基于数据的脑血流动力学模型量化了 2 型糖尿病患者脑血流调节功能的损伤。

IF 4.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Vasilis Z Marmarelis, Dae C Shin, Yue Kang, Vera Novak
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引用次数: 0

摘要

我们研究了大脑中动脉(MCA)的脑血流速度(CBv)对动脉血压(ABP)自发变化(称为动态脑自动调节(dCA))和作为血液二氧化碳张力替代物的潮气末二氧化碳(end-tidal CO2)的调节动态,称为动态血管运动反应性(DVR)、通过分析从 36 名 2 型糖尿病 (T2DM) 患者和 22 名年龄/性别匹配、无动脉高血压的非糖尿病对照组患者身上收集到的仰卧休息时的时间序列数据,我们将这些数据称为动态血管运动反应性 (DVR)。我们的分析采用了一种稳健的动态建模方法,利用主动态模式(PDM)估计 ABP 和潮气末二氧化碳(视为两个 "输入")自发变化到通过经颅多普勒超声测量的 MCA CBv 变化(视为 "输出")的特定受试者动态转换。PDM 的定量分析结果表明,DVR 和 dCA 的 T2DM 在两个特定的 PDM 贡献方面都发生了显著的变化(p<0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Data-based modeling of cerebral hemodynamics quantifies impairment of cerebral blood flow regulation in type-2 diabetes.

We studied the regulation dynamics of cerebral blood velocity (CBv) at middle cerebral arteries (MCA) in response to spontaneous changes of arterial blood pressure (ABP), termed dynamic cerebral autoregulation (dCA), and end-tidal CO2 as proxy for blood CO2 tension, termed dynamic vasomotor reactivity (DVR), by analyzing time-series data collected at supine rest from 36 patients with Type-2 Diabetes Mellitus (T2DM) and 22 age/sex-matched non-diabetic controls without arterial hypertension. Our analysis employed a robust dynamic modeling methodology that utilizes Principal Dynamic Modes (PDM) to estimate subject-specific dynamic transformations of spontaneous changes in ABP and end-tidal CO2 (viewed as two "inputs") into changes of CBv at MCA measured via Transcranial Doppler ultrasound (viewed as the "output"). The quantitative results of PDM analysis indicate significant alterations in T2DM of both DVR and dCA in terms of two specific PDM contributions that rise to significance (p < 0.05). Our results further suggest that the observed DVR and dCA alterations may be due to reduction of cholinergic activity (based on previously published results from cholinergic blockade data) that may disturb the sympatho-vagal balance in T2DM. Combination of these two model-based "physio-markers" differentiated T2DM patients from controls (p = 0.0007), indicating diabetes-related alteration of cerebrovascular regulation, with possible diagnostic implications.

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来源期刊
Journal of Cerebral Blood Flow and Metabolism
Journal of Cerebral Blood Flow and Metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.80%
发文量
300
审稿时长
3 months
期刊介绍: JCBFM is the official journal of the International Society for Cerebral Blood Flow & Metabolism, which is committed to publishing high quality, independently peer-reviewed research and review material. JCBFM stands at the interface between basic and clinical neurovascular research, and features timely and relevant research highlighting experimental, theoretical, and clinical aspects of brain circulation, metabolism and imaging. The journal is relevant to any physician or scientist with an interest in brain function, cerebrovascular disease, cerebral vascular regulation and brain metabolism, including neurologists, neurochemists, physiologists, pharmacologists, anesthesiologists, neuroradiologists, neurosurgeons, neuropathologists and neuroscientists.
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