Abstract
Stroke is a pathophysiological condition which results in alterations in cerebral
blood flow (CBF). The mechanism by which the brain maintains adequate CBF in presence
of fluctuating cerebral perfusion pressure (CPP) is known as cerebral autoregulation
(CA). Disturbances in CA may be influenced by a number of physiological pathways including
the autonomic nervous system (ANS). The cerebrovascular system is innervated by adrenergic
and cholinergic nerve fibers. The role of the ANS in regulating CBF is widely disputed
owing to several factors including the complexity of the ANS and cerebrovascular interactions,
limitations to measurements, variation in methods to assess the ANS in relation to
CBF as well as experimental approaches that can or cannot provide insight into the
sympathetic control of CBF. CA is known to be impaired in stroke however the number
of studies investigating the mechanisms by which this occurs are limited. This literature
review will focus on highlighting the assessment of the ANS and CBF via indices derived
from the analyses of heart rate variability (HRV), and baroreflex sensitivity (BRS),
and providing a summary of both clinical and animal model studies investigating the
role of the ANS in influencing CA in stroke. Understanding the mechanisms by which
the ANS influences CBF in stroke patients may provide the foundation for novel therapeutic
approaches to improve functional outcomes in stroke patients.
Keywords
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Article info
Publication history
Published online: February 27, 2023
Accepted:
February 22,
2023
Received in revised form:
November 22,
2022
Received:
December 24,
2021
Identification
Copyright
© 2023 Published by Elsevier B.V.
