Cerebral hemodynamic changes induced by sympathetic stimulation tests

Sympathetic neuronal activity is primarily responsible for the neurogenic control of cerebral autoregulation. The stimulation of sympathetic nerves causes both large arterial constriction and small vessel dilation in experimental animals. However, the role of the sympathetic nervous system in the control of cerebral hemodynamics has yet to be clarified in humans. In order to assess the effect of sympathetic activation on human cerebral hemodynamics, we performed a simultaneous transcranial Doppler (TCD) monitoring of bilateral middle cerebral arterial flow velocity in 16 healthy male volunteers (mean age 26) during well-known sympathetic activation measures such as isometric hand-grip exercise (IHE) and cold pressor test (CPT). Blood pressure was checked manually before and at each minute during tests. The mean arterial pressure (MAP) was calculated as (systolic pressure + 2 X diastolic pressure)/3. There was a significant increase in MCA flow velocities during both sympathetic activation tests. The percent increase of diastolic velocity (36% with IHE and 24% with CPT) was significantly higher than systolic velocity (21% with IHE and 9% with CPT). The pulsatility index was significantly decreased during the tests (from 0.75 to 0.58 with IHE and from 0.81 to 0.63 with CPT). These results suggest that sympathetic activation increases MCA flow velocities, related with a reduction in small vessel resistance and/or a constriction of large arteries.