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. 2023 Jul;43(7):1216-1218.
doi: 10.1177/0271678X231172854. Epub 2023 Apr 27.

Point/counterpoint: Cerebrovascular resistance is a flawed concept

Jonathan Ince  1 , Jatinder S Minhas  1   2 , Ronney B Panerai  1   2
Affiliations

Point/counterpoint: Cerebrovascular resistance is a flawed concept

Jonathan Ince et al. J Cereb Blood Flow Metab. 2023 Jul.

Abstract

The relationship between cerebral blood flow and blood pressure is a critical part of investigation of cerebral autoregulation. Conventionally, cerebrovascular resistance (CVR) has been used to describe this relationship, but the underlying principles used for this method is flawed in real-world application for several reasons. Despite this, the use of CVR remains entrenched within current literature. This 'Point/Counterpoint' review provides a summary of the flaws in using CVR and explains the benefits of calculating the more accurate critical closing pressure (CrCP) and resistance-area product (RAP) parameters, with support of real-world data.

Keywords: Cerebrovascular resistance; cerebral autoregulation; cerebral vascular conductance; critical closing pressure; resistance-area product.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A demonstration of the differences in describing the BP-CBFv relationship between CVR and CrCP. Estimation of CrCP is calculated from CBFv and arterial BP recordings for a healthy subject, with an approximate CrCP of 20 mmHg. The dotted line illustrates how the relationship may be described using CVR, in which the relationship must cross the axes origin. (Modified from source: The critical closing pressure of the cerebral circulation, Medical Engineering & Physics)
See this image and copyright information in PMC

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