Abstract
Simple SummaryCerebral autoregulation is a homeostatic feedback mechanism that maintains a relatively constant cerebral blood flow despite changes in blood pressure. Impaired cerebral autoregulation results in unstable cerebral blood flow and is detrimental to the outcome of neurological diseases. Therefore, metrics of cerebral autoregulation were increasingly used to assess cerebrovascular health or to guide hemodynamic management. Intermittent sequential pneumatic compression (ISPC) is an effective physiotherapy technique that could improve motor deficits in patients with acute cerebral infarction. The present study focuses on the coupling relationships between arterial blood pressure and changes in oxygenated hemoglobin in the cerebral cortex to investigate the effect of ISPC on cerebral autoregulation in patients with cerebral infarction, as compared with the healthy controls. This study may help to advance the understanding of the physiological mechanisms of ISPC intervention and can provide a basis for evaluating the efficacy of ISPC interventions in patients with cerebral infarction.This study aims to explore the effect of intermittent sequential pneumatic compression (ISPC) intervention on the coupling relationship between arterial blood pressure (ABP) and changes in oxyhaemoglobin (Δ [O2Hb]). The coupling strength between the two physiological systems was estimated using a coupling function based on dynamic Bayesian inference. The participants were 22 cerebral infarction patients and 20 age- and sex-matched healthy controls. Compared with resting state, the coupling strength from ABP to Δ [O2Hb] oscillations was significantly lower in the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and temporal lobe cortex (TLC) during the ISPC intervention in cerebral infarction patients in interval II. Additionally, the coupling strength was significantly lower in the bilateral SMC in both groups in interval III. These findings indicate that ISPC intervention may facilitate cerebral circulation in the bilateral PFC, SMC, and TLC in cerebral infarction patients. ISPC may promote motor function recovery through its positive influences on motor-related networks. Furthermore, the coupling between Δ [O2Hb] and ABP allows non-invasive assessments of autoregulatory function to quantitatively assess the effect of rehabilitation tasks and to guide therapy in clinical situations.
Highlights
Stroke is a leading cause of disability worldwide, resulting in a substantial burden on caregivers and society [1]
During the Intermittent sequential pneumatic compression (ISPC) intervention, the mean arterial pressure increased and the heart rate decreased in both groups, no significant differences were observed
The results showed that in interval I, the wavelet amplitude of the ∆ [O2Hb] signals increased following ISPC intervention in the LSMC and RSMC (p < 0.0083) in patients with cerebral infarction
Summary
Stroke is a leading cause of disability worldwide, resulting in a substantial burden on caregivers and society [1]. Intermittent sequential pneumatic compression (ISPC) is an effective physiotherapy technique that could improve motor function defects in patients with cerebral infarction and motor impairment [5]. Combining this technique with rehabilitation training can effectively ameliorate neurological deficits and restore a certain degree of motor function to the limbs of patients who have experienced cerebral infarction [5]. Previous study has suggested that the application of ISPC will lead to an increase in hemodynamic shear stress, which can induce the improvement of endothelial function and growth of collateral arteries [6]. Brain—cardiovascular interactions during ISPC intervention are not well understood
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