Utilizing transfer function analysis to assess the cerebral autoregulation in patients with idiopathic intracranial hypertension (IIH), and to explore its improvement after venous sinus stenting.
In total, 15 consecutive IIH patients with venous sinus stenosis and 15 controls were recruited. All the patients underwent digital subtraction angiography and venous manometry. Venous sinus stenting was offered to IIH patients with trans-stenosis pressure gradient ≥8 mmHg. Cerebral autoregulation was assessed pre- and post- operation by transfer function analysis (rate of recovery/phase/gain) using the spontaneous oscillations of the cerebral blood flow velocity and arterial blood pressure.
The autoregulatory parameters – phase shift at 0.06-0.12 Hz and rate of recovery, were all significantly lower in IIH patients than in the controls [(57.94° ± 23.22° vs. 34.59° ± 24.15°, p<0.001; (39.87 ± 21.95) %/s vs. (20.56 ± 46.66) %/s, p=0.045, respectively), was significantly lower in IIH patients than in the controls, which indicated the capacity of cerebral autoregulation was impaired in these patients. In total, 6 patients with bilateral transverse or sigmoid sinus stenosis received venous sinus stenting. And the phase shift was significantly higher in post-stenting group compared with that in the pre-stenting group (39.62° ± 20.26° vs. 22.79° ± 19.96°, p=0.04).
Patients with IIH were more likely to have impaired CA, which can be improved after venous sinus stenting. Transfer function analysis is potentially useful in clinical studies to investigate the hemodynamics in IIH patients.

© 2021 Institute of Physics and Engineering in Medicine.