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      Dynamic cerebral autoregulation across the cardiac cycle during 8 hr of recovery from acute exercise

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          Abstract

          Current protocols examining cerebral autoregulation (CA) parameters require participants to refrain from exercise for 12–24 hr, however there is sparse objective evidence examining the recovery trajectory of these measures following exercise across the cardiac cycle (diastole, mean, and systole). Therefore, this study sought to determine the duration acute exercise impacts CA and the within‐day reproducibility of these measures. Nine participants performed squat–stand maneuvers at 0.05 and 0.10 Hz at baseline before three interventions: 45‐min moderate‐continuous exercise (at 50% heart‐rate reserve), 30‐min high‐intensity intervals (ten, 1‐min at 85% heart‐rate reserve), and a control day (30‐min quiet rest). Squat–stands were repeated at hours zero, one, two, four, six, and eight after each condition. Transcranial doppler ultrasound of the middle cerebral artery (MCA) and the posterior cerebral artery (PCA) was used to characterize CA parameters across the cardiac cycle. At baseline, the systolic CA parameters were different than mean and diastolic components (ps < 0.015), however following both exercise protocols in both frequencies this disappeared until hour four within the MCA (ps > 0.079). In the PCA, phase values were affected only following high‐intensity intervals until hour four (ps > 0.055). Normalized gain in all cardiac cycle domains remained different following both exercise protocols (ps < 0.005) and across the control day ( p < .050). All systolic differences returned by hour six across all measures (ps < 0.034). Future CA studies may use squat–stand maneuvers to assess the cerebral pressure–flow relationship 6 hr after exercise. Finally, CA measures under this paradigm appear to have negligible within‐day variation, allowing for reproducible interpretations to be drawn.

          Abstract

          Nine participants performed squat‐stand maneuvers at 0.05 and 0.10 Hz at baseline before three interventions: 45‐min moderate‐continuous exercise (at 50% heart‐rate reserve), 30‐min high‐intensity intervals (ten, one minute at 85% heart‐rate reserve), and a control day (30‐min quiet rest). Squat‐stands were repeated at hours zero, one, two, four, six, and eight after each condition. exercise was shown to affect dynamic CA into recovery up to 4 hr following exercise, with HIIT demonstrating greater affects than MICT (each phase of the cardiac cycle responded differently to exercise, with the systolic component showing impairments for up to 4 hr, compared to diastolic and mean which recovered after 2 hr in all measures).

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          Integrative regulation of human brain blood flow.

          Herein, we review mechanisms regulating cerebral blood flow (CBF), with specific focus on humans. We revisit important concepts from the older literature and describe the interaction of various mechanisms of cerebrovascular control. We amalgamate this broad scope of information into a brief review, rather than detailing any one mechanism or area of research. The relationship between regulatory mechanisms is emphasized, but the following three broad categories of control are explicated: (1) the effect of blood gases and neuronal metabolism on CBF; (2) buffering of CBF with changes in blood pressure, termed cerebral autoregulation; and (3) the role of the autonomic nervous system in CBF regulation. With respect to these control mechanisms, we provide evidence against several canonized paradigms of CBF control. Specifically, we corroborate the following four key theses: (1) that cerebral autoregulation does not maintain constant perfusion through a mean arterial pressure range of 60-150 mmHg; (2) that there is important stimulatory synergism and regulatory interdependence of arterial blood gases and blood pressure on CBF regulation; (3) that cerebral autoregulation and cerebrovascular sensitivity to changes in arterial blood gases are not modulated solely at the pial arterioles; and (4) that neurogenic control of the cerebral vasculature is an important player in autoregulatory function and, crucially, acts to buffer surges in perfusion pressure. Finally, we summarize the state of our knowledge with respect to these areas, outline important gaps in the literature and suggest avenues for future research.
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            Cerebral autoregulation.

            Autoregulation of blood flow denotes the intrinsic ability of an organ or a vascular bed to maintain a constant perfusion in the face of blood pressure changes. Alternatively, autoregulation can be defined in terms of vascular resistance changes or simply arteriolar caliber changes as blood pressure or perfusion pressure varies. While known in almost any vascular bed, autoregulation and its disturbance by disease has attracted particular attention in the cerebrovascular field. The basic mechanism of autoregulation of cerebral blood flow (CBF) is controversial. Most likely, the autoregulatory vessel caliber changes are mediated by an interplay between myogenic and metabolic mechanisms. Influence of perivascular nerves and most recently the vascular endothelium has also been the subject of intense investigation. CBF autoregulation typically operates between mean blood pressures of the order of 60 and 150 mm Hg. These limits are not entirely fixed but can be modulated by sympathetic nervous activity, the vascular renin-angiotensin system, and any factor (notably changes in arterial carbon dioxide tension) that decreases or increases CBF. Disease states of the brain may impair or abolish CBF autoregulation. Thus, autoregulation is lost in severe head injury or acute ischemic stroke, leaving surviving brain tissue unprotected against the potentially harmful effect of blood pressure changes. Likewise, autoregulation may be lost in the surroundings of a space-occupying brain lesion, be it a tumor or a hematoma. In many such disease states, autoregulation may be regained by hyperventilatory hypocapnia. Autoregulation may also be impaired in neonatal brain asphyxia and infections of the central nervous system, but appears to be intact in spreading depression and migraine, despite impairment of chemical and metabolic control of CBF. In chronic hypertension, the limits of autoregulation are shifted toward high blood pressure. Acute hypertensive encephalopathy, on the other hand, is thought to be due to autoregulatory failure at very high pressure. In long-term diabetes mellitus there may be chronic impairment of CBF autoregulation, probably due to diabetic microangiopathy.
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              The effects of high-intensity interval training vs. moderate-intensity continuous training on body composition in overweight and obese adults: a systematic review and meta-analysis.

              The objective of this study is to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) for improvements in body composition in overweight and obese adults.
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                Author and article information

                Contributors
                jonathan.smirl@ucalgary.ca
                Journal
                Physiol Rep
                Physiol Rep
                10.1002/(ISSN)2051-817X
                PHY2
                physreports
                Physiological Reports
                John Wiley and Sons Inc. (Hoboken )
                2051-817X
                12 March 2020
                March 2020
                : 8
                : 5 ( doiID: 10.14814/phy2.v8.5 )
                : e14367
                Affiliations
                [ 1 ] Concussion Research Laboratory Faculty of Health and Exercise Science University of British Columbia Kelowna BC Canada
                [ 2 ] Sport Injury Prevention Research Center Faculty of Kinesiology University of Calgary Calgary AB Canada
                [ 3 ] Human Performance Laboratory Faculty of Kinesiology University of Calgary Calgary AB Canada
                [ 4 ] Hotchkiss Brain Institute University of Calgary Calgary AB Canada
                [ 5 ] Faculty of Medicine University of British Columbia Vancouver BC Canada
                [ 6 ] MD/PhD Program Faculty of Medicine University of British Columbia Vancouver BC Canada
                [ 7 ] Experimental Medicine Program Faculty of Medicine University of British Columbia Vancouver BC Canada
                [ 8 ] Southern Medical Program University of British Columbia Kelowna BC Canada
                [ 9 ] Alberta Children’s Hospital Research Institute University of Calgary Calgary AB Canada
                [ 10 ] Libin Cardiovascular Institute of Alberta University of Calgary Calgary AB Canada
                Author notes
                [*] [* ] Correspondence

                Jonathan D. Smirl, Department of Kinesiology, University of Calgary, Sport Injury Prevention Research Center, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.

                Email: jonathan.smirl@ 123456ucalgary.ca

                Author information
                https://orcid.org/0000-0003-1054-0038
                Article
                PHY214367
                10.14814/phy2.14367
                7066871
                32163235
                26d12a63-e328-4b75-b7e9-3d0a65350941
                © 2020 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 December 2019
                : 28 December 2019
                : 30 December 2019
                Page count
                Figures: 6, Tables: 1, Pages: 15, Words: 10960
                Categories
                Endurance and Performance
                Cardiovascular Physiology
                Central Nervous System
                Original Research
                Original Research
                Custom metadata
                2.0
                March 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.7 mode:remove_FC converted:12.03.2020

                acute recovery,blood pressure,cerebral autoregulation,cerebral blood flow,exercise

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