title: Assessment of functional hemispheric asymmetry by bilateral simultaneous cerebral blood flow velocity monitoring.
abstract: The aim of this study was to investigate side-to-side differences of simultaneously measured middle cerebral artery (MCA) blood flow velocities during various hemisphere-specific tasks. Using a transcranial Doppler device, flow velocity changes of 24 healthy, right-handed subjects were monitored simultaneously in the left and right MCA during different hemisphere-specific tasks. Mean flow velocity (MFV) curves were averaged for each individual subject and task. Simultaneously, heart rate, blood pressure and end-tidal carbon dioxide (CO2) were measured in a subgroup of six subjects. When compared with the resting state, all stimuli produced significant (p < 0.001) bilateral MFV increases, ranging from 2.5-9.2%. A lateralization of MFV increases with a significantly (p < 0.001) more pronounced increase in MFV in the hemisphere contralateral to the performing band was observed both during simple sequential finger movements and a complex spatial task. During the complex spatial task, consistently higher MFV increases were observed in the right MCA (p < 0.001), regardless of the side of task performance. Recognition of pictorial material presented as part of a memory task, also resulted in a side-to-side difference of respective MFV increases (right > left, p < 0.001), whereas memorization did not. Whereas bilateral MFV elevations observed during stimulation with white noise were only discrete and not lateralized, exposure to overt speech produced significantly higher (p < 0.001) MFV increases in the left MCA. The time course of the MFV reaction showed a rapid increase with an initial maximum after 4-5 s. Heart rate, blood pressure, and end-tidal CO2 showed only subtle changes during the stimulation periods. In conclusion, the observed side-to-side differences of MFV reaction in the left and right MCA concur with current functional imaging data. Bilateral simultaneous repetitive transcranial Doppler monitoring is a sensitive method to detect cerebral perfusion asymmetries caused by hemisphere-specific activation, and thus may be helpful for noninvasive assessment of hemispheric dominance for language.
authors.affiliation: Department of Neurology, Technical University of Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Klingelhöfer
authors.forename: G
authors.initials: G
authors.lastname: Matzander
authors.forename: D
authors.initials: D
authors.lastname: Sander
authors.forename: J
authors.initials: J
authors.lastname: Schwarze
authors.forename: H
authors.initials: H
authors.lastname: Boecker
authors.forename: C
authors.initials: C
authors.lastname: Bischoff
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male