Neckties and Cerebrovascular Reactivity in Young Healthy Males : A Pilot Randomised Crossover Trial

Abstract EN

Background.

A necktie may elevate intracranial pressure through compression of venous return.

We hypothesised that a tight necktie would deleteriously alter cerebrovascular reactivity.

Materials and Methods.

A necktie was simulated using bespoke apparatus comprising pneumatic inner-tube with aneroid pressure-gauge.

Using a randomised crossover design, cerebrovascular reactivity was measured with the “pseudo-tie” worn inflated or deflated for 5 minutes (simulating tight/loose necktie resp.).

Reactivity was calculated using breath hold index (BHI) and paired “t” testing used for comparative analysis.

Results.

We enrolled 40 healthy male volunteers.

There was a reduction in cerebrovascular reactivity of 0.23 units with “tight” pseudotie (BHI loose 1.44 (SD 0.48); BHI tight 1.21 (SD 0.38) P<.001).

Conclusion.

Impairment in cerebrovascular reactivity was found with inflated pseudo-tie.

However, mean BHI is still within a range of considered normal.

The situation may differ in patients with vascular risk factors, and confirmatory work is recommended.