Key result
Sympathetic blockade with oral Prazosin increased wavelet phase synchronization index for frequency components ≤0.03 Hz compared to placebo, indicating sympathetic involvement in cerebral blood flow.
Why the study?
Does α1-adrenergic blockade alter cerebral pressure-flow relations in healthy participants?
RCT (n=18)
randomly assigned
Does α1-adrenergic blockade alter cerebral pressure-flow relations in healthy participants?
Sympathetic nervous system activity plays a role in very-low-frequency cerebral blood flow dynamics, demonstrating a frequency-dependent interplay.
Hypothesis-generating for sympathetic modulation of cerebral blood flow; leaves open clinical relevance pending larger trials.
The dynamic regulation of cerebral blood flow (CBF) is thought to involve myogenic and chemoreflex mechanisms, but the extent to which the sympathetic nervous system also plays a role remains debated. Here we sought to identify the role of human sympathetic neurovascular control by examining cerebral pressure-flow relations using linear transfer function analysis and multivariate wavelet decomposition analysis that explicitly accounts for the confounding effects of dynamic end-tidal Pco2 (PetCO2 ) fluctuations. In 18 healthy participants randomly assigned to the α1-adrenergic blockade group (n = 9; oral Prazosin, 0.05 mg/kg) or the placebo group (n = 9), we recorded blood pressure, middle cerebral blood flow velocity, and breath-to-breath PetCO2 Analyses showed that the placebo administration did not alter wavelet phase synchronization index (PSI) values, whereas sympathetic blockade increased PSI for frequency components ≤0.03 Hz. Additionally, three-way interaction effects were found for PSI change scores, indicating that the treatment response varied as a function of frequency and whether PSI values were PetCO2 corrected. In contrast, sympathetic blockade did not affect any linear transfer function parameters. These data show that very-low-frequency CBF dynamics have a composite origin involving, not only nonlinear and nonstationary interactions between BP and PetCO2 , but also frequency-dependent interplay with the sympathetic nervous system.
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Saleem et al. (2016) conducted an RCT in Healthy participants (n=18). α1-adrenergic blockade (oral Prazosin) vs. placebo was evaluated on wavelet phase synchronization index (PSI) values. Sympathetic blockade with oral Prazosin increased wavelet phase synchronization index for frequency components ≤0.03 Hz compared to placebo, indicating sympathetic involvement in cerebral blood flow.
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