What recording duration is required to provide physiologically valid and reliable dynamic cerebral autoregulation transfer functional analysis estimates?

Joel S Burma; Lauren N Miutz; Kailey T Newel; Lawrence Labrecque; Audrey Drapeau; Patrice Brassard; Paige Copeland; Alannah Macaulay; Jonathan D Smirl

doi:10.1088/1361-6579/abf1af

What recording duration is required to provide physiologically valid and reliable dynamic cerebral autoregulation transfer functional analysis estimates?

Physiol Meas. 2021 May 11;42(4). doi: 10.1088/1361-6579/abf1af.

Authors

Joel S Burma^{1

2

3

4

5

6

7

8}, Lauren N Miutz^{1

2

3

4

5

6

7}, Kailey T Newel⁹, Lawrence Labrecque^{10

11}, Audrey Drapeau^{10

11}, Patrice Brassard^{10

11}, Paige Copeland⁸, Alannah Macaulay⁸, Jonathan D Smirl^{1

2

3

4

5

6

7

8}

Affiliations

¹ Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
² Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
³ Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
⁴ Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
⁵ Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada.
⁶ Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
⁷ Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.
⁸ Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada.
⁹ Faculty of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada.
¹⁰ Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.
¹¹ Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada.

PMID: 33761474
DOI: 10.1088/1361-6579/abf1af

Abstract

Objective. Currently, a recording of 300 s is recommended to obtain accurate dynamic cerebral autoregulation estimates using transfer function analysis (TFA). Therefore, this investigation sought to explore the concurrent validity and the within- and between-day reliability of TFA estimates derived from shorter recording durations from squat-stand maneuvers.Approach. Retrospective analyses were performed on 70 young, recreationally active or endurance-trained participants (17 females; age: 26 ± 5 years, [range: 20-39 years]; body mass index: 24 ± 3 kg m^-2). Participants performed 300 s of squat-stands at frequencies of 0.05 and 0.10 Hz, where shorter recordings of 60, 120, 180, and 240 s were extracted. Continuous transcranial Doppler ultrasound recordings were taken within the middle and posterior cerebral arteries. Coherence, phase, gain, and normalized gain metrics were derived. Bland-Altman plots with 95% limits of agreement (LOA), repeated measures ANOVA's, two-tailed paired t-tests, coefficient of variation, Cronbach's alpha, intraclass correlation coefficients, and linear regressions were conducted.Main results. When examining the concurrent validity across different recording durations, group differences were noted within coherence (F₍₄₁₅₅₎ > 11.6,p < 0.001) but not phase (F₍₄₁₅₅₎ < 0.27,p > 0.611), gain (F₍₄₁₅₅₎ < 0.61,p > 0.440), or normalized gain (F₍₄₁₅₅₎ < 0.85,p > 0.359) parameters. The Bland-Altman 95% LOA measuring the concurrent validity, trended to narrow as recording duration increased (60 s: < ±0.4, 120 s: < ±0.3, 180 s < ±0.3, 240 s: < ±0.1). The validity of the 180 and 240 s recordings further increased when physiological covariates were included within regression models.Significance. Future studies examining autoregulation should seek to have participants perform 300 s of squat-stand maneuvers. However, valid and reliable TFA estimates can be drawn from 240 s or 180 s recordings if physiological covariates are controlled.

Keywords: cerebral blood flow; dynamic cerebral autoregulation; reliability; transcranial Doppler ultrasound; transfer function analysis; validity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Blood Flow Velocity
Blood Pressure
Cerebrovascular Circulation*
Female
Homeostasis
Humans
Reproducibility of Results
Retrospective Studies
Ultrasonography, Doppler, Transcranial*
Young Adult

Grants and funding

CIHR/Canada