A network-based model of dynamic cerebral autoregulation.

Abstract

Cerebrovascular diseases continue to be one of the leading causes of morbidity and mortality in humans. Abnormalities in dynamic cerebral autoregulation (dCA) have been implicated in many of these disease conditions. Accurate models are therefore needed to better understand the complex pathophysiology behind impaired dCA. We thus present here a simple framework for modelling a vessel-driven network model of dCA in the microvasculature, as opposed to the conventional compartmental modelling approach. Network models incorporate the actual connectivity and anatomy of the vasculature, thereby allowing us to include and trace changes in the calibre and morphology of individual vessels, investigate the spatial specificity and heterogeneity of the various control mechanisms to help disentangle their contributions, and link the model parameters to the actual network physiology. The proposed control feedback mechanisms are incorporated at the level of the individual vessel, and the dynamic pressure and flow fields are solved for here within a simple vessel network. In response to an upstream pressure drop, the network is found to be able to recover cerebral blood flow (CBF) while exhibiting the characteristic autoregulatory behaviour in terms of changes in vessel calibre and the biphasic flow response. We assess the feasibility of our formulation in larger networks by comparing the simulation results to those obtained using a one-dimensional (1D) model of CBF applied to the same microvasculature network and find that our model results are in very good agreement with the 1D solution, while significantly reducing the computational cost, thus enabling more detailed models of network behaviour to be adopted in the future. Accurate and computationally feasible models of dCA that are more representative of the vasculature can help increase the translatability of haemodynamic models into the clinical environment, which would help develop more informed treatment guidelines for patients with cerebrovascular diseases.