Using FSL, we performed a whole brain voxel-wise analysis and a global mean grey matter analysis comparing for the effects of both risk genes on cerebral perfusion. No significant alterations were seen for APOE genotype, but in MAPT rs242557 A carriers, we observed a significantly hyperperfusion in the left anterior cingulate cortex and left insular cortex. There were no effects of APOE or MAPT status on the global perfusion. These results are novel and may suggest that MAPT genotypes demonstrated a distinct hemodynamic profile in a very young age.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1048-1058"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel model to quantify blood transit time in cerebral arteries using ASL-based 4D magnetic resonance angiography with example clinical application in moyamoya disease.","authors":"Alex A Bhogal, Simone M Uniken Venema, Pieter T Deckers, Kim van de Ven, Maarten Versluis, Kees P Braun, Albert van der Zwan, Jeroen Cw Siero","doi":"10.1177/0271678X251321640","DOIUrl":"10.1177/0271678X251321640","url":null,"abstract":"<p><p>Angiography is critical for visualizing cerebral blood flow in intracranial steno-occlusive diseases. Current 4D magnetic resonance angiography (MRA) techniques primarily focus on macrovascular structures, yet few have quantified hemodynamic timing. This study introduces a novel model to estimate macrovascular arterial transit time (mATT) derived from arterial spin labeling (ASL)-based 4D-MRA. We provide examples of our method that visualize mATT differences throughout the brain of patients with intracranial steno-occlusive disease (moyamoya), as well as changes in mATT resulting from the cerebrovascular reactivity response to an acetazolamide (ACZ) injection. Furthermore, we present a method that projects sparse arterial signals into a 3D native brain-region atlas space and correlates regional mATT with other hemodynamic parameters of interest, such as tissue transit time and cerebrovascular reactivity. This approach offers a non-invasive, quantitative assessment of macrovascular dynamics, with potential to enhance understanding of large-vessel and tissue-level hemodynamics and augment monitoring of treatment outcomes in steno-occlusive disease patients. Furthermore, it sets the stage for more in-depth investigations of the macrovascular contribution to brain hemodynamics.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1069-1081"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing astrocyte-mediated neurovascular coupling by combining optogenetics and biophysical modeling.","authors":"Alejandro Suarez, Lazaro Fernandez, Jorge Riera","doi":"10.1177/0271678X241311010","DOIUrl":"10.1177/0271678X241311010","url":null,"abstract":"<p><p>Vasoactive signaling from astrocytes is an important contributor to the neurovascular coupling (NVC), which aims at providing energy to neurons during brain activation by increasing blood perfusion in the surrounding vasculature. Pharmacological manipulations have been previously combined with experimental techniques (e.g., transgenic mice, uncaging, and multiphoton microscopy) and stimulation paradigms to isolate <i>in vivo</i> individual pathways of the astrocyte-mediated NVC. Unfortunately, these pathways are highly nonlinear and non-additive. To separate these pathways in a unified framework, we combine a comprehensive biophysical model of vasoactive signaling from astrocytes with a unique optogenetic stimulation method that selectively induces astrocytic Ca²⁺ signaling in a large population of astrocytes. We also use a sensitivity analysis and an optimization technique to estimate key model parameters. Optogenetically-induced Ca²⁺ signals in astrocytes cause a cerebral blood flow (CBF) response with two major components. Component-1 was rapid and smaller (ΔCBF∼13%, 18 seconds), while component-2 was slowest and highest (ΔCBF ∼18%, 45 seconds). The proposed biophysical model was adequate in reproducing component-2, which was validated with a pharmacological manipulation. Model's predictions were not in contradiction with previous studies. Finally, we discussed scenarios accounting for the existence of component-1, which once validated might be included in our model.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1100-1115"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Control of neurovascular coupling by ATP-sensitive potassium channels.","authors":"Ryan M Bowen, Nathaniel W York, Jonah Padawer-Curry, Adam Q Bauer, Jin-Moo Lee, Colin G Nichols","doi":"10.1177/0271678X251313906","DOIUrl":"10.1177/0271678X251313906","url":null,"abstract":"<p><p>Regional blood flow within the brain is tightly coupled to regional neuronal activity, a process known as neurovascular coupling (NVC). In this study, we demonstrate the striking role of SUR2- and Kir6.1-dependent ATP-sensitive potassium (K_ATP) channels in control of NVC in the sensory cortex of conscious mice, in response to mechanical stimuli. We demonstrate that either globally increased (pinacidil-activated) or decreased (glibenclamide-inhibited) K_ATP activity markedly disrupts NVC; pinacidil-activation is capable of completely abolishing stimulus-evoked cortical hemodynamic responses, while glibenclamide slows and reduces the response. The response is similarly slowed and reduced in SUR2 KO animals, while animals expressing gain-of-function (GOF) mutations in Kir6.1, which underlie Cantú syndrome, exhibit baseline reduction of NVC as well as increased sensitivity to pinacidil. In revealing the dramatic effects of either increasing or decreasing SUR2/Kir6.1-dependent K_ATP activity on NVC, whether pharmacologically or genetically induced, the study has important implications both for monogenic K_ATP channel diseases and for more common brain pathologies.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1130-1143"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cerebral oxygenation and usual parameters of cerebral perfusion in critically ill patients with acute brain injury.","authors":"Timothée Ayasse, Samuel Gaugain, Charles de Roquetaillade, Alexis Hermans-Didier, Manuel Kindermans, Benjamin G Chousterman, Romain Barthélémy","doi":"10.1177/0271678X241310780","DOIUrl":"10.1177/0271678X241310780","url":null,"abstract":"<p><p>In patients with acute brain injury (ABI), optimizing cerebral perfusion parameters relies on multimodal monitoring. This include data from systemic monitoring-mean arterial pressure (MAP), arterial carbon dioxide tension (PaCO₂), arterial oxygen saturation (SaO₂), hemoglobin levels (Hb), and temperature-as well as neurological monitoring-intracranial pressure (ICP), cerebral perfusion pressure (CPP), and transcranial Doppler (TCD) velocities. We hypothesized that these parameters alone were not sufficient to assess the risk of cerebral ischemia. We conducted a retrospective, single-center study of patients admitted in our ICU between 2015 and 2021. Patients with ABI and multimodal neuromonitoring were included. ABI included traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracranial hemorrhage and ischemic stroke. The relationship between jugular venous oxygen saturation (SjvO₂) and cerebral perfusion parameters was analyzed. Patients were categorized into two groups based on SjvO₂, with a threshold of 60% used to define cerebral ischemia. We compared the parameters used to optimize cerebral perfusion between groups and their diagnosis accuracy for cerebral ischemia was evaluated. Univariable and multivariable analyses were performed to assess the association between the guideline-recommended therapeutic targets and the risk of cerebral ischemia. 601 evaluations from 96 patients with simultaneous ICP, SjvO₂ and TCD were analyzed. Poor relationships were found between SjvO₂ and the parameters of cerebral perfusion. TCD flow velocities and PaCO₂ were lower in the cerebral ischemia group while MAP, ICP and CPP were not different between groups. Most ischemic episodes occurred despite ICP < 22 mmHg and CPP ≥ 60 mmHg. For the diagnosis of cerebral ischemia, only TCD parameters and PaCO₂ were associated with an area under the curve (AUC) > 0.5 but with a low accuracy. In multivariable analysis, the only guideline-recommended therapeutic target associated with a reduction of cerebral ischemia was a diastolic flow velocity (FV) > 20 cm.s^-1.</p>","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1059-1068"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}