Cerebrovascular responsiveness to hypercapnia is stable over six months in older adults

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Abstract

The primary purpose of this Brain in Motion (BIM) sub-study was to determine the 6-month stability of resting blood flow velocity and cerebrovascular responsiveness to a euoxic hypercapnic challenge in a group of physically inactive community dwelling men and men aged ≥55 yrs (range 55-92 yrs). At baseline and 6 months later 88 women (65±6 yr) and 78 men (67±7 yr) completed a hypercapnic challenge (step changes from resting end-tidal PCO2 ((PETCO2) to +1, +5 and +8 mmHg above rest) while cerebral blood flow velocity was assessed using transcranial Doppler ultrasound. Peak velocity of the middle cerebral artery (MCAv) was increased (p<0.05) at the second visit during rest (51±2 vs. 52±4); however, these differences were abolished (p>0.05) when MCAv was normalized to PETCO2. During hypercapnia, MCAv tended to be increased at follow-up, but this finding was absent when MCAv/PETCO2 was compared across time. Cerebrovascular reactivity (i.e., ΔMCAv/ΔPETCO2) was similar (p>0.05) between testing occasions regardless of the approach taken (i.e., considering only the lower step [from +1 to +5 mmHg]; the upper step [+5 to +8 mmHg]; or the complete test taken together). In conclusion, this study has shown that cerebral blood flow and cerebrovascular responsiveness to acute euoxic hypercapnia are stable in older, healthy adults over a 6-month period. Modest changes in MCAv over time must be viewed in the context of underlying differences in PETCO2, an important finding with implications for future studies considering cerebral blood flow velocity.

Figures

  • Fig 1. Schematic depicting the hypercapnic challenge completed by subjects at Baseline and 6-month follow-up.Cerebrovascular reserve was calculated using four distinct approaches: “Lower” considered the Δ VP/ΔPETCO2 during the +1.0 to +5.0 mmHg step change in PETCO2; “Upper” considered the Δ VP/ΔPETCO2 during the +5.0 to +8.0 mmHg step change in PETCO2; “Span” considered the total Δ VP/ΔPETCO2, where Δ was calculated as the difference between +8.0 mmHg and +1.0 mmHg values; and “Regression” calculated the slope of the response across the three stages.
  • Table 1. Anthropometric measures, resting heart rate, cerebral blood flow velocity, end-tidal partial pressures for CO2 and O2, and blood pressures at Baseline and 6 Months.
  • Fig 2. (A) Negative relationship between restingmaximal peak cerebral blood flow velocity (MCAv) and age in men and women at Baseline. (B) Stable relationship of subjects’ cardiovascular fitness (VO2max) values between Baseline and 6 Months.
  • Table 2. Cerebrovascular responses during hypercapnic challenge at Baseline and 6 Months.
  • Table 3. Middle cerebral artery velocity (MCAv) normalized to PETCO2 during hypercapnic challenge at Baseline and 6 Months.
  • Fig 3. Bland-Altman plots illustrating differences in CVR between Baseline and 6 Monthmeasurements in women (top panels; empty circles) and men (bottom panels; filled circles). Responses observed at +1.0 mmHg (left), +5.0 mmHg (center), and +8.0 mmHg (right) of above resting PETCO2 are presented separately.
  • Fig 4. Bland-Altman plots illustrating differences in CVC between Baseline and 6 Monthmeasurements in women (top panels; empty circles) and men (bottom panels; filled circles). Responses observed at +1.0 mmHg (left), +5.0 mmHg (center), and +8.0 mmHg (right) of above resting PETCO2 are presented separately.
  • Fig 5. Comparison of strategies for computing cerebrovascular responsiveness in older adults undergoing a hypercapnic challenge. Values are mean±SD. *, p<0.05 from Lower; †, p<0.05 from Upper; ‡, p<0.05 from Span.

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APA

Spencer, M. D., Tyndall, A. V., Davenport, M. H., Argourd, L., Anderson, T. J., Eskes, G. A., … Poulin, M. J. (2015). Cerebrovascular responsiveness to hypercapnia is stable over six months in older adults. PLoS ONE, 10(11). https://doi.org/10.1371/journal.pone.0143059

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