TY - JOUR
T1 - Dynamic cerebral autoregulation reproducibility is affected by physiological variability
AU - Sanders, Marit L.
AU - Elting, Jan Willem J.
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:
Copyright © 2019 Sanders, Elting, Panerai, Aries, Bor-Seng-Shu, Caicedo, Chacon, Gommer, Van Huffel, Jara, Kostoglou, Mahdi, Marmarelis, Mitsis, Müller, Nikolic, Nogueira, Payne, Puppo, Shin, Simpson, Tarumi, Yelicich, Zhang and Claassen.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019
Y1 - 2019
N2 - Parameters describing dynamic cerebral autoregulation (DCA) have limited reproducibility. In an international, multi-center study, we evaluated the influence of multiple analytical methods on the reproducibility of DCA. Fourteen participating centers analyzed repeated measurements from 75 healthy subjects, consisting of 5 min of spontaneous fluctuations in blood pressure and cerebral blood flow velocity signals, based on their usual methods of analysis. DCA methods were grouped into three broad categories, depending on output types: (1) transfer function analysis (TFA); (2) autoregulation index (ARI); and (3) correlation coefficient. Only TFA gain in the low frequency (LF) band showed good reproducibility in approximately half of the estimates of gain, defined as an intraclass correlation coefficient (ICC) of > 0.6. None of the other DCA metrics had good reproducibility. For TFA-like and ARI-like methods, ICCs were lower than values obtained with surrogate data (p < 0.05). For TFA-like methods, ICCs were lower for the very LF band (gain 0.38 ± 0.057, phase 0.17 ± 0.13) than for LF band (gain 0.59 ± 0.078, phase 0.39 ± 0.11, p ≤ 0.001 for both gain and phase). For ARI-like methods, the mean ICC was 0.30 ± 0.12 and for the correlation methods 0.24 ± 0.23. Based on comparisons with ICC estimates obtained from surrogate data, we conclude that physiological variability or non-stationarity is likely to be the main reason for the poor reproducibility of DCA parameters.
AB - Parameters describing dynamic cerebral autoregulation (DCA) have limited reproducibility. In an international, multi-center study, we evaluated the influence of multiple analytical methods on the reproducibility of DCA. Fourteen participating centers analyzed repeated measurements from 75 healthy subjects, consisting of 5 min of spontaneous fluctuations in blood pressure and cerebral blood flow velocity signals, based on their usual methods of analysis. DCA methods were grouped into three broad categories, depending on output types: (1) transfer function analysis (TFA); (2) autoregulation index (ARI); and (3) correlation coefficient. Only TFA gain in the low frequency (LF) band showed good reproducibility in approximately half of the estimates of gain, defined as an intraclass correlation coefficient (ICC) of > 0.6. None of the other DCA metrics had good reproducibility. For TFA-like and ARI-like methods, ICCs were lower than values obtained with surrogate data (p < 0.05). For TFA-like methods, ICCs were lower for the very LF band (gain 0.38 ± 0.057, phase 0.17 ± 0.13) than for LF band (gain 0.59 ± 0.078, phase 0.39 ± 0.11, p ≤ 0.001 for both gain and phase). For ARI-like methods, the mean ICC was 0.30 ± 0.12 and for the correlation methods 0.24 ± 0.23. Based on comparisons with ICC estimates obtained from surrogate data, we conclude that physiological variability or non-stationarity is likely to be the main reason for the poor reproducibility of DCA parameters.
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U2 - 10.3389/fphys.2019.00865
DO - 10.3389/fphys.2019.00865
M3 - Research Article
C2 - 31354518
AN - SCOPUS:85069901274
SN - 1664-042X
VL - 10
JO - Frontiers in Physiology
JF - Frontiers in Physiology
IS - JUL
M1 - 865
ER -