Transfer function analysis for the assessment of cerebral autoregulation using spontaneous oscillations in blood pressure and cerebral blood flow.
Cerebral autoregulation (CA) is a key mechanism to protect the brain against excessive fluctuations in blood pressure (BP) and maintain cerebral blood flow. Analyzing the relationship between spontaneous BP and cerebral blood flow velocity (CBFV) using transfer function analysis is a widely used technique to quantify CA in a non-invasive way. The objective of this review was to provide an overview of transfer function techniques used in the assessment of CA. 113 publications were included. This literature showed that there is no gold standard for the execution and implementation of the transfer function. There is a high diversity in settings and criteria used for transfer function analysis. Notable is also the high number of studies which report little on the settings. This disparity makes it difficult to replicate or compare the results of the different studies and further hinders the opportunity to make a distinction between intact and impaired CA in different patient groups. More research on the effects of different implementation techniques on CA results and optimization of the transfer function analysis is urgently needed. Furthermore, international guidelines should be created to inform the minimal description of the applied technique and the interpretation of transfer function outcomes in scientific research.
Radboud University Medical Center, Hemodynamic Lab at the Department of Geriatric Medicine, and Radboud Alzheimer Center, The Netherlands.
Aisha S S
AS
Meel-van den Abeelen
Radboud University Medical Center, Hemodynamic Lab at the Department of Geriatric Medicine, and Radboud Alzheimer Center, The Netherlands.
Arenda H E A
AH
van Beek
MIRA-Institute for Biomedical Technology and of Technical Medicine, of the Faculty of Science and Technology, University of Twente, The Netherlands.
Cornelis H
CH
Slump
Leicester NIHR Biomedical Research Unit in Cardiovascular Sciences, Glenfield Hospital, Leicester, UK.
Ronney B
RB
Panerai
Radboud University Medical Center, Hemodynamic Lab at the Department of Geriatric Medicine, and Radboud Alzheimer Center, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, The Netherlands. Electronic address: jurgen.claassen@radboudumc.nl.
Jurgen A H R
JA
Claassen
D000818:Animals; D001794:Blood Pressure; D001921:Brain / Q000098:blood supply* / Q000502:physiology*; D002560:Cerebrovascular Circulation; D006706:Homeostasis; D006801:Humans
Cerebral autoregulation; Method comparison; Review; Transfer function analysis