Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?

Jan Willem Elting; Marit L. Sanders; Ronney B. Panerai; Marcel Aries; Edson Bor-Seng-Shu; Alexander Caicedo; Max Chacon; Erik D. Gommer; Sabine Van Huffel; José L. Jara; Kyriaki Kostoglou; Adam Mahdi; Vasilis Z. Marmarelis; Georgios D. Mitsis; Martin Müller; Dragana Nikolic; Ricardo C. Nogueira; Stephen J. Payne; Corina Puppo; Dae C. Shin; David M. Simpson; Takashi Tarumi; Bernardo Yelicich; Rong Zhang; Jurgen A.H.R. Claassen

doi:10.1371/journal.pone.0227651

Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?

Jan Willem Elting, Marit L. Sanders, Ronney B. Panerai, Marcel Aries, Edson Bor-Seng-Shu, Alexander Caicedo, Max Chacon, Erik D. Gommer, Sabine Van Huffel, José L. Jara, Kyriaki Kostoglou, Adam Mahdi, Vasilis Z. Marmarelis, Georgios D. Mitsis, Martin Müller, Dragana Nikolic, Ricardo C. Nogueira, Stephen J. Payne, Corina Puppo, Dae C. ShinDavid M. Simpson, Takashi Tarumi, Bernardo Yelicich, Rong Zhang, Jurgen A.H.R. Claassen

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Abstract

We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured twice in 75 healthy subjects. DCA was analyzed by 14 different centers with a variety of different analysis methods. Intraclass Correlation (ICC) values increased significantly when subjects with low power spectral density MABP (PSD-MABP) values were removed from the analysis for all gain, phase and autoregulation index (ARI) parameters. Gain in the low frequency band (LF) had the highest ICC, followed by phase LF and gain in the very low frequency band. No significant differences were found between analysis methods for gain parameters, but for phase and ARI parameters, significant differences between the analysis methods were found. Alternatively, the Spearman-Brown prediction formula indicated that prolongation of the measurement duration up to 35 minutes may be needed to achieve good reproducibility for some DCA parameters. We conclude that poor DCA reproducibility (ICC<0.4) can improve to good (ICC > 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased.

Original language	English (US)
Article number	e0227651
Pages (from-to)	e0227651
Journal	PLOS ONE
Volume	15
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0227651
State	Published - Jan 1 2020

All Science Journal Classification (ASJC) codes

General Biochemistry, Genetics and Molecular Biology
General Agricultural and Biological Sciences
General

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Elting, J. W., Sanders, M. L., Panerai, R. B., Aries, M., Bor-Seng-Shu, E., Caicedo, A., Chacon, M., Gommer, E. D., Van Huffel, S., Jara, J. L., Kostoglou, K., Mahdi, A., Marmarelis, V. Z., Mitsis, G. D., Müller, M., Nikolic, D., Nogueira, R. C., Payne, S. J., Puppo, C., ... Claassen, J. A. H. R. (2020). Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability? PLOS ONE, 15(1), e0227651. Article e0227651. https://doi.org/10.1371/journal.pone.0227651

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title = "Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?",

abstract = "We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured twice in 75 healthy subjects. DCA was analyzed by 14 different centers with a variety of different analysis methods. Intraclass Correlation (ICC) values increased significantly when subjects with low power spectral density MABP (PSD-MABP) values were removed from the analysis for all gain, phase and autoregulation index (ARI) parameters. Gain in the low frequency band (LF) had the highest ICC, followed by phase LF and gain in the very low frequency band. No significant differences were found between analysis methods for gain parameters, but for phase and ARI parameters, significant differences between the analysis methods were found. Alternatively, the Spearman-Brown prediction formula indicated that prolongation of the measurement duration up to 35 minutes may be needed to achieve good reproducibility for some DCA parameters. We conclude that poor DCA reproducibility (ICC<0.4) can improve to good (ICC > 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased.",

author = "Elting, {Jan Willem} and Sanders, {Marit L.} and Panerai, {Ronney B.} and Marcel Aries and Edson Bor-Seng-Shu and Alexander Caicedo and Max Chacon and Gommer, {Erik D.} and {Van Huffel}, Sabine and Jara, {Jos{\'e} L.} and Kyriaki Kostoglou and Adam Mahdi and Marmarelis, {Vasilis Z.} and Mitsis, {Georgios D.} and Martin M{\"u}ller and Dragana Nikolic and Nogueira, {Ricardo C.} and Payne, {Stephen J.} and Corina Puppo and Shin, {Dae C.} and Simpson, {David M.} and Takashi Tarumi and Bernardo Yelicich and Rong Zhang and Claassen, {Jurgen A.H.R.}",

note = "Publisher Copyright: {\textcopyright} 2020 Elting et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

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Elting, JW, Sanders, ML, Panerai, RB, Aries, M, Bor-Seng-Shu, E, Caicedo, A, Chacon, M, Gommer, ED, Van Huffel, S, Jara, JL, Kostoglou, K, Mahdi, A, Marmarelis, VZ, Mitsis, GD, Müller, M, Nikolic, D, Nogueira, RC, Payne, SJ, Puppo, C, Shin, DC, Simpson, DM, Tarumi, T, Yelicich, B, Zhang, R & Claassen, JAHR 2020, 'Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?', PLOS ONE, vol. 15, no. 1, e0227651, pp. e0227651. https://doi.org/10.1371/journal.pone.0227651

TY - JOUR

T1 - Assessment of dynamic cerebral autoregulation in humans

T2 - Is reproducibility dependent on blood pressure variability?

AU - Elting, Jan Willem

AU - Sanders, Marit L.

AU - Panerai, Ronney B.

AU - Aries, Marcel

AU - Bor-Seng-Shu, Edson

AU - Caicedo, Alexander

AU - Chacon, Max

AU - Gommer, Erik D.

AU - Van Huffel, Sabine

AU - Jara, José L.

AU - Kostoglou, Kyriaki

AU - Mahdi, Adam

AU - Marmarelis, Vasilis Z.

AU - Mitsis, Georgios D.

AU - Müller, Martin

AU - Nikolic, Dragana

AU - Nogueira, Ricardo C.

AU - Payne, Stephen J.

AU - Puppo, Corina

AU - Shin, Dae C.

AU - Simpson, David M.

AU - Tarumi, Takashi

AU - Yelicich, Bernardo

AU - Zhang, Rong

AU - Claassen, Jurgen A.H.R.

N1 - Publisher Copyright: © 2020 Elting et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured twice in 75 healthy subjects. DCA was analyzed by 14 different centers with a variety of different analysis methods. Intraclass Correlation (ICC) values increased significantly when subjects with low power spectral density MABP (PSD-MABP) values were removed from the analysis for all gain, phase and autoregulation index (ARI) parameters. Gain in the low frequency band (LF) had the highest ICC, followed by phase LF and gain in the very low frequency band. No significant differences were found between analysis methods for gain parameters, but for phase and ARI parameters, significant differences between the analysis methods were found. Alternatively, the Spearman-Brown prediction formula indicated that prolongation of the measurement duration up to 35 minutes may be needed to achieve good reproducibility for some DCA parameters. We conclude that poor DCA reproducibility (ICC<0.4) can improve to good (ICC > 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased.

AB - We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured twice in 75 healthy subjects. DCA was analyzed by 14 different centers with a variety of different analysis methods. Intraclass Correlation (ICC) values increased significantly when subjects with low power spectral density MABP (PSD-MABP) values were removed from the analysis for all gain, phase and autoregulation index (ARI) parameters. Gain in the low frequency band (LF) had the highest ICC, followed by phase LF and gain in the very low frequency band. No significant differences were found between analysis methods for gain parameters, but for phase and ARI parameters, significant differences between the analysis methods were found. Alternatively, the Spearman-Brown prediction formula indicated that prolongation of the measurement duration up to 35 minutes may be needed to achieve good reproducibility for some DCA parameters. We conclude that poor DCA reproducibility (ICC<0.4) can improve to good (ICC > 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased.

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Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?

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