Systemic and cerebral hemodynamics and mental activity in marked neuro-emotional stress]

Changes in efficiency of mental activity and general and brain hemodynamics in students of physico-mathematical faculty when they solve problems on math analysis for 3 hours under conditions of pronounced neuro-emotional tension (NET) during examination have been experimentally studied. The results obtained from these studies are considered. It is shown that relation of higher nervous activity and general and brain hemodynamics is determined by efficiency of the activity, its energy provision (intensity), the level of NET and the rate of automated psychic reactions. A conclusion is made that efficiency of the activity is a basic system-forming factor in a relation arising between higher nervous activity, on the one hand, and general and brain hemodynamics, on the other hand. The higher is the efficiency, the lower are power requirements and the level of NET and the higher is the rate of automated psychic reactions: mental working capacity.     

Conditioned reflex activity and several vegetative reactions in dogs during the recovery period following repeated reanimation]

Conditioned activity and vegetative reactions were studied in dogs which repeatedly underwent clinical death from electrical trauma and were reanimated by donor artificial blood circulation. (The first clinical death was provoked 15 to 18 months prior to the repeated death and was caused by drowning and blood loss). On the first few days after reanimation the functions of the higher parts of the CNS and the vegetative nervous system were considerably disturbed. This was manifested in diminished effector reactions to conditioned stimuli, in narcotic and ultraparadoxal phases in conditioned activity, in tachycardia and a higher respiratory rate. The disturbances gradually diminished and by the 5th to 13th day following reanimation completely disappeared. The nature and depth of the disturbances correlated with the basic properties of the animals' type of higher nervous activity. The conditioned reactions were restored despite the retained pronounced dystrophic and destructive changes in the cerebral cortex. This is significant proof of important compensatory capacity for conditioned activity in dogs.     

Cerebral hemodynamic response to maximal exercise

The response of central and cerebral hemodynamics to a stepwise increase in dynamic exercise until failure was studied in healthy young men. Each subject was examined using Doppler ultrasound assessment of blood flow in the middle cerebral artery (MCA), Doppler echocardiography, and spiroergometry. Hemodynamic parameters were recorded before the study and during the last several seconds of each step of the dynamic exercise. The central hemodynamic and energy exchange parameters exhibited typical changes with increasing exercise intensity. The peak systolic blood flow velocity in the MCA increased only in response to exercise of a moderate intensity (1 W/kg body weight, 45% of the maximal oxygen uptake); the further increase in exercise intensity did not affect the blood flow velocity. The cerebral vascular resistance index at the last step of the exercise was 24% higher than at rest. The increase in the MCA resistance index during the exercise was moderately correlated with the increase in the pulse pressure and systolic blood pressure, whereas the increase in blood pressure was not related to the increase in the peak systolic blood flow velocity in the MCA in response to an exercise intensity at which the oxygen uptake was higher than 45% of its maximal value. The differences between the responses of central and cerebral hemodynamics to the stepwise increase in exercise intensity reflect the phenomenon of cerebral hemodynamic autoregulation.     

A brain-computer interface based on bilateral transcranial Doppler ultrasound

In this study, we investigate the feasibility of a BCI based on transcranial Doppler ultrasound (TCD), a medical imaging technique used to monitor cerebral blood flow velocity. We classified the cerebral blood flow velocity changes associated with two mental tasks--a word generation task, and a mental rotation task. Cerebral blood flow velocity was measured simultaneously within the left and right middle cerebral arteries while nine able-bodied adults alternated between mental activity (i.e. word generation or mental rotation) and relaxation. Using linear discriminant analysis and a set of time-domain features, word generation and mental rotation were classified with respective average accuracies of 82.9%±10.5 and 85.7%±10.0 across all participants. Accuracies for all participants significantly exceeded chance. These results indicate that TCD is a promising measurement modality for BCI research.     

天丹通络胶囊联合丁苯酞软胶囊治疗急性脑梗死的疗效及对炎症因子和脑血流动力学的影响

摘要 目的：探讨天丹通络胶囊联合丁苯酞软胶囊治疗急性脑梗死（ACI）的疗效及对炎症因子和脑血流动力学的影响。方法：按照随机数字表法将合肥市第一人民医院2019年1月-2021年12月间接收的100例ACI患者分为对照组（50例,丁苯酞软胶囊治疗）和观察组（50例,天丹通络胶囊联合丁苯酞软胶囊治疗）。对比两组疗效、量表评分、炎症因子和脑血流动力学,统计两组治疗期间不良反应发生率。结果：观察组84.00%的临床总有效率高于对照组66.00%（P<0.05）。与对照组比较,治疗后观察组Barthel指数评分升高,美国国立卫生研究院卒中量表（NIHSS）评分降低（P<0.05）。观察组治疗后的白介素-6（IL-6）、超敏C反应蛋白（hs-CRP）低于对照组,白介素-10（IL-10）高于对照组（P<0.05）。观察组治疗后的阻力指数（RI）低于对照组,脑血流收缩期峰值血流速度（Vs）、平均血流速度（Vm）、舒张期血流速度（Vd）较对照组高（P<0.05）。不良反应发生率组间对比无差异（P>0.05）。结论：天丹通络胶囊联合丁苯酞软胶囊有助于降低ACI患者的炎症因子水平,改善脑血流动力学,效果显著。     

Regulation of oxygen transport during brain activation: stimulus-induced hemodynamic responses in human and animal cortices

BACKGROUND: The correlation between regional changes in neuronal activity and changes in hemodynamics is a major issue for noninvasive neuroimaging techniques such as functional magnetic resonance imaging (fMRI) and near-infrared optical imaging (NIOI). A tight coupling of these changes has been assumed to elucidate brain function from data obtained with those techniques. In the present study, we investigated the relationship between neuronal activity and hemodynamic responses in the occipital cortex of humans during visual stimulation and in the somatosensory cortex of rats during peripheral nerve stimulation. METHODS: The temporal frequency dependence of macroscopic hemodynamic responses on visual stimuli was investigated in the occipital cortex of humans by simultaneous measurements made using fMRI and NIOI. The stimulus-intensity dependence of both microscopic hemodynamic changes and changes in neuronal activity in response to peripheral nerve stimulation was investigated in animal models by analyzing membrane potential (fluorescence), hemodynamic parameters (visible spectra and laser-Doppler flowmetry), and vessel diameter (image analyzer). RESULTS: Above a certain level of stimulus-intensity, increases in regional cerebral blood flow (rCBF) were accompanied by a decrease in regional cerebral blood volume (rCBV), i.e., dissociation of rCBF and rCBV responses occurred in both the human and animal experiments. Furthermore, the animal experiments revealed that the distribution of increased rCBF and O2 spread well beyond the area of neuronal activation, and that the increases showed saturation in the activated area. CONCLUSIONS: These results suggest that above a certain level of neuronal activity, a regulatory mechanism between regional cerebral blood flow (rCBF) and rCBV acts to prevent excess O2 inflow into the focally activated area.     

Cerebral hemodynamics response to low intensity physical exercise

The aim of this research was to study the cerebral hemodynamics reaction to step increase of physical exercises intensity during bicycle ergometer test in young healthy male subjects. Hemodynamics parameters were registered with the transcranial Doppler ultrasonography of middle cerebral artery (MCA) prior to the study and during the last seconds of every step of physical exercise. Cerebral hemodynamics response to physical exercise was characterized by a significant increase of peak systolic blood velocity in the MCA up to 0.25 W/kg of the body weight (90 rpm with regard to 0 W/kg) without further increase of blood velocity in the same physical exercise becoming more intensive up to 0.5 W/kg of the body weight. The stabilization mechanism of blood velocity in cerebral arteries in case of physical exercise increase and, hence, the autoregulation mechanism of cerebral circulation means that the increase of regional cerebral vascular resistance depends on the value of arterial pressure. The autoregulation mechanism of cerebral circulation starts working with he exercise intensity of 0.25 W/kg and the value of systolic blood pressure about 140-145 mm Hg.     

Characteristics of free-radical oxidation and antiradical protection of the brain in adaptation to chronic stress

During the phase of long-lasting adaptation to chronic emotional painful stress three stages have been distinguished on the basis of physiological and neurobiochemical data. The first stage (1 week of stress)--transition from urgent to long-lasting adaptation--corresponds to labilization of vegetative indices, predominance of fear reactions and suppression of research behaviour in rats, inhibition of lipid peroxidation, activation of superoxide scavenging activity, decrease in cholesterol content in brain lipids. The second stage (2 weeks of stress)--long-lasting adaptation--is characterized by normalization of the behaviour, stabilization of high blood pressure, maximum brain antiradical activity and low level of lipid peroxidation. The third stage (3 weeks of stress)--transition from long-lasting adaptation to exhaustion--is characterized by blood pressure lowering, disturbed regulation of vegetative functions, behavioural hyperactivity in the open field, increased lipid peroxidation and decreased phospholipid content.     

灯盏花素注射液联合依达拉奉注射液对未溶栓急性脑梗死患者神经功能、脑血流动力学和血清炎症细胞因子的影响

摘要 目的：观察灯盏花素注射液联合依达拉奉注射液对未溶栓急性脑梗死（ACI）患者神经功能、脑血流动力学和血清炎症细胞因子的影响。方法：选取2020年4月~2022年1月来我院接受治疗的未溶栓ACI患者82例。采用随机数字表法将患者分为对照组（依达拉奉注射液治疗,41例）和实验组（灯盏花素注射液联合依达拉奉注射液治疗,41例）。观察两组临床疗效,神经功能、脑血流动力学和血清炎症细胞因子的变化,记录两组不良反应情况。结果：实验组的临床总有效率为90.24%,高于对照组的68.29%,差异有统计学意义（P<0.05）。实验组治疗7d后美国国立卫生研究院卒中量表（NIHSS）评分低于对照组,日常生活活动能力（ADL）评分高于对照组P<0.05）。实验组治疗7d后脑血流平均血流速度（Vm）、收缩期峰值血流速度（Vs）、舒张期血流速度（Vd）高于对照组（P<0.05）。实验组治疗7 d后白介素-6（IL-6）、超敏C反应蛋白（hs-CRP）水平低于对照组（P<0.05）。两组均未出现严重的不良反应。结论：依达拉奉注射液联合灯盏花素注射液治疗未溶栓ACI患者,可调节脑血流动力学,减轻神经功能损伤,降低血清炎症细胞因子,且具有较好的安全性。     

目标导向液体治疗联合右美托咪定对创伤性颅脑损伤患者血流动力学、脑氧代谢及炎症因子的影响

目的:探讨目标导向液体(GDFT)治疗联合右美托咪定对创伤性颅脑损伤(TBI)患者血流动力学、脑氧代谢及炎症因子的影响。方法:选取2016年3月~2019年3月期间我院收治的TBI患者142例,根据随机数字表法分为对照组1(n=47,GDFT治疗)、对照组2(n=47,常规液体联合右美托咪定)和研究组(n=48,GDFT联合右美托咪定),比较三组患者围术期指标、血流动力学、脑氧代谢及炎症因子变化情况,记录三组围术期间不良反应状况。结果:三组患者术后12、24 h心率(HR)、呼吸频率(RR)及动脉-颈内静脉血氧含量差(AVDO2)均较术前降低,且研究组低于对照组1、对照组2(P<0.05);三组患者术后12、24 h血氧饱和度(Sjv O2)较术前升高,且研究组高于对照组1、对照组2(P<0.05);三组患者术后12、24 h白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)呈逐渐下降趋势(P<0.05);研究组术后12、24 h的IL-6、TNF-α低于对照组1、对照组2(P<0.05)。对照组2、对照组1、研究组术中总液体量、胶体量、晶体量依次减少(P<0.05),住院天数依次缩短(P<0.05)。三组不良反应发生率对比未见显著差异(P>0.05)。结论:TBI患者手术麻醉过程中给予GDFT联合右美托咪定方案,促进机体HR、RR趋于平稳的同时还可改善脑氧代谢及炎性因子水平,且不增加不良反应发生率。     

Human cerebrovascular and autonomic rhythms during vestibular activation

Otolith activation increases muscle sympathetic nerve activity (MSNA), and MSNA activation may alter associations among autonomic oscillators, including those modulating cerebral hemodynamics. The purpose of this study was to determine the influence of vestibulosympathetic activation on cerebral and autonomic rhythms. We recorded the ECG, finger arterial pressure, end-tidal CO(2), respiration, cerebral blood flow velocity, and MSNA in eight subjects. Subjects breathed at 0.25 Hz for 5 min in the prone and head-down positions. We analyzed data in time and frequency domains and performed cross-spectral analyses to determine coherence and transfer function magnitude. Head-down rotation increased MSNA from 7 +/- 1.3 to 12 +/- 1.5 bursts/min (P = 0.001) but did not affect R-R intervals, arterial pressures, mean cerebral blood flow velocities (V(mean)), or their power spectra. Vestibular activation with head-down rotation had no effect on mean arterial pressure and V(mean) transfer function magnitude. The two new findings from this study are 1) head-down rotation independently activates the sympathetic nervous system with no effect on parasympathetic activity or V(mean); and 2) frequency-dependent associations between arterial pressures and V(mean) are independent of vestibular activation. These findings support the concept that vestibular-autonomic interactions independently and redundantly serve to maintain steady-state hemodynamics.     

右美托咪定联合瑞芬太尼对全身麻醉下髋关节置换术患者脑氧代谢、血流动力学和认知功能的影响

摘要 目的：瑞芬太尼、右美托咪定对全身麻醉下髋关节置换术患者的脑氧代谢、血流动力学和认知功能的影响。方法：选取2016年6月~2019年10月期间我院收治的100例行髋关节置换术的患者。采用随机数字表法分为对照组和研究组,各50例。对照组患者麻醉中予以瑞芬太尼,研究组则在对照组的基础上复合右美托咪定,比较两组患者血流动力学、脑氧代谢和认知功能情况,记录两组患者围术期间不良反应发生率。结果：两组手术开始后30 min（T1）~手术结束时（T2）时间点平均动脉压（MAP）、心率（HR）均呈下降趋势,但研究组高于对照组（P<0.05）。两组T1~T2时间点动脉血氧含量（CaO₂）、颈内静脉血氧含量（CjvO₂）均呈下降趋势,且研究组低于对照组（P<0.05）;两组T1~T2时间点颈静脉球部血氧饱和度（SjvO₂）呈升高趋势,且研究组高于对照组（P<0.05）。两组术前~术后7 d简明精神状态量表（MMSE）评分均呈下降后升高趋势（P<0.05）;研究组术后3 d、术后7 d MMSE评分高于对照组（P<0.05）。研究组术后3 d、术后7 d的认知功能障碍（POCD）发生率低于对照组（P<0.05）。两组不良反应发生率比较无差异（P>0.05）。结论：全身麻醉下髋关节置换术患者麻醉方案选用右美托咪定联合瑞芬太尼,可减轻血流动力学波动,维持脑氧供需平衡,可减少POCD发生风险,且安全性较好。     

Antistress and angioprotective influence of nitric oxide in epilepsy-prone rats of Krushinskiĭ-Molodkina strain

In rats of Krushinsky-Molodkina strain (KMR), the audiogenic stress induced epileptiform seizure and development of acute disturbances of cerebral circulation of hemorrhagic nature. The inhibitor of NO-synthase (L-NNA) increased the severity of clinical symptoms, mortality, and the intensity of intracranial hemorrhages. In contrast, L-arginine elevated the resistance of KMRs to acoustic stress. The intensity of nitrergic innervation was analyzed in preparations of the middle cerebral artery with the use of histochemical NADPH-diaphorase staining. In preparations of control KMRs, a net of NADPH-positive perivascular nerve fibers was found, while in experimental KMRs, in an hour after sound stimulation, such fibers practically were not revealed. Preliminary exposure of KMRs in hypoxic conditions (1 hour in hypobaric chamber at simulated altitude of 5000 m above the sea level) decreased the development of stress lesions. The protective effect of hypoxic training disappeared after the administration of NO-synthase inhibitor (L-NNA). The study demonstrated participation of nitric oxide (NO) in adaptive reactions of cerebral hemodynamics linked with the significant increase of cerebral blood flow.     

Responses of central and cerebral hemodynamics to active orthostasis in healthy subjects

Regular trends in changes in cerebral and central hemodynamics were studied in 28 healthy men aged 20–26 years during active orthostatic stress. The hemodynamic parameters of the blood flow in the middle cerebral artery (MCA), systemic hemodynamics, and parameters of pulmonary ventilation were recorded simultaneously for 10 min while a subject was in a horizontal position and for the same period after the position had been changed to vertical (active rising). In healthy subjects, several types of responses of cerebral and central hemodynamics were detected during active orthostasis.     

A simple mathematical model of the interaction between intracranial pressure and cerebral hemodynamics

Ursino, Mauro, and Carlo Alberto Lodi. A simplemathematical model of the interaction between intracranial pressure andcerebral hemodynamics. J. Appl.Physiol. 82(4): 1256-1269, 1997.A simplemathematical model of intracranial pressure (ICP) dynamics oriented toclinical practice is presented. It includes the hemodynamics of thearterial-arteriolar cerebrovascular bed, cerebrospinal fluid (CSF)production and reabsorption processes, the nonlinear pressure-volumerelationship of the craniospinal compartment, and a Starling resistormechanism for the cerebral veins. Moreover, arterioles are controlledby cerebral autoregulation mechanisms, which are simulated by means ofa time constant and a sigmoidal static characteristic. The model isused to simulate interactions between ICP, cerebral blood volume, andautoregulation. Three different related phenomena are analyzed: thegeneration of plateau waves, the effect of acute arterial hypotensionon ICP, and the role of cerebral hemodynamics during pressure-volume index (PVI) tests. Simulation results suggest the following:1) ICP dynamics may become unstablein patients with elevated CSF outflow resistance and decreasedintracranial compliance, provided cerebral autoregulation is efficient.Instability manifests itself with the occurrence of self-sustainedplateau waves. 2) Moderate acutearterial hypotension may have completely different effects on ICP,depending on the value of model parameters. If physiological compensatory mechanisms (CSF circulation and intracranial storage capacity) are efficient, acute hypotension has only negligible effectson ICP and cerebral blood flow (CBF). If these compensatory mechanismsare poor, even modest hypotension may induce a large transient increasein ICP and a significant transient reduction in CBF, with risks ofsecondary brain damage. 3) The ICPresponse to a bolus injection (PVI test) is sharply affected, viacerebral blood volume changes, by cerebral hemodynamics andautoregulation. We suggest that PVI tests may be used to extractinformation not only on intracranial compliance and CSF circulation,but also on the status of mechanisms controlling CBF.

     

Relationships between Cerebral Blood Flow Dynamics and Bioelectric Activity of the Human Brain in Experimental Acute Hypoxia

The relationships between the parameters of oxygen content in the body (hemoglobin saturation with oxygen and trancutaneous oxygen tension), central hemodynamics (cardiac output), and cerebral hemodynamics (cerebral blood flow rate) were studied during a hypoxic test (inhalation of an oxygen–nitrogen mixture containing 8% oxygen for 15 min). Special attention was paid to the relationships between the dynamics of cerebral blood flow and cerebral bioelectric activity measured by EEG parameters. It was demonstrated that the trancutaneous oxygen tension decreased to a greater extent than the hemoglobin saturation with oxygen and the cerebral blood flow increased to a greater extent than the cardiac output. The increase in cerebral blood flow and the increase in the indices and power of and EEG waves in the course of hypoxia were strongly positively correlated with each other in most subjects. However, if these parameters were considered in the series of subjects, the degree of the increase in the indices and power of and waves in different subjects was negatively correlated with the increase in the cerebral blood flow. The results are explained in terms of redistribution of blood flow in the body to provide a better oxygen supply to the brain and optimization of the ratios between the cerebral oxygen consumption and the functional load on the system of oxygen supply.     

On the neurosecretory system of Dendrobaena atheca Cernosvitov

Four kinds of neurosecretory cells A, B, U and C are distinguished in the central nervous system of Dendrobaena atheca Cernosvitov. A cells, which show different morphological characteristics under different physiological states and during their cyclic changes, are the most active neurosecretory cells. They form the outer layer of the cortical cell zone in the cerebral ganglion. B cells are large and medium sized and are distributed in all parts of the central nervous system. U cells are found only in the sub-pharyngeal ganglion while C cells are distributed in the sub-pharyngeal as well as in the ventral nerve cord ganglion. The number and secretory activity of C cells decrease in caudal direction. Further, Gomori-positive cells are also observed in the ganglia of the vegetative nervous system. A rudimentary neurohaemal organ, the storage zone, has been observed in the cerebral ganglion and there appears to be another neurohaemal area in the ventral nerve cord ganglion. The storage zone is formed by the terminal ends of the axons of A cells. The chrome alum haematoxylin phloxin (CHP) and aldehyde fuchsin (AF) positive substances in the form of granules are found in this area. The cerebral ganglion is richly supplied by blood capillaries. The distal end of the axons of B cells are swollen like a bulb while in some cases the axons are united to form an axonal tract. Extra-cellular material is abundant in different parts of the nervous system. In all cell types, the perinuclear zone is the first to show activity in the secretory cycle. It appears that the nucleus may be involved in the elaboration of the neurosecretory material in the cells.     

Phase dual‐slopes in frequency‐domain near‐infrared spectroscopy for enhanced sensitivity to brain tissue: First applications to human subjects

We present a first in vivo application of phase dual‐slopes (DS?), measured with frequency‐domain near‐infrared spectroscopy on four healthy human subjects, to demonstrate their enhanced sensitivity to cerebral hemodynamics. During arterial blood pressure oscillations elicited at a frequency of 0.1 Hz, we compare three different ways to analyze either intensity (I) or phase (?) data collected on the subject's forehead at multiple source‐detector distances: Single‐distance, single‐slope and DS. Theoretical calculations based on diffusion theory show that the method with the deepest maximal sensitivity (at about 11 mm) is DS?. The in vivo results indicate a qualitative difference of phase data (especially DS?) and intensity data (especially single‐distance intensity [SDI]), which we assign to stronger contributions from scalp hemodynamics to SDI and from cortical hemodynamics to DS?. Our findings suggest that scalp hemodynamic oscillations may be dominated by blood volume dynamics, whereas cortical hemodynamics may be dominated by blood flow velocity dynamics.     

Mental stress and cognitive performance do not increase overall level of cerebral O2 uptake in humans.

We measured cerebral metabolic rate of oxygen (CMRO2), cerebral blood flow (CBF), and cerebral lactate output during rest, during the execution of mental arithmetic, and during mental stress induced by physical and psychological annoyance. Measurements were performed in healthy volunteers by use of the Kety-Schmidt technique with 133Xe as the inert gas. Electroencephalographic desynchronization and highly significant increases in plasma catecholamines and heart rate verified that the test measurements were performed during conditions differing distinctly from the resting state. In accordance with an earlier study (Sokoloff et al. J. Clin. Invest. 34: 1101-1108, 1985), a minimal and nonsignificant 1% reduction of global CMRO2 during mental arithmetic was observed, signifying that this form of mental activation was unassociated with any detectable increase in overall cerebral synaptic activity. Mental stress induced a slight but highly significant (P less than 0.002) 6% reduction in global CMRO2. This finding is in contrast to results from earlier investigations and contradicts the generally accepted notion of an association between mental arousal and a diffuse upregulation of cerebral synaptic activity. During mental arithmetic and mental stress, cerebral lactate output increased by 207 and 344%, respectively, but because of large individual variations in the measured responses, the elevations reached statistical significance only during mental arithmetic.     

Ergoreflex: The essence and mechanisms

Physical load increases sympathetic nervous activity, which results in an increased cardiac output, constriction of peripheral vessels, and elevated systemic blood pressure. These changes are outcomes of two mechanisms: the central command from cerebral structures that trigger voluntary movements to activate the vasomotor center and the reflexes initiated by mechanical and metabolic changes in a working muscle. The latter mechanism of the sympathetic system activation is termed ergoreflex. The main effects of ergoreflex on the indices of systemic hemodynamics are the following: activation of mechanosensitive afferents mainly leads to inhibition of the tonic vagal effects on the heart, which explains the rapid increase in heartbeats upon loading; activation of chemosensitive afferents comes with some delay in pace with metabolite accumulation in muscles and leads to an increase in efferent sympathetic activity and a rise in blood pressure. The metabolic reflex effect is particularly high in the case of muscle fatigue. This review deals with the mechanisms underlying the ergoreflex and their adaptation to hypodynamia, physical training, and some pathologies.