General Discussion corresponding signal to the central nervous system. This results in a reaction of the autonomic nervous system: one of the responses is decreasing respectively increasing heart rate to restore blood pressure. Ogoh et al 19 showed baroreceptor reflex plays an important role in dCA when ABP is rapidly decreased. They showed attenuated dCA after full cardiac autonomic (sympathetic-cholinergic) blockade using the leg cuff method. The exact relationship between baroreceptor reflex and dCA needs to be further investigated. Another regulatory mechanism that is underexposed but is important for cerebral metabolism is brain temperature regulation 29. This could be very interesting to study, especially since there is increased attention in brain cooling after stroke and very little is known about the consequences of brain cooling e.g. for cerebral autoregulation. Conclusions The work in this thesis was aimed at investigating methodology of dCA evaluation in order to improve clinical applicability. From this work the following conclusions can be drawn: » Reproducibility of dCA evaluation based on either spontaneous blood pressure variations or paced breathing is too low for a reliable clinical test. » Cerebrovascular reactivity index is higher in Alzheimer’s disease compared to healthy elderly, whereas dCA parameters do not differ. » Quantification of NVC is more reliable when incorporating a dCA model for correction of blood pressure related blood flow velocity variations. » Generating blood pressure variations by cyclic changes of pump speed in a machine for extra corporeal circulation facilitate studying dCA during cardiac bypass surgery. 131
proefschrift gommer inhoud met kaft.indd
To see the actual publication please follow the link above