Abstract
The brain is a neurovascular organ. A stimulus-response approach is effective in interrogating the physiology of its vasculature. Ideally, the stimulus is standardized across patients, and in a single patient over time. We developed a standard stimulus and attempted to measure, classify, and interpret the many forms of responses. Over the past 20 years, our work has delivered nuanced insights into normal cerebral vascular physiology, as well as adaptive physiological responses in the presence of disease. The trajectory of our understanding did not follow a logical linear progression; rather, it emerged as a coalescence of new, old, and previously dismissed, ideas that had accumulated over time. In this essay, we review what we believe were our most valuable – and sometimes controversial insights during our two decades-long journey.
Highlights
The patterns of blood flow distribution in the brain in response to a vasoactive stimulus can be complex in the presence of cerebrovascular disease, but they are the only comprehensive output data we can access
We identified a single repeatable vasoactive stimulus and a surrogate measure of CBF
We performed CVR tests on a healthy cohort to establish normal values. This enables the identification and scoring of pathology in individual patients. We applied these data to understand how the observed patterns of flow revealed vascular pathophysiology in terms of perfusion pressures and vascular diameter summarized as vascular resistance
Summary
The patterns of blood flow distribution in the brain in response to a vasoactive stimulus can be complex in the presence of cerebrovascular disease, but they are the only comprehensive output data we can access. Interpretations we proffer, and conclusions we come to, can emanate only from analyzing these data.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
