Neurovascular coupling methods in healthy individuals using transcranial doppler ultrasonography:  A systematic review and consensus agreement

James D. Ball; Eleanor Hills; Afzaa Altaf; Pranav Ramesh; Matthew Green; Farhaana B.S. Surti; Jatinder S. Minhas; Thompson G. Robinson; Bert Bond; Alice Lester; Ryan Hoiland; Timo Klein; Jia Liu; Nathalie Nasr; Rehan T. Junejo; Martin Müller; Andrea Lecchini-Visintini; Georgios Mitsis; Joel S. Burma; Jonathan D. Smirl; Michael A. Pizzi; Elsa Manquat; Samuel J. E. Lucas; Karen J. Mullinger; Steve Mayhew; Damian M. Bailey; Gabriel Rodrigues; Pedro Paulo Soares; Aaron A. Phillips; Prokopis C. Prokopiou; Lucy C. Beishon

doi:10.1177/0271678x241270452

Neurovascular coupling methods in healthy individuals using transcranial doppler ultrasonography: A systematic review and consensus agreement

James D. Ball
, Eleanor Hills
, Afzaa Altaf
, Pranav Ramesh
, Matthew Green
, Farhaana B.S. Surti
, Jatinder S. Minhas
, Thompson G. Robinson
, Bert Bond
, Alice Lester
, Ryan Hoiland
, Timo Klein
, Jia Liu
, Nathalie Nasr
, Rehan T. Junejo
, Martin Müller
, Andrea Lecchini-Visintini
, Georgios Mitsis
, Joel S. Burma
, Jonathan D. Smirl

Michael A. Pizzi, Elsa Manquat, Samuel J. E. Lucas, Karen J. Mullinger, Steve Mayhew, Damian M. Bailey, Gabriel Rodrigues, Pedro Paulo Soares, Aaron A. Phillips, Prokopis C. Prokopiou, Lucy C. Beishon

Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital Leicester, Leicester LE3 9QP, UK
NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
Public Health and Sports Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Institute of Sports Science, University of Rostock, Rostock, Germany
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen University Town, Shenzhen, China
Department of Neurology, Poitiers University Hospital, Poitiers, France
Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
Department of Neurology and Neurorehabilitation, Lucerne Kantonsspital, Spitalstrasse, Lucerne, Switzerland
University of Southampton
School of Bioengineering, McGill University, Montreal, Quebec, Canada
Sport Injury Research Prevention Center, University of Calgary, Calgary, Alberta, Canada
Department of Neurology, University of Florida, Florida, USA
Department of Anaesthesia and Critical Care, Hospital Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France
School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK; Centre for Human Brain Health (CHBH), University of Birmingham, Edgbaston, Birmingham, UK.
Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2QX, UK.
Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
Department of Physiology and Pharmacology, University of Calgary, Alberta, Canada
Department of Radiology, Harvard Medical School, Boston, MA, USA

Research output: Contribution to journal › Review article › peer-review

16 Citations (Scopus)

13 Downloads (Pure)

Abstract

Neurovascular coupling (NVC) is the perturbation of cerebral blood flow (CBF) to meet varying metabolic demands induced by various levels of neural activity. NVC may be assessed by Transcranial Doppler ultrasonography (TCD), using task activation protocols, but with significant methodological heterogeneity between studies, hindering cross-study comparisons. Therefore, this review aimed to summarise and compare available methods for TCD-based healthy NVC assessments. Medline (Ovid), Scopus, Web of Science, EMBASE (Ovid) and CINAHL were searched using a predefined search strategy (PROSPERO: CRD42019153228), generating 6006 articles. Included studies contained TCD-based assessments of NVC in healthy adults. Study quality was assessed using a checklist, and findings were synthesised narratively. 76 studies (2697 participants) met the review criteria. There was significant heterogeneity in the participant position used (e.g., seated vs supine), in TCD equipment, and vessel insonated (e.g. middle, posterior, and anterior cerebral arteries). Larger, more significant, TCD-based NVC responses typically included a seated position, baseline durations >one-minute, extraneous light control, and implementation of previously validated protocols. In addition, complementary, combined position, vessel insonated and stimulation type protocols were associated with more significant NVC results. Recommendations are detailed here, but further investigation is required in patient populations, for further optimisation of TCD-based NVC assessments.

Original language	English
Pages (from-to)	1409-1429
Number of pages	21
Journal	Journal of Cerebral Blood Flow and Metabolism
Volume	44
Issue number	12
Early online date	7 Aug 2024
DOIs	https://doi.org/10.1177/0271678x241270452
Publication status	Published - Dec 2024

Bibliographical note

Data Access Statement

This was a systematic review of existing research studies and no primary research was conducted

Funding

The author(s) disclosed receipt of the following financial sup- port for the research, authorship, and/or publication of this article: JB is an NIHR ARC-funded PhD student. JSM holds a Stroke Association Senior Clinical Lectureship (SA SCLM23\100003). LB is an Academic Clinical Lecturer funded by the NIHR. This research is funded by the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, Stroke Association, NHS or the UK Department of Health and Social Care.

Funders
National Institute for Health Research Southampton Biomedical Research Centre
NIHR Leicester Biomedical Research Centre
BRC

Keywords

healthy
narrative summary
neurovascular coupling
systematic review
transcranial doppler ultrasonography

Access to Document

10.1177/0271678x241270452Licence: CC BY 4.0

Neurovascular coupling methods in healthy individuals using transcranial doppler ultrasonography: A systematic review and consensus agreement
Copyright © 2024 The Author(s). This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
Final published version, 1.63 MBLicence: CC BY 4.0

Cite this

Ball, J. D., Hills, E., Altaf, A., Ramesh, P., Green, M., Surti, F. B. S., Minhas, J. S., Robinson, T. G., Bond, B., Lester, A., Hoiland, R., Klein, T., Liu, J., Nasr, N., Junejo, R. T., Müller, M., Lecchini-Visintini, A., Mitsis, G., Burma, J. S., ... Beishon, L. C. (2024). Neurovascular coupling methods in healthy individuals using transcranial doppler ultrasonography: A systematic review and consensus agreement. Journal of Cerebral Blood Flow and Metabolism, 44(12), 1409-1429. https://doi.org/10.1177/0271678x241270452

@article{c65c0236cac447deabf11961be680549,

title = "Neurovascular coupling methods in healthy individuals using transcranial doppler ultrasonography: A systematic review and consensus agreement",

abstract = "Neurovascular coupling (NVC) is the perturbation of cerebral blood flow (CBF) to meet varying metabolic demands induced by various levels of neural activity. NVC may be assessed by Transcranial Doppler ultrasonography (TCD), using task activation protocols, but with significant methodological heterogeneity between studies, hindering cross-study comparisons. Therefore, this review aimed to summarise and compare available methods for TCD-based healthy NVC assessments. Medline (Ovid), Scopus, Web of Science, EMBASE (Ovid) and CINAHL were searched using a predefined search strategy (PROSPERO: CRD42019153228), generating 6006 articles. Included studies contained TCD-based assessments of NVC in healthy adults. Study quality was assessed using a checklist, and findings were synthesised narratively. 76 studies (2697 participants) met the review criteria. There was significant heterogeneity in the participant position used (e.g., seated vs supine), in TCD equipment, and vessel insonated (e.g. middle, posterior, and anterior cerebral arteries). Larger, more significant, TCD-based NVC responses typically included a seated position, baseline durations >one-minute, extraneous light control, and implementation of previously validated protocols. In addition, complementary, combined position, vessel insonated and stimulation type protocols were associated with more significant NVC results. Recommendations are detailed here, but further investigation is required in patient populations, for further optimisation of TCD-based NVC assessments.",

keywords = "healthy, narrative summary, neurovascular coupling, systematic review, transcranial doppler ultrasonography",

author = "Ball, \{James D.\} and Eleanor Hills and Afzaa Altaf and Pranav Ramesh and Matthew Green and Surti, \{Farhaana B.S.\} and Minhas, \{Jatinder S.\} and Robinson, \{Thompson G.\} and Bert Bond and Alice Lester and Ryan Hoiland and Timo Klein and Jia Liu and Nathalie Nasr and Junejo, \{Rehan T.\} and Martin M{\"u}ller and Andrea Lecchini-Visintini and Georgios Mitsis and Burma, \{Joel S.\} and Smirl, \{Jonathan D.\} and Pizzi, \{Michael A.\} and Elsa Manquat and Lucas, \{Samuel J. E.\} and Mullinger, \{Karen J.\} and Steve Mayhew and Bailey, \{Damian M.\} and Gabriel Rodrigues and Soares, \{Pedro Paulo\} and Phillips, \{Aaron A.\} and Prokopiou, \{Prokopis C.\} and Beishon, \{Lucy C.\}",

note = "Copyright {\textcopyright} 2024 The Author(s). This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).",

year = "2024",

month = dec,

doi = "10.1177/0271678x241270452",

language = "English",

volume = "44",

pages = "1409--1429",

journal = "Journal of Cerebral Blood Flow and Metabolism",

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Ball, JD, Hills, E, Altaf, A, Ramesh, P, Green, M, Surti, FBS, Minhas, JS, Robinson, TG, Bond, B, Lester, A, Hoiland, R, Klein, T, Liu, J, Nasr, N, Junejo, RT, Müller, M, Lecchini-Visintini, A, Mitsis, G, Burma, JS, Smirl, JD, Pizzi, MA, Manquat, E, Lucas, SJE, Mullinger, KJ, Mayhew, S, Bailey, DM, Rodrigues, G, Soares, PP, Phillips, AA, Prokopiou, PC & Beishon, LC 2024, 'Neurovascular coupling methods in healthy individuals using transcranial doppler ultrasonography: A systematic review and consensus agreement', Journal of Cerebral Blood Flow and Metabolism, vol. 44, no. 12, pp. 1409-1429. https://doi.org/10.1177/0271678x241270452

TY - JOUR

T1 - Neurovascular coupling methods in healthy individuals using transcranial doppler ultrasonography: A systematic review and consensus agreement

AU - Ball, James D.

AU - Hills, Eleanor

AU - Altaf, Afzaa

AU - Ramesh, Pranav

AU - Green, Matthew

AU - Surti, Farhaana B.S.

AU - Minhas, Jatinder S.

AU - Robinson, Thompson G.

AU - Bond, Bert

AU - Lester, Alice

AU - Hoiland, Ryan

AU - Klein, Timo

AU - Liu, Jia

AU - Nasr, Nathalie

AU - Junejo, Rehan T.

AU - Müller, Martin

AU - Lecchini-Visintini, Andrea

AU - Mitsis, Georgios

AU - Burma, Joel S.

AU - Smirl, Jonathan D.

AU - Pizzi, Michael A.

AU - Manquat, Elsa

AU - Lucas, Samuel J. E.

AU - Mullinger, Karen J.

AU - Mayhew, Steve

AU - Bailey, Damian M.

AU - Rodrigues, Gabriel

AU - Soares, Pedro Paulo

AU - Phillips, Aaron A.

AU - Prokopiou, Prokopis C.

AU - Beishon, Lucy C.

PY - 2024/12

Y1 - 2024/12

N2 - Neurovascular coupling (NVC) is the perturbation of cerebral blood flow (CBF) to meet varying metabolic demands induced by various levels of neural activity. NVC may be assessed by Transcranial Doppler ultrasonography (TCD), using task activation protocols, but with significant methodological heterogeneity between studies, hindering cross-study comparisons. Therefore, this review aimed to summarise and compare available methods for TCD-based healthy NVC assessments. Medline (Ovid), Scopus, Web of Science, EMBASE (Ovid) and CINAHL were searched using a predefined search strategy (PROSPERO: CRD42019153228), generating 6006 articles. Included studies contained TCD-based assessments of NVC in healthy adults. Study quality was assessed using a checklist, and findings were synthesised narratively. 76 studies (2697 participants) met the review criteria. There was significant heterogeneity in the participant position used (e.g., seated vs supine), in TCD equipment, and vessel insonated (e.g. middle, posterior, and anterior cerebral arteries). Larger, more significant, TCD-based NVC responses typically included a seated position, baseline durations >one-minute, extraneous light control, and implementation of previously validated protocols. In addition, complementary, combined position, vessel insonated and stimulation type protocols were associated with more significant NVC results. Recommendations are detailed here, but further investigation is required in patient populations, for further optimisation of TCD-based NVC assessments.

AB - Neurovascular coupling (NVC) is the perturbation of cerebral blood flow (CBF) to meet varying metabolic demands induced by various levels of neural activity. NVC may be assessed by Transcranial Doppler ultrasonography (TCD), using task activation protocols, but with significant methodological heterogeneity between studies, hindering cross-study comparisons. Therefore, this review aimed to summarise and compare available methods for TCD-based healthy NVC assessments. Medline (Ovid), Scopus, Web of Science, EMBASE (Ovid) and CINAHL were searched using a predefined search strategy (PROSPERO: CRD42019153228), generating 6006 articles. Included studies contained TCD-based assessments of NVC in healthy adults. Study quality was assessed using a checklist, and findings were synthesised narratively. 76 studies (2697 participants) met the review criteria. There was significant heterogeneity in the participant position used (e.g., seated vs supine), in TCD equipment, and vessel insonated (e.g. middle, posterior, and anterior cerebral arteries). Larger, more significant, TCD-based NVC responses typically included a seated position, baseline durations >one-minute, extraneous light control, and implementation of previously validated protocols. In addition, complementary, combined position, vessel insonated and stimulation type protocols were associated with more significant NVC results. Recommendations are detailed here, but further investigation is required in patient populations, for further optimisation of TCD-based NVC assessments.

KW - healthy

KW - narrative summary

KW - neurovascular coupling

KW - systematic review

KW - transcranial doppler ultrasonography

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UR - https://www.scopus.com/pages/publications/85200656231

U2 - 10.1177/0271678x241270452

DO - 10.1177/0271678x241270452

M3 - Review article

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SN - 0271-678X

VL - 44

SP - 1409

EP - 1429

JO - Journal of Cerebral Blood Flow and Metabolism

JF - Journal of Cerebral Blood Flow and Metabolism

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ER -