Risk Factors for Delayed Neurocognitive Recovery According to Brain Biomarkers and Cerebral Blood Flow Velocity

Background and Objectives: The aim of this study is to identify risk factors for the development of delayed neurocognitive recovery (dNCR). Materials and Methods: 140 patients underwent neurocognitive evaluations (Adenbrooke, MoCa, trial making, and CAM test) and middle cerebral artery (MCA) blood flow velocity (BFV) measurements, one day before cardiac surgery. BFV was re-evaluated after anesthesia induction, before the beginning, middle, end, and after cardiopulmonary bypass (CPB) and postsurgery. To measure glial fibrillary acidic protein (GFAP) and neurofilament heavy chain (Nf-H), blood samples were collected after anesthesia induction, 24 and 48 h after the surgery. Neurocognitive evaluation was repeated 7–10 days after surgery. According to the results, patients were divided into two groups: with dNCR (dNCR group) and without dNCR (non-dNCR group). Results: 101 patients completed participation in this research. GFAP increased in both the non-dNCR group (p < 0.01) and in the dNCR group (p < 0.01), but there was no difference between the groups (after 24 h, p 0.342; after 48 h, p 0.273). Nf-H increased in both groups (p < 0.01), but there was no difference between them (after 24 h, p = 0.240; after 48 h, p = 0.597). MCA BFV was significantly lower in the dNCR group during the bypass (37.13 cm/s SD 7.70 versus 43.40 cm/s SD 9.56; p = 0.001) and after surgery (40.54 cm/s SD 11.21 versus 47.6 cm/s SD 12.01; p = 0.003). Results of neurocognitive tests correlated with CO2 concentration (Pearson’s r 0.40, p < 0.01), hematocrit (r 0.42, p < 0.01), MCA BFV during bypass (r 0.41, p < 0.01), and age (r −0.533, p < 0.01). The probability of developing dNCR increases 1.21 times with every one year of increased age (p < 0.01). The probability of developing dNCR increases 1.07 times with a decrease of BFV within 1 cm/s during bypass (p = 0.02). Conclusion: Risk factors contributing to dNCR among the tested patients were older age and middle cerebral artery blood flow velocity decrease during bypass.

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Both remifentanil and nitrous oxide attenuate pain-induced increases in cerebral blood flow velocity of the middle cerebral artery

Inpharma Weekly ◽

10.2165/00128413-200313810-00034 ◽

2003 ◽

Vol &NA; (1381) ◽

pp. 15

Author(s):

&NA;

Keyword(s):

Blood Flow ◽

Nitrous Oxide ◽

Cerebral Blood Flow ◽

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Blood Flow Velocity ◽

Cerebral Blood Flow Velocity

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Slow oscillations in middle cerebral artery cerebral blood flow velocity and aging

Neurological Research ◽

10.1179/174313206x153987 ◽

2007 ◽

Vol 29 (3) ◽

pp. 260-263 ◽

Cited By ~ 2

Author(s):

Philip M. Lewis ◽

Piotr Smielewski ◽

John D. Pickard ◽

Marek Czosnyka

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Blood Flow Velocity ◽

Cerebral Blood Flow Velocity ◽

Slow Oscillations

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Changes in Cerebral Blood Flow Velocity Associated With Biofeedback-Assisted Relaxation Treatment of Migraine Headaches are Specific for the Middle Cerebral Artery

Headache The Journal of Head and Face Pain ◽

10.1111/j.1526-4610.1995.hed3506358.x ◽

1995 ◽

Vol 35 (6) ◽

pp. 358-362 ◽

Cited By ~ 15

Author(s):

Albert Wauquier ◽

Angele McGrady ◽

Louise Aloe ◽

Todd Klausner ◽

Brad Collins

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Blood Flow Velocity ◽

Cerebral Blood Flow Velocity ◽

Migraine Headaches

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Biofeedback-Assisted Relaxation in Migraine Headache: Relationship to Cerebral Blood Flow Velocity in the Middle Cerebral Artery

Headache The Journal of Head and Face Pain ◽

10.1046/j.1526-4610.2003.03048.x ◽

2003 ◽

Vol 43 (3) ◽

pp. 245-250 ◽

Cited By ~ 16

Author(s):

Sachinder Vasudeva ◽

Alice L. Claggett ◽

Gretchen E. Tietjen ◽

Angele V. McGrady

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Blood Flow Velocity ◽

Migraine Headache ◽

Cerebral Blood Flow Velocity

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Blood Flow Velocity Changes in the Middle Cerebral Artery Induced by Driving Fatigue

Advanced Engineering Forum ◽

10.4028/www.scientific.net/aef.2-3.219 ◽

2011 ◽

Vol 2-3 ◽

pp. 219-222

Author(s):

Hong Wang ◽

Xiao Mei Chi ◽

Ya Jing Yan ◽

Ning Ning Zhang

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Blood Flow Velocity ◽

Cerebral Blood Flow Velocity ◽

Driving Fatigue ◽

Velocity Changes ◽

Fatigue Driving

The cerebral blood flow velocity (CBFV) of middle cerebral artery (MCA) was detected during the fatigue driving using Transcranial Doppler. The CBFV was also analyzed after the fatigue driving by different means of relaxation to alleviate brain fatigue. The results show that the CBFV in MCA is reduced by driving fatigue.

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Effects of GV20 Acupuncture on Cerebral Blood Flow Velocity of Middle Cerebral Artery and Anterior Cerebral Artery Territories, and CO2 Reactivity During Hypocapnia in Normal Subjects

The Journal of Alternative and Complementary Medicine ◽

10.1089/acm.2010.0232 ◽

2011 ◽

Vol 17 (3) ◽

pp. 219-224 ◽

Cited By ~ 16

Author(s):

Hyung-sik Byeon ◽

Sang-kwan Moon ◽

Seong-uk Park ◽

Woo-sang Jung ◽

Jung-mi Park ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Blood Flow Velocity ◽

Anterior Cerebral Artery ◽

Cerebral Blood Flow Velocity ◽

Normal Subjects ◽

Co2 Reactivity

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Differential Increases in Blood Flow Velocity in the Middle Cerebral Artery after Tourniquet Deflation during Sevoflurane, Isoflurane or Propofol Anaesthesia

Anaesthesia and Intensive Care ◽

10.1177/0310057x0903700412 ◽

2009 ◽

Vol 37 (4) ◽

pp. 598-603 ◽

Cited By ~ 5

Author(s):

Y. Kadoi ◽

C. H. Kawauchi ◽

M. Ide ◽

S. Saito ◽

A. Mizutani

Keyword(s):

Blood Flow ◽

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Blood Flow Velocity ◽

Orthopaedic Surgery ◽

Cerebral Blood Flow Velocity ◽

Pneumatic Tourniquet ◽

Arterial Blood ◽

Tourniquet Deflation

The purpose of this study was to examine the comparative effects of sevoflurane, isoflurane or propofol on cerebral blood flow velocity after tourniquet deflation during orthopaedic surgery. Thirty patients undergoing elective orthopaedic surgery were randomly divided into sevoflurane, isoflurane and propofol groups. Anaesthesia was maintained with sevoflurane, isoflurane or propofol infusion in 33% oxygen and 67% nitrous oxide, in whatever concentrations were necessary to keep bispectral index values between 45 and 50. Ventilatory rate or tidal volume was adjusted to target PaCO2 of 35 mmHg. A 2.0 MHz transcranial Doppler probe was attached to the patient's head at the temporal window and mean blood flow velocity in the middle cerebral artery was continuously measured. The extremity was exsanguinated with an Esmarch bandage and the pneumatic tourniquet was inflated to a pressure of 450 mmHg. Arterial blood pressure, heart rate, velocity in the middle cerebral artery and arterial blood gas analysis were measured every minute for 10 minutes after release of the tourniquet in all three groups. Velocity in the middle cerebral artery in the three groups increased for five minutes after tourniquet deflation. Because of the different cerebrovascular effects of the three agents, the degree of increase in flow velocity in the isoflurane group was greater than in the other two groups, the change in flow velocity in the propofol group being the lowest (at three minutes after deflation 40∓7%, 32∓6% and 28∓10% in the isoflurane, sevoflurane and propofol groups respectively, P <0.05).

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