# Human cerebral blood flow regulation: sex, mechanism, and stress differences

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2020 · $615,157

## Abstract

Project Summary/Abstract
Cerebrovascular disease is the third leading killer in the U.S., and contributes to decreased quality of
life and increased long-term care spending. The risk of cerebrovascular disease is inversely
associated with resting cerebral blood flow (CBF). Men exhibit a lower resting CBF and have twice
the risk of cerebrovascular disease when compared to premenopausal women. The ability of cerebral
vessels to respond to challenges is also inversely related to disease risk, and may be useful in
identifying at-risk patients pre-clinically. However, these studies are often confounded by aging and/or
comorbidities, and the associations provide little insight into physiologic mechanisms responsible for
sexually dimorphic cerebrovascular disease risk. Conversely, animal studies use supraphysiologic
levels of hormone treatment in primarily young animals, which limits the translational relevance of
animal CBF mechanisms. While there is general agreement that estrogen is protective in healthy
adults, the basic impact of sex, and physiologic fluctuations in sex hormones, on mechanisms of CBF
control remains unclear. The overall goal of this research program is to investigate the mechanisms
which actively control cerebral blood flow (CBF) in humans, particularly how men and women differ in
control mechanisms on a regional basis throughout the brain circulation. We propose to study CBF
control mechanisms in healthy younger (18-40 yrs) adult men and women. The overall hypothesis is
that female sex and sex hormones contribute to larger stress-induced increases in CBF, due to
greater prostanoid (COX) and nitric oxide (NOS) dilation. A key technological innovation of this
proposal derives from multi-mode, high-resolution, flow sensitive MRI to quantify CBF at macro- and
microvascular levels, at rest, and in response to environmental challenges. Additionally, the research
design allows us to quantify sex differences in two vascular control mechanisms across all brain
regions. Our preliminary data demonstrate: hypoxic cerebral vasodilation is 60-100% higher in
women compared to men, COX inhibition reduces dilation in women but not men, NOS inhibition
reduces vasodilation more in women, and hypoxic vasodilation is increased in women during early
luteal cycle, in part to greater COX-mediated vasodilation. We also will use sex hormone
suppression, followed by single hormone addition, to systematically study the impacts on CBF control
in both sexes. We have substantial preliminary findings that support our hypotheses, and have
integrated physiologic, pharmacologic, and MRI approaches to test our hypotheses. This state-of-the-
art approach will yield previously unattainable insight into not only maintaining CBF, but actively
controlling it during physiologic demands for increased flow. These novel, high resolution, regionally-
specific, sex-specific, and mechanism-specific findings will serve as a knowledge platform, for
designing sex-specific CBF stud...

## Key facts

- **NIH application ID:** 9865867
- **Project number:** 1R01HL150361-01
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** WILLIAM G SCHRAGE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $615,157
- **Award type:** 1
- **Project period:** 2020-06-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9865867

## Citation

> US National Institutes of Health, RePORTER application 9865867, Human cerebral blood flow regulation: sex, mechanism, and stress differences (1R01HL150361-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9865867. Licensed CC0.

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