Lack of correlation between cerebral vasomotor reactivity and dynamic cerebral autoregulation during stepwise increases in inspired CO2 concentration

Cerebral vasomotor reactivity (CVMR) and dynamic cerebral autoregulation (CA) are measured extensively in clinical and research studies. However, the relationship between these measurements of cerebrovascular function is not well understood. In this study, we measured changes in cerebral blood flow velocity (CBFV) and arterial blood pressure (BP) in response to stepwise increases in inspired CO₂ concentrations of 3% and 6% to assess CVMR and dynamic CA in 13 healthy young adults (2 women, 32±9 yrs). CVMR was assessed as percentage changes in CBFV (CVMR_CBFV) or cerebrovascular conductance index (CVCi, CVMR_CVCi) in response to hypercapnia. Dynamic CA was estimated by performing transfer function analysis between spontaneous oscillations in BP and CBFV. Steady-state CBFV and CVCi both increased exponentially during hypercapnia; CVMR_CBFV and CVMR_CVCi were greater at 6% (3.85±0.90 and 2.45±0.79%/mmHg) than 3% CO₂ (2.09±1.47 and 0.21±1.56%/mmHg, p=0.009 and 0.005, respectively). Furthermore, CVMR_CBFV was greater than CVMR_CVCi during either 3% or 6% CO₂ (p=0.017 and p<0.001, respectively). Transfer function gain and coherence increased in the very low frequency range (0.02-0.07Hz) and phase decreased in the low frequency range (0.07-0.20Hz) when breathing 6%, but not 3% CO₂. There were no correlations between the measurements of CVMR and dynamic CA. These findings demonstrated influences of inspired CO₂ concentrations on assessment of CVMR and dynamic CA. The lack of correlation between CVMR and dynamic CA suggests that cerebrovascular responses to changes in arterial CO₂ and BP are mediated by distinct regulatory mechanisms.

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