Introduction sis for quantifying dynamic cerebral autoregulation. The influence of different signal analysis aspects will be studied as well as the influence of spontaneous versus evoked blood pressure variations. Secondly our aim is to evaluate clinical application of the developed dCA analy- sis. Dynamic cerebral autoregulation is studied in several patient groups and the diagnostic respectively prognostic value of these test will be studied. Outline of this thesis Both methodological aspects and clinical applications of dynamic cerebral auto- regulation are addressed in the subsequent chapters of this thesis. Chapter 2 addresses the reproducibility of assessment of dynamic cerebral auto- regulation by means of transfer function analysis. The influence of various aspects of signal analysis will be studied. Chapter 3 evaluates the use of transfer function analysis and cerebrovascular reactivity by means of acetazolamide infusion. A patient group with small vessel disease will be studied in which dCA is evaluated before, during and after the infusion of acetazolamide. This allows to study measures of dCA in combination with cerebrovascular reactivity. In chapter 4 the effect of a neurodegenerative disease on dCA will be studied. Results from three groups will be compared: patients with Alzheimer’s disease, subjects with mild cognitive impairment and healthy elderly. Chapter 5 describes an improved method to quantify neurovascular coupling (NVC) responses by incorporation the process of dCA in a model for NVC responses upon visual stimulation. Blood pressure related CBFV changes are explained by the dCA part of the model whereas visual stimulus related CBFV changes are explained by the NVC part. In chapter 6 a method is described for evaluating dCA during cardiopulmonary bypass where blood pressure variabilityis not influenced through control of heart rate. It is tested whether externally evoked variability of blood pressure through changing pump flow is adequate in creating sufficient CBFV variability to enable the study of dCA. 15
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