Blood Brain Flow and Exercise

NCT02653638 | Completed Early Phase 1

• 5 other identifiers: 2015-0331CVR-AAA4385A176000EDUC/KINESIOLOGY/KINESIO4R00HL118154-03
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

Cerebral vasodilator responses to CO2 will be measured in young healthy adults, healthy sedentary older adults, and healthy exercise trained older adults. This variable will be examined before and after administering the cyclooxygenase inhibitor indomethacin, which has been shown to blunt cerebral vasodilator responses. In addition, the investigators will examine these counter-regulatory hemodynamic mechanisms to hypoperfusion caused by indomethacin.

Conditions

Cerebrovascular Circulation

Keywords

Cerebral Vasodilator Function; White Matter Hyperintensity Volume; Default Mode Network Connectivity; Cognitive Function; Cardiorespiratory Fitness; Aging

Outcome Measures

Primary Outcomes (1)

• Cerebral Vasodilator Responses

  Utilize a Transcranial Doppler to measure blood flow velocity in response to inhaled carbon dioxide.

  Measurement at baseline

Secondary Outcomes (2)

• Cerebral Vasodilator Responses

  Measurement beginning 60 minutes post drug and measured through 180 minutes

• Blood Pressure

  Measurement at baseline and beginning 60 minutes post drug and measured through 180 minutes

Study Arms (1)

Drug

EXPERIMENTAL

Control-Hypercapnic Trials: Three stepwise CO2 elevations will be applied to the patient by adding fractional concentration of inspired CO2 (FICO2) at 2%, 4%, and 6% each time, balanced with room air. The end tidal CO2 (PetCO2) will be elevated and maintained constant for three minutes at each target level. Breath-by-breath changes in minute ventilation (VE) and PetCO2 will be measured. Drug-Indomethacin: Healthy volunteers, indomethacin suspension will be orally administered at 1.2 mg/kg. After drug administration, the patient will rest quietly for 90 minutes.

Other: Control; Drug: Indomethacin

Interventions

Control OTHER

1. Transcranial Doppler 2. Blood Pressure 3. Heart Rate 4. Oxygen Saturation

Drug

Indomethacin DRUG

1. Transcranial Doppler 2. Blood Pressure 3. Heart Rate 4. Oxygen Saturation

Drug

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Young subjects between 18-35 years old
• Older subjects between 55-75 years old
• Nonsmokers
• Physically active (exercise more than 3 times per week for at least 30 minutes)
• Sedentary (no formal exercise over 1 hour per week).

You may not qualify if:

• Outside of the specified age range
• Present with history or evidence of hepatic, renal, or hematological disease; peripheral vascular disease; stroke/neurovascular disease; diabetes; hypertension
• Take medications that indicate hepatic, renal, hematological disease; cardiovascular disease, including hypertension; stroke/neurovascular disease; and diabetes
• Body mass index \>34 kg/m2
• Take physician-prescribed medications that may interact with indomethacin: 1) cardiovascular drugs (e.g. angiotensin-converting-enzyme inhibitor (ACE inhibitors), angiotensin II receptor blockers (ARB's), Diuretics); 2) drugs that would increase bleeding risk (e.g. warfarin, heparin, clopidogrel, rivaroxaban, other NSAIDs); or 3) drugs associated with increased renal toxicity (e.g. cyclosporin, tacrolimus)
• Vulnerable populations (i.e. pregnant women, prisoners, individuals lacking capacity to consent, etc.)

Sponsors & Collaborators

• University of Wisconsin, Madison: lead
• National Institutes of Health (NIH): collaborator
• National Heart, Lung, and Blood Institute (NHLBI): collaborator

Study Sites (1)

Gymnasium-Natatorium

Madison, Wisconsin, 53716, United States

Location

Related Publications (41)

• Andrews-Hanna JR, Snyder AZ, Vincent JL, Lustig C, Head D, Raichle ME, Buckner RL. Disruption of large-scale brain systems in advanced aging. Neuron. 2007 Dec 6;56(5):924-35. doi: 10.1016/j.neuron.2007.10.038.

  PMID: 18054866 BACKGROUND

• Damoiseaux JS, Beckmann CF, Arigita EJ, Barkhof F, Scheltens P, Stam CJ, Smith SM, Rombouts SA. Reduced resting-state brain activity in the "default network" in normal aging. Cereb Cortex. 2008 Aug;18(8):1856-64. doi: 10.1093/cercor/bhm207. Epub 2007 Dec 5.

  PMID: 18063564 BACKGROUND

• Ainslie PN, Cotter JD, George KP, Lucas S, Murrell C, Shave R, Thomas KN, Williams MJ, Atkinson G. Elevation in cerebral blood flow velocity with aerobic fitness throughout healthy human ageing. J Physiol. 2008 Aug 15;586(16):4005-10. doi: 10.1113/jphysiol.2008.158279. Epub 2008 Jul 17.

  PMID: 18635643 BACKGROUND

• Erickson KI, Voss MW, Prakash RS, Basak C, Szabo A, Chaddock L, Kim JS, Heo S, Alves H, White SM, Wojcicki TR, Mailey E, Vieira VJ, Martin SA, Pence BD, Woods JA, McAuley E, Kramer AF. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011 Feb 15;108(7):3017-22. doi: 10.1073/pnas.1015950108. Epub 2011 Jan 31.

  PMID: 21282661 BACKGROUND

• Bakker SL, de Leeuw FE, den Heijer T, Koudstaal PJ, Hofman A, Breteler MM. Cerebral haemodynamics in the elderly: the rotterdam study. Neuroepidemiology. 2004 Jul-Aug;23(4):178-84. doi: 10.1159/000078503.

  PMID: 15272220 BACKGROUND

• Selim M, Jones R, Novak P, Zhao P, Novak V. The effects of body mass index on cerebral blood flow velocity. Clin Auton Res. 2008 Dec;18(6):331-8. doi: 10.1007/s10286-008-0490-z. Epub 2008 Aug 22.

  PMID: 18726054 BACKGROUND

• Dandona P, James IM, Newbury PA, Woollard ML, Beckett AG. Cerebral blood flow in diabetes mellitus: evidence of abnormal cerebrovascular reactivity. Br Med J. 1978 Jul 29;2(6133):325-6. doi: 10.1136/bmj.2.6133.325.

  PMID: 687900 BACKGROUND

• Barnes JN, Schmidt JE, Nicholson WT, Joyner MJ. Cyclooxygenase inhibition abolishes age-related differences in cerebral vasodilator responses to hypercapnia. J Appl Physiol (1985). 2012 Jun;112(11):1884-90. doi: 10.1152/japplphysiol.01270.2011. Epub 2012 Mar 22.

  PMID: 22442028 BACKGROUND

• Lipsitz LA, Mukai S, Hamner J, Gagnon M, Babikian V. Dynamic regulation of middle cerebral artery blood flow velocity in aging and hypertension. Stroke. 2000 Aug;31(8):1897-903. doi: 10.1161/01.str.31.8.1897.

  PMID: 10926954 BACKGROUND

• Kearney-Schwartz A, Rossignol P, Bracard S, Felblinger J, Fay R, Boivin JM, Lecompte T, Lacolley P, Benetos A, Zannad F. Vascular structure and function is correlated to cognitive performance and white matter hyperintensities in older hypertensive patients with subjective memory complaints. Stroke. 2009 Apr;40(4):1229-36. doi: 10.1161/STROKEAHA.108.532853. Epub 2009 Feb 26.

  PMID: 19246701 BACKGROUND

• Smith EE, Greenberg SM. Beta-amyloid, blood vessels, and brain function. Stroke. 2009 Jul;40(7):2601-6. doi: 10.1161/STROKEAHA.108.536839. Epub 2009 May 14.

  PMID: 19443808 BACKGROUND

• Girouard H, Iadecola C. Neurovascular coupling in the normal brain and in hypertension, stroke, and Alzheimer disease. J Appl Physiol (1985). 2006 Jan;100(1):328-35. doi: 10.1152/japplphysiol.00966.2005.

  PMID: 16357086 BACKGROUND

• Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol. 1994 Nov 15;24(6):1468-74. doi: 10.1016/0735-1097(94)90141-4.

  PMID: 7930277 BACKGROUND

• Panza JA, Quyyumi AA, Brush JE Jr, Epstein SE. Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. N Engl J Med. 1990 Jul 5;323(1):22-7. doi: 10.1056/NEJM199007053230105.

  PMID: 2355955 BACKGROUND

• Kugiyama K, Kerns SA, Morrisett JD, Roberts R, Henry PD. Impairment of endothelium-dependent arterial relaxation by lysolecithin in modified low-density lipoproteins. Nature. 1990 Mar 8;344(6262):160-2. doi: 10.1038/344160a0.

  PMID: 2106627 BACKGROUND

• Luscher TF, Diederich D, Siebenmann R, Lehmann K, Stulz P, von Segesser L, Yang ZH, Turina M, Gradel E, Weber E, et al. Difference between endothelium-dependent relaxation in arterial and in venous coronary bypass grafts. N Engl J Med. 1988 Aug 25;319(8):462-7. doi: 10.1056/NEJM198808253190802.

  PMID: 3136329 BACKGROUND

• Taddei S, Virdis A, Ghiadoni L, Versari D, Salvetti A. Which endothelium-derived factors are really important in humans? Biol Chem. 2006 Feb;387(2):151-7. doi: 10.1515/BC.2006.020.

  PMID: 16497146 BACKGROUND

• Taddei S, Virdis A, Mattei P, Ghiadoni L, Gennari A, Fasolo CB, Sudano I, Salvetti A. Aging and endothelial function in normotensive subjects and patients with essential hypertension. Circulation. 1995 Apr 1;91(7):1981-7. doi: 10.1161/01.cir.91.7.1981.

  PMID: 7895356 BACKGROUND

• Mitchell GF, van Buchem MA, Sigurdsson S, Gotal JD, Jonsdottir MK, Kjartansson O, Garcia M, Aspelund T, Harris TB, Gudnason V, Launer LJ. Arterial stiffness, pressure and flow pulsatility and brain structure and function: the Age, Gene/Environment Susceptibility--Reykjavik study. Brain. 2011 Nov;134(Pt 11):3398-407. doi: 10.1093/brain/awr253.

  PMID: 22075523 BACKGROUND

• Ide K, Eliasziw M, Poulin MJ. Relationship between middle cerebral artery blood velocity and end-tidal PCO2 in the hypocapnic-hypercapnic range in humans. J Appl Physiol (1985). 2003 Jul;95(1):129-37. doi: 10.1152/japplphysiol.01186.2002.

  PMID: 19278048 BACKGROUND

• Ivancev V, Bakovic D, Obad A, Breskovic T, Palada I, Joyner MJ, Dujic Z. Effects of indomethacin on cerebrovascular response to hypercapnea and hypocapnea in breath-hold diving and obstructive sleep apnea. Respir Physiol Neurobiol. 2009 May 15;166(3):152-8. doi: 10.1016/j.resp.2009.03.001. Epub 2009 Mar 18.

  PMID: 19442931 BACKGROUND

• Xie A, Skatrud JB, Morgan B, Chenuel B, Khayat R, Reichmuth K, Lin J, Dempsey JA. Influence of cerebrovascular function on the hypercapnic ventilatory response in healthy humans. J Physiol. 2006 Nov 15;577(Pt 1):319-29. doi: 10.1113/jphysiol.2006.110627. Epub 2006 Aug 24.

  PMID: 16931556 BACKGROUND

• DeSouza CA, Shapiro LF, Clevenger CM, Dinenno FA, Monahan KD, Tanaka H, Seals DR. Regular aerobic exercise prevents and restores age-related declines in endothelium-dependent vasodilation in healthy men. Circulation. 2000 Sep 19;102(12):1351-7. doi: 10.1161/01.cir.102.12.1351.

  PMID: 10993851 BACKGROUND

• Kelley RE, Chang JY, Scheinman NJ, Levin BE, Duncan RC, Lee SC. Transcranial Doppler assessment of cerebral flow velocity during cognitive tasks. Stroke. 1992 Jan;23(1):9-14. doi: 10.1161/01.str.23.1.9.

  PMID: 1731426 BACKGROUND

• Droste DW, Harders AG, Rastogi E. A transcranial Doppler study of blood flow velocity in the middle cerebral arteries performed at rest and during mental activities. Stroke. 1989 Aug;20(8):1005-11. doi: 10.1161/01.str.20.8.1005.

  PMID: 2667197 BACKGROUND

• Geda YE, Roberts RO, Knopman DS, Christianson TJ, Pankratz VS, Ivnik RJ, Boeve BF, Tangalos EG, Petersen RC, Rocca WA. Physical exercise, aging, and mild cognitive impairment: a population-based study. Arch Neurol. 2010 Jan;67(1):80-6. doi: 10.1001/archneurol.2009.297.

  PMID: 20065133 BACKGROUND

• Baker LD, Frank LL, Foster-Schubert K, Green PS, Wilkinson CW, McTiernan A, Cholerton BA, Plymate SR, Fishel MA, Watson GS, Duncan GE, Mehta PD, Craft S. Aerobic exercise improves cognition for older adults with glucose intolerance, a risk factor for Alzheimer's disease. J Alzheimers Dis. 2010;22(2):569-79. doi: 10.3233/JAD-2010-100768.

  PMID: 20847403 BACKGROUND

• Lautenschlager NT, Cox KL, Flicker L, Foster JK, van Bockxmeer FM, Xiao J, Greenop KR, Almeida OP. Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA. 2008 Sep 3;300(9):1027-37. doi: 10.1001/jama.300.9.1027.

  PMID: 18768414 BACKGROUND

• Galetta F, Franzoni F, Plantinga Y, Ghiadoni L, Rossi M, Prattichizzo F, Carpi A, Taddei S, Santoro G. Ambulatory blood pressure monitoring and endothelium-dependent vasodilation in the elderly athletes. Biomed Pharmacother. 2006 Sep;60(8):443-7. doi: 10.1016/j.biopha.2006.07.013. Epub 2006 Aug 2.

  PMID: 16904861 BACKGROUND

• Franzoni F, Ghiadoni L, Galetta F, Plantinga Y, Lubrano V, Huang Y, Salvetti G, Regoli F, Taddei S, Santoro G, Salvetti A. Physical activity, plasma antioxidant capacity, and endothelium-dependent vasodilation in young and older men. Am J Hypertens. 2005 Apr;18(4 Pt 1):510-6. doi: 10.1016/j.amjhyper.2004.11.006.

  PMID: 15831361 BACKGROUND

• Green DJ, O'Driscoll G, Joyner MJ, Cable NT. Exercise and cardiovascular risk reduction: time to update the rationale for exercise? J Appl Physiol (1985). 2008 Aug;105(2):766-8. doi: 10.1152/japplphysiol.01028.2007. Epub 2008 Jan 3. No abstract available.

  PMID: 18174390 BACKGROUND

• Seifert T, Brassard P, Wissenberg M, Rasmussen P, Nordby P, Stallknecht B, Adser H, Jakobsen AH, Pilegaard H, Nielsen HB, Secher NH. Endurance training enhances BDNF release from the human brain. Am J Physiol Regul Integr Comp Physiol. 2010 Feb;298(2):R372-7. doi: 10.1152/ajpregu.00525.2009. Epub 2009 Nov 18.

  PMID: 19923361 BACKGROUND

• Serrador JM, Picot PA, Rutt BK, Shoemaker JK, Bondar RL. MRI measures of middle cerebral artery diameter in conscious humans during simulated orthostasis. Stroke. 2000 Jul;31(7):1672-8. doi: 10.1161/01.str.31.7.1672.

  PMID: 10884472 BACKGROUND

• Raz L, Jayachandran M, Tosakulwong N, Lesnick TG, Wille SM, Murphy MC, Senjem ML, Gunter JL, Vemuri P, Jack CR Jr, Miller VM, Kantarci K. Thrombogenic microvesicles and white matter hyperintensities in postmenopausal women. Neurology. 2013 Mar 5;80(10):911-8. doi: 10.1212/WNL.0b013e3182840c9f. Epub 2013 Feb 13.

  PMID: 23408873 BACKGROUND

• MacLeod CM. Half a century of research on the Stroop effect: an integrative review. Psychol Bull. 1991 Mar;109(2):163-203. doi: 10.1037/0033-2909.109.2.163. No abstract available.

  PMID: 2034749 BACKGROUND

• Lucas SJ, Ainslie PN, Murrell CJ, Thomas KN, Franz EA, Cotter JD. Effect of age on exercise-induced alterations in cognitive executive function: relationship to cerebral perfusion. Exp Gerontol. 2012 Aug;47(8):541-51. doi: 10.1016/j.exger.2011.12.002. Epub 2012 Jan 2.

  PMID: 22230488 BACKGROUND

• Owen AM, Downes JJ, Sahakian BJ, Polkey CE, Robbins TW. Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia. 1990;28(10):1021-34. doi: 10.1016/0028-3932(90)90137-d.

  PMID: 2267054 BACKGROUND

• Frauenfelder BA, Schuepbach D, Baumgartner RW, Hell D. Specific alterations of cerebral hemodynamics during a planning task: a transcranial Doppler sonography study. Neuroimage. 2004 Jul;22(3):1223-30. doi: 10.1016/j.neuroimage.2004.03.008.

  PMID: 15219594 BACKGROUND

• Schuepbach D, Boeker H, Duschek S, Hell D. Rapid cerebral hemodynamic modulation during mental planning and movement execution: evidence of time-locked relationship with complex behavior. Clin Neurophysiol. 2007 Oct;118(10):2254-62. doi: 10.1016/j.clinph.2007.07.013. Epub 2007 Sep 4.

  PMID: 17766175 BACKGROUND

• Jensen K, Kjaergaard S, Malte E, Bunemann L, Therkelsen K, Knudsen F. Effect of graduated intravenous and standard rectal doses of indomethacin on cerebral blood flow in healthy volunteers. J Neurosurg Anesthesiol. 1996 Apr;8(2):111-6. doi: 10.1097/00008506-199604000-00002.

  PMID: 8829556 BACKGROUND

• Carlsson I, Wennmalm A. Effect of different prostaglandin synthesis inhibitors on post-occlusive blood flow in human forearm. Prostaglandins. 1983 Aug;26(2):241-52. doi: 10.1016/0090-6980(83)90092-8.

  PMID: 6417728 BACKGROUND

MeSH Terms

Interventions

Indomethacin

Intervention Hierarchy (Ancestors)

Indoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds

Study Officials

• Jill N Barnes, PhD

  University of Wisconsin, Madison

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: early phase 1
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 22, 2015
• First Posted: January 12, 2016
• Study Start: June 1, 2016
• Primary Completion: April 1, 2019
• Study Completion: April 1, 2019
• Last Updated: December 18, 2019

Record last verified: 2019-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)