Effects of sustained low-level elevations of carbon dioxide on cerebral blood flow and autoregulation of the intracerebral arteries in humans.
Cerebral blood flow velocity (CBFv) was measured by insonating the middle cerebral arteries of four subjects using a 2 Mhz transcranial Doppler. Ambient CO2 was elevated to 0.7% for 23 d in the first study and to 1.2% for 23 d in the same subjects in the second study. By non-parametric testing CBFv was elevated significantly by +35% above pre-exposure levels during the first 1-3 d at both exposure levels, after which CBFv progressively readjusted to pre-exposure levels. Despite similar CBFv responses, headache was only reported during the initial phase of exposure to 1.2% CO2. Vascular reactivity to CO2 assessed by rebreathing showed a similar pattern with the CBFv increases early in the exposures being greater than those elicited later. An increase in metabolic rate of the visual cortex was evoked by having the subjects open and close their eyes during a visual stimulus. Evoked CBFv responses measured in the posterior cerebral artery were also elevated in the first 1-3 d of both studies returning to pre-exposure levels as hypercapnia continued. Cerebral vascular autoregulation assessed by raising head pressure during 10 degrees head-down tilt both during the low-level exposures and during rebreathing was unaltered. There were no changes in the retinal microcirculation during serial fundoscopy studies. The time-dependent changes in CO2 vascular reactivity might be due either to retention of bicarbonate in brain extracellular fluid or to progressive increases in ventilation, or both. Cerebral vascular autoregulation appears preserved during chronic exposure to these low levels of ambient CO2.
Sliwka
U
U
Department of Neurology, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.
Krasney
J A
JA
Simon
S G
SG
Schmidt
P
P
Noth
J
J
D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001783:Blood Flow Velocity / Q000187:drug effects; D002245:Carbon Dioxide / Q000009:adverse effects*; D002536:Cerebral Arteries / Q000187:drug effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D018504:Ecological Systems, Closed; D018475:Head-Down Tilt / Q000502:physiology; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D006935:Hypercapnia / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D012171:Retinal Vessels / Q000187:drug effects; D018561:Space Simulation; D018709:Statistics, Nonparametric; D017585:Ultrasonography, Doppler, Transcranial
D002245:Carbon Dioxide