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J Appl Physiol 91: 2493-2502, 2001;
8750-7587/01 $5.00
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Vol. 91, Issue 6, 2493-2502, December 2001

Dynamic cerebral autoregulation is preserved in neurally mediated syncope

Ronald Schondorf1, Reuben Stein1, Richard Roberts1, Julie Benoit1, and William Cupples2

1 Autonomic Reflex Laboratory, Department of Neurology, McGill University, and 2 Division of Nephrology, Lady Davis Institute, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada H3T 1E2

To test whether cerebral autoregulation is impaired in patients with neurally mediated syncope (NMS), we evaluated 15 normal subjects and 37 patients with recurrent NMS. Blood pressure (BP), heart rate, and cerebral blood velocity (CBV) (transcranial Doppler) were recorded at rest and during 80° head-up tilt (HUT). Static cerebral autoregulation as assessed from the change in cerebrovascular resistance during HUT was the same in NMS and controls. Properties of dynamic cerebral autoregulation were inferred from transfer gain, coherence, and phase of the relationship between BP and CBV estimated from filtered data segments (0.02-0.8 Hz). During the 3 min preceding syncope, dynamic cerebral autoregulation of subjects with NMS did not differ from that of controls nor did it change over the course of HUT in patients with NMS or in control subjects. Dynamic cerebral autoregulation was also unaffected by the degree of orthostatic intolerance as inferred from latency to onset of syncope. We conclude that cerebral autoregulation in patients with recurrent syncope does not differ from that of normal control subjects.

cerebrovascular circulation; Fourier analysis; hemodynamics


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