目的:脑血管自动调节定义为脑血管在血压变化的情况下维持稳定脑血流量的能力。使用压力反应性指数(平均动脉血压和颅内压之间的相关系数)进行评估。本范围审查的目的是描述有关脑电图和脑血管自动调节关联的现有证据,以确定关键概念并发现当前知识中的差距。
方法:Embase,MEDLINE,Scopus,和WebofScience进行了搜索,考虑了它们从成立到2023年9月之间的文章。纳入标准是人类(儿科和成人)和动物研究,描述了连续EEG和脑血管自动调节评估之间的相关性。
结果:十项研究描述了481名人类受试者(67%的成年人,59%的重症患者)被确定。七项研究评估了定性(例如癫痫发作,癫痫样电位)和五个定量评估(例如脑电双频指数,α-δ比)脑电图指标。根据颅内压评估脑血管自动调节,经颅多普勒,或近红外光谱。通过最多两项研究评估了脑血管自动调节和脑电图指标的特定组合。癫痫发作,高度恶性模式或爆发抑制,alpha峰值频率,脑电双频指数与脑血管自动调节有关。其他指标显示没有或不一致的关联。
结论:评估脑电图和脑血管自动调节之间联系的研究很少。确定的研究包括各种脑电图和脑血管自动调节采集方法,年龄组,和疾病,几乎没有什么总体结论。然而,脑电图指标与脑血管自动调节之间存在关联的初步证据促使进一步深入研究.
OBJECTIVE: Cerebrovascular autoregulation is defined as the capacity of cerebral blood vessels to maintain stable cerebral blood flow despite changing blood pressure. It is assessed using the pressure reactivity index (the correlation coefficient between mean arterial blood pressure and intracranial pressure). The objective of this scoping
review is to describe the existing evidence concerning the association of EEG and cerebrovascular autoregulation in order to identify key concepts and detect gaps in the current knowledge.
METHODS: Embase, MEDLINE, SCOPUS, and Web of Science were searched considering articles between their inception up to September 2023. Inclusion criteria were human (paediatric and adult) and animal studies describing correlations between continuous EEG and cerebrovascular autoregulation assessments.
RESULTS: Ten studies describing 481 human subjects (67% adult, 59% critically ill) were identified. Seven studies assessed qualitative (e.g. seizures, epileptiform potentials) and five evaluated quantitative (e.g. bispectral index, alpha-delta ratio) EEG metrics. Cerebrovascular autoregulation was evaluated based on intracranial pressure, transcranial Doppler, or near infrared spectroscopy. Specific combinations of cerebrovascular autoregulation and EEG metrics were evaluated by a maximum of two studies. Seizures, highly malignant patterns or burst suppression, alpha peak frequency, and bispectral index were associated with cerebrovascular autoregulation. The other metrics showed either no or inconsistent associations.
CONCLUSIONS: There is a paucity of studies evaluating the link between EEG and cerebrovascular autoregulation. The studies identified included a variety of EEG and cerebrovascular autoregulation acquisition methods, age groups, and diseases allowing for few overarching conclusions. However, the preliminary evidence for the presence of an association between EEG metrics and cerebrovascular autoregulation prompts further in-depth investigations.