European Journal of Applied Physiology

, Volume 118, Issue 8, pp 1527–1538 | Cite as

Evaluating the methods used for measuring cerebral blood flow at rest and during exercise in humans

  • Michael M. Tymko
  • Philip N. Ainslie
  • Kurt J. Smith
Invited Review
Part of the following topical collections:
  1. Assessment of cardiovascular function during human activities


The first accounts of measuring cerebral blood flow (CBF) in humans were made by Angelo Mosso in ~1880, who recorded brain pulsations in patients with skull defects. In 1890, Charles Roy and Charles Sherrington determined in animals that brain pulsations—assessed via a similar method used by Mosso—were altered during a variety of stimuli including sensory nerve stimulation, asphyxia, and pharmacological interventions. Between 1880 and 1944, measurements for CBF were typically relied on skull abnormalities in humans. Thereafter, Kety and Schmidt introduced a new methodological approach in 1945 that involved nitrous oxide dilution combined with serial arterial and jugular venous blood sampling. Less than a decade later (1950’s), several research groups employed the Kety-Schmidt technique to assess the effects of exercise on global CBF and metabolism; these studies demonstrated an uncoupling of CBF and metabolism during exercise, which was contrary to early hypotheses. However, there were several limitations to this technique related to low temporal resolution and the inability to measure regional CBF. These limitations were overcome in the 1960’s when transcranial Doppler ultrasound (TCD) was developed as a method to measure beat-by-beat cerebral blood velocity. Between 1990 and 2010, TCD further progressed our understanding of CBF regulation and allowed for insight into other mechanistic factors, independent of local metabolism, involved in regulating CBF during exercise. Recently, it was discovered that TCD may not be accurate under several physiological conditions. Other measures of indexing CBF such as Duplex ultrasound and magnetic resonance imaging, although not without some limitations, may be more applicable for future investigations.


Kety-Schmidt technique Transcranial Doppler ultrasound Duplex ultrasound Cerebral blood flow Exercise 



Anterior cerebral artery


Anterior cerebral artery blood velocity


Blood oxygenation level dependent


Cerebral blood flow


Cerebral blood velocity


Common carotid artery


Cerebral metabolic rate


External carotid artery


Global cerebral blood flow


Internal carotid artery


Internal carotid artery blood velocity


Middle cerebral artery


Middle cerebral artery blood velocity


Magnetic resonance imaging


Partial pressure of arterial carbon dioxide


Posterior cerebral artery


Posterior cerebral artery blood velocity


Partial pressure of end-tidal carbon dioxide


Positron emission tomography


Transcranial Doppler ultrasound.


Vertebral artery



This work was funded by the natural sciences and engineering research council (NSERC), and by a Canada research chair (CRC).

Author contributions

All authors contributed to drafting and critically revising the article for important intellectual content. All authors approved the final version of the manuscript and all persons designated as authors qualify for authorship, and all those who qualify for authorship are listed.

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, Faculty of Health and Social DevelopmentUniversity of British ColumbiaKelownaCanada
  2. 2.School of Sports Science, Exercise and HealthThe University of Western AustraliaCrawleyAustralia

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