Cerebrovascular regulation is not blunted during mental stress

New Findings What is the central question of the study? What are the effects of acute mental stress on the mechanisms regulating cerebral blood flow? What is the main finding and its importance? The major new findings are as follows: (i) high mental stress and hypercapnia had an interactive effect on mean middle cerebral artery blood velocity; (ii) high mental stress altered the regulation of cerebral blood flow; (iii) the increased cerebrovascular hypercapnic reactivity was not driven by changes in mean arterial pressure alone; and (iv) this increased perfusion with mental stress appeared not to be justified functionally by an increase in oxygen demand (as determined by near‐infrared spectroscopy‐derived measures). Abstract In this study, we examined the effects of acute mental stress on cerebrovascular function. Sixteen participants (aged 23 ± 4 years; five female) were exposed to low and high mental stress using simple arithmetic (counting backwards from 1000) and more complex arithmetic (serial subtraction of 13 from a rapidly changing four‐digit number), respectively. During consecutive conditions of baseline, low stress and high stress, end‐tidal partial pressure of CO 2 ( ) was recorded at normocapnia (37 ± 3 mmHg) and clamped at two elevated levels ( P < 0.01): 41 ± 1 and 46 ± 1 mmHg. Mean right middle cerebral artery blood velocity (MCAv mean ; transcranial Doppler ultrasound), right prefrontal cortex haemodynamics (near‐infrared spectroscopy) and mean arterial blood pressure (MAP; finger photoplethysmography) were measured continuously. Cerebrovascular hypercapnic reactivity (ΔMCAv mean /Δ ), cerebrovascular conductance (CVC; MCAv mean /MAP), CVC CO 2 reactivity (ΔCVC/Δ ) and total peripheral resistance (MAP/cardiac output) were calculated. Acute high mental stress increased MCAv mean by 7 ± 7%, and more so at higher (32 ± 10%; interaction, P = 0.03), illustrating increased sensitivity to CO 2 (i.e. its major regulator). High mental stress also increased MAP (17 ± 9%; P ≤ 0.01), coinciding with increased near‐infrared spectroscopy‐derived prefrontal haemoglobin volume and saturation measures. High mental stress elevated both cerebrovascular hypercapnic and conductance reactivities (main effect of stress, P ≤ 0.04). These findings indicate that the cerebrovascular response to acute high mental stress results in a coordinated regulation between multiple processes.