A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic
Abstract Normal pressure hydrocephalus (NPH) is associated with a reduction in cerebral blood flow and an ischemic metabolic state. Ischemia should exhaust the available autoregulation in an attempt to correct the metabolic imbalance. There is evidence of some retained autoregulation reserve in NPH....
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-10-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-75214-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850275699690045440 |
|---|---|
| author | Grant Alexander Bateman Alexander Robert Bateman |
| author_facet | Grant Alexander Bateman Alexander Robert Bateman |
| author_sort | Grant Alexander Bateman |
| collection | DOAJ |
| description | Abstract Normal pressure hydrocephalus (NPH) is associated with a reduction in cerebral blood flow and an ischemic metabolic state. Ischemia should exhaust the available autoregulation in an attempt to correct the metabolic imbalance. There is evidence of some retained autoregulation reserve in NPH. The aim of this study is to model the cerebral autoregulation in NPH to discover a solution to this apparent paradox. A lumped parameter model was developed utilizing the known limits of autoregulation in man. The model was tested by predicting the cerebral blood volume changes which would be brought about by changes in resistance. NPH and the post shunt state were then modeled using the known constraints provided from the literature. The model successfully predicted the cerebral blood volume changes brought about by altering the cerebral perfusion pressure to the limit of autoregulation. The model suggests that NPH is associated with a balanced increase in resistance within the arterial and venous outflow segments. The arterial resistance decreased after modelling shunt insertion. The model suggests that the cerebral blood flow is actively limited in NPH by arteriolar constriction. This may occur to minimize the rise in ICP by reducing the apparent CSF formation rate. |
| format | Article |
| id | doaj-art-c5154bb2259147de9ce2f649dd1bf320 |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-c5154bb2259147de9ce2f649dd1bf3202025-08-20T01:50:38ZengNature PortfolioScientific Reports2045-23222024-10-0114111110.1038/s41598-024-75214-6A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemicGrant Alexander Bateman0Alexander Robert Bateman1Department of Medical Imaging, John Hunter HospitalSchool of Mechanical Engineering, University of New South WalesAbstract Normal pressure hydrocephalus (NPH) is associated with a reduction in cerebral blood flow and an ischemic metabolic state. Ischemia should exhaust the available autoregulation in an attempt to correct the metabolic imbalance. There is evidence of some retained autoregulation reserve in NPH. The aim of this study is to model the cerebral autoregulation in NPH to discover a solution to this apparent paradox. A lumped parameter model was developed utilizing the known limits of autoregulation in man. The model was tested by predicting the cerebral blood volume changes which would be brought about by changes in resistance. NPH and the post shunt state were then modeled using the known constraints provided from the literature. The model successfully predicted the cerebral blood volume changes brought about by altering the cerebral perfusion pressure to the limit of autoregulation. The model suggests that NPH is associated with a balanced increase in resistance within the arterial and venous outflow segments. The arterial resistance decreased after modelling shunt insertion. The model suggests that the cerebral blood flow is actively limited in NPH by arteriolar constriction. This may occur to minimize the rise in ICP by reducing the apparent CSF formation rate.https://doi.org/10.1038/s41598-024-75214-6AutoregulationCerebral blood flowNormal pressure hydrocephalusIschemiaCSF formation rate |
| spellingShingle | Grant Alexander Bateman Alexander Robert Bateman A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic Scientific Reports Autoregulation Cerebral blood flow Normal pressure hydrocephalus Ischemia CSF formation rate |
| title | A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic |
| title_full | A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic |
| title_fullStr | A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic |
| title_full_unstemmed | A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic |
| title_short | A lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic |
| title_sort | lumped parameter modelling study of cerebral autoregulation in normal pressure hydrocephalus suggests the brain chooses to be ischemic |
| topic | Autoregulation Cerebral blood flow Normal pressure hydrocephalus Ischemia CSF formation rate |
| url | https://doi.org/10.1038/s41598-024-75214-6 |
| work_keys_str_mv | AT grantalexanderbateman alumpedparametermodellingstudyofcerebralautoregulationinnormalpressurehydrocephalussuggeststhebrainchoosestobeischemic AT alexanderrobertbateman alumpedparametermodellingstudyofcerebralautoregulationinnormalpressurehydrocephalussuggeststhebrainchoosestobeischemic AT grantalexanderbateman lumpedparametermodellingstudyofcerebralautoregulationinnormalpressurehydrocephalussuggeststhebrainchoosestobeischemic AT alexanderrobertbateman lumpedparametermodellingstudyofcerebralautoregulationinnormalpressurehydrocephalussuggeststhebrainchoosestobeischemic |