# Evaluation of cerebrovascular reactivity using transcranial Doppler in patients with influenza

**Authors:** Ana Orsolic Beslic, Kresimir Caljkusic, Antonela Matana, Katarina Tomelic Ercegovic, Mirela Pavicic Ivelja

PMC · DOI: 10.1371/journal.pone.0340768 · PLOS One · 2026-01-12

## TL;DR

This study found that influenza can temporarily impair cerebrovascular function, which may affect blood flow to the brain.

## Contribution

The study demonstrates that influenza acutely impairs cerebrovascular reactivity, which recovers over time.

## Key findings

- Influenza patients had significantly lower cerebral blood flow velocities compared to healthy controls.
- Cerebrovascular reactivity, measured by BHI, was significantly reduced in influenza patients.
- Cerebrovascular function improved three months post-recovery, suggesting temporary impairment.

## Abstract

Influenza is primarily a respiratory disease but can cause a broad spectrum of complications, including those affecting the cerebrovascular system. The aim of this study was to evaluate cerebrovascular reactivity in patients during and after influenza infection. A total of 92 participants, mean age 43 years, were enrolled; 46 patients with confirmed influenza infection and 46 healthy controls. Cerebrovascular reactivity was assessed using transcranial Doppler in combination with the breath-holding test and quantified by the breath-holding index (BHI). The influenza group demonstrated significantly lower cerebral blood flow velocities in the middle cerebral artery both at rest (PSVrest, MVrest, p < 0.001) and after the breath-holding test (PSVmax, MVmax, p < 0.001) compared to healthy controls. The BHI was also significantly reduced in the influenza group (p < 0.001), indicating impaired cerebrovascular reactivity. Among participants reassessed three months post-recovery, blood flow velocities after the breath-holding test were significantly higher than during the acute phase (PSVmax, MVmax, p < 0.001), and BHI also improved (p < 0.001), suggesting restoration of cerebrovascular function. These findings suggest that influenza may transiently impair cerebrovascular reactivity, providing new insights into potential mechanisms influencing cerebrovascular function and hemodynamics.

## Linked entities

- **Diseases:** influenza (MONDO:0005812)

## Full-text entities

- **Diseases:** hypertension (MESH:D006973), hemorrhagic strokes (MESH:D000083302), ischemic stroke (MESH:D002544), rhinorrhea (MESH:D012818), Guillain-Barre syndrome (MESH:D020275), cerebral perfusion (MESH:D002547), Cerebrovascular (MESH:D002561), hematologic disease (MESH:D006402), stroke (MESH:D020521), stenosis of the vertebral artery or external carotid artery (MESH:D016893), periodontal pathogens (MESH:D010518), rhabdomyolysis (MESH:D012206), chills (MESH:D023341), hyperlipidemia (MESH:D006949), brain infection (MESH:D007239), obesity (MESH:D009765), long-term disability (MESH:D000088562), hypercapnia (MESH:D006935), post-influenza encephalitis (MESH:D004660), myocarditis (MESH:D009205), liver cirrhosis (MESH:D008103), Reye's syndrome (MESH:D012202), malignant disease (MESH:D009369), chronic hepatitis C (MESH:D019698), Infectious Diseases (MESH:D003141), respiratory (MESH:D012131), HIV-infected (MESH:D015658), coronary heart disease (MESH:D003327), Comorbidity (MESH:D004194), hypoxemia (MESH:D000860), respiratory disease (MESH:D012140), injury (MESH:D014947), cough (MESH:D003371), cardiovascular and cerebrovascular diseases (MESH:D002318), death (MESH:D003643), headache (MESH:D006261), atherosclerotic (MESH:D050197), COVID-19 infection (MESH:D000086382), depression (MESH:D003866), impaired cerebrovascular reactivity (MESH:D000275), respiratory tract infections (MESH:D012141), ILI (MESH:D007251), atrial fibrillation (MESH:D001281), diabetes mellitus (MESH:D003920), inflammation (MESH:D007249), influenza pneumonia (MESH:D011014), heart disease (MESH:D006331), fever (MESH:D005334), endothelial (MESH:D005642), encephalopathy (MESH:D001927), MI (MESH:D009203), endothelial dysfunction (MESH:D014652), occlusive disease of cerebral arteries (MESH:D001157), ischemic brain injury (MESH:D001930)
- **Chemicals:** BHT (-), acetazolamide (MESH:D000086), alcohol (MESH:D000438), oseltamivir (MESH:D053139), CO2 (MESH:D002245)
- **Species:** Helicobacter pylori (species) [taxon 210], Cytomegalovirus (genus) [taxon 10358], Chlamydia pneumoniae (species) [taxon 83558], Orthomyxoviridae (family) [taxon 11308], Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

7 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12795361/full.md

## References

54 references — full list in the complete paper: https://tomesphere.com/paper/PMC12795361/full.md

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Source: https://tomesphere.com/paper/PMC12795361