Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 22.
doi: 10.1007/s00421-025-05972-2. Online ahead of print.

The impact of posture changes on critical closing pressure and resistance-area product regulation in healthy subjects

X Zhong  1 , R H Clough  1 , R B Panerai #  1   2 , J S Minhas #  3   4
Affiliations

The impact of posture changes on critical closing pressure and resistance-area product regulation in healthy subjects

X Zhong et al. Eur J Appl Physiol. .

Abstract

Introduction: Cerebral blood flow (CBF) is affected by posture changes, but there is a paucity of research examining the effect of posture on dynamic cerebral autoregulation (dCA). The step responses of critical closing pressure (CrCP) and resistance area product (RAP) obtained from the cerebral blood velocity (CBv) signal can reflect the changes in dCA, enabling exploration of dCA changes in supine, sitting and upright postures.

Methods: In 22 participants (11 males, aged 30.2 ± 14.3 years), two recordings were made for each posture, corresponding to supine, sitting, and standing. Blood pressure (BP, Finometer), MCAv and PCAv (transcranial Doppler ultrasound), end-tidal carbon dioxide (EtCO2, capnography) and heart rate (ECG) were continuously recorded. CrCP and RAP were obtained for each cardiac cycle, and the step responses of CBv (SRVMCA/PCA), CrCP (SRVCrCP), and RAP (SRVRAP), for both arteries, were calculated after subcomponent and transfer function analysis.

Results: Moving from supine to sitting, and then standing, led to reductions in mean MCAv (p < 0.001), PCAv (p = 0.037), BP (p < 0.001) and EtCO2 (p < 0.001), accompanied by changes in SRVMCA (p = 0.002), but not in SRVPCA (p = 0.78). For both arteries, SRVRAP and SRVCrCP reflected changes in posture (both p < 0.001).

Conclusion: Posture changes can significantly affect the step responses of MCAv, CrCP, and RAP. The interaction between posture and EtCO2 from the perspective of the CrCP and RAP step responses needs further exploration in future studies.

Keywords: Cerebral blood flow; Posture; Vasomotor reactivity.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: The authors report no conflict of interest. Ethical approval: Ethical approval was obtained from the University of Leicester Research Ethics Committee (Reference: 28664-jm591-ls: cardiovascularsciences) in February 2021. The study was conducted in line with the Declaration of Helsinki (2013) and all participants provided written informed consent.

References

    1. Aaslid R, Lindegaard KF, Sorteberg W, Nornes H (1989) Cerebral autoregulation dynamics in humans. Stroke 20(1):45–52. https://doi.org/10.1161/01.str.20.1.45 - DOI - PubMed
    1. Alagiakrishnan K (2019) Falls and hypotensive syndromes in the elderly. Hypotensive Syndromes in Geriatric Patients. Springer, pp 167–177
    1. Barnes SC, Panerai RB, Beishon L, Hanby M, Robinson TG, Haunton VJ (2022) Cerebrovascular responses to somatomotor stimulation in Parkinson’s disease: a multivariate analysis. J Cereb Blood Flow Metab 42(8):1547–1558. https://doi.org/10.1177/0271678x211065204 - DOI - PubMed - PMC
    1. Beishon LC, Panerai RB, Robinson TG, Subramaniam H, Haunton VJ (2018) The assessment of cerebrovascular response to a language task from the Addenbrooke’s cognitive examination in cognitive impairment: a feasibility functional transcranial Doppler ultrasonography study. J Alzheimers Dis Rep 2(1):153–164. https://doi.org/10.3233/ADR-180068 - DOI - PubMed - PMC
    1. Brasil S, de Carvalho Nogueira R, Salinet ÂSM, Yoshikawa MH, Teixeira MJ, Paiva W, Malbouisson LMS, Bor-Seng-Shu E, Panerai RB (2023) Critical closing pressure and cerebrovascular resistance responses to intracranial pressure variations in neurocritical patients. Neurocrit Care 39(2):399–410 - DOI - PubMed - PMC

LinkOut - more resources