Assessments of flow by transcranial Doppler ultrasound in the middle cerebral artery during exercise in humans.

This study examined the consistency between three indexes of cerebral blood flow (CBF) obtained by using transcranial Doppler ultrasound in eight human volunteers. Each subject undertook three sessions of graded exercise, consisting of 6 min of rest, 6 min at 20% of maximal oxygen uptake (VO2 max), 6 min at 40% VO2 max, and 6 min of recovery. Values were obtained every 10 ms for the velocity associated with the maximal frequency of the Doppler shift (VP), the intensity-weighted mean velocity (VIWM), and total signal power (P). Beat-by-beat averages for three indexes (P, IWM, provided significantly different results for the percent changes in CBF with exercise. At 20% of VO2 max, P and IWM showed significant (P < 0.05) increases of 8 and 6%, respectively, whereas showed a nonsignificant increase of 3%. At 40% of VO2 max, P and IWM showed significant (P < 0.05) increases of 14 and 8%, respectively, whereas showed a nonsignificant increase of 4%. Our results suggest that the increase in CBF with exercise that has been reported with transcranial Doppler ultrasound needs to be treated with caution, as much of the response could arise as an artifact from the increase in amplitude and frequency of the arterial pressure waveform.