Abstract
Neurovascular coupling is a key control mechanism in cerebral blood flow (CBF) regulation. Importantly, this process was demonstrated to be affected in several neurological disorders, including epilepsy. Neurovascular coupling (NVC) is the basis for functional brain imaging, such as PET, SPECT, fMRI, and fNIRS, to assess and map neuronal activity, thus understanding NVC is critical to properly interpret functional imaging signals. However, hemodynamics, as assessed by these functional imaging techniques, continue to be used as a surrogate to map seizure activity; studies of NVC and cerebral blood flow control during and following seizures are rare. Recent studies have provided conflicting results, with some studies showing focal increases in CBF at the onset of a seizure while others show decreases. In this brief review article, we provide an overview of the current knowledge state of neurovascular coupling and discuss seizure-related alterations in neurovascular coupling and CBF control.
Highlights
The brain is a high-energy-consuming organ that lacks significant energy reserves
Insights into these processes will help to consolidate our understanding of cerebral blood flow (CBF) regulation and provide the clarity that is needed to interpret data from functional imaging techniques, such as functional magnetic resonance imaging, which are used as proxies for neuronal activity or as diagnostic or prognostic tools in pathologies like epilepsy
The more we learn about cerebrovascular autoregulation and neurovascular coupling (NVC) in physiology, the more we appreciate the complexity of CBF regulation
Summary
The brain is a high-energy-consuming organ that lacks significant energy reserves. As such, it requires a constant and continuous supply of oxygen and glucose via the blood for its normal computational functions, during heightened activity and at rest. Cerebrovascular autoregulation is an endogenous vascular-controlled process that is intrinsic to vascular myocytes that typically manifests as pressure-dependent constriction (increased pressure) or dilation (decreased pressure) of blood vessels known as the myogenic response [4] This mechanism ensures a constant blood supply to the brain despite changes in systemic pressure. We provide an overview of the current knowledge state of physiological cerebrovascular autoregulation and NVC and discuss seizure-related alterations in NVC during ictal and postictal periods Insights into these processes will help to consolidate our understanding of CBF regulation and provide the clarity that is needed to interpret data from functional imaging techniques, such as functional magnetic resonance imaging (fMRI), which are used as proxies for neuronal activity or as diagnostic or prognostic tools in pathologies like epilepsy
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