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Stroke Research and Treatment
Volume 2011 (2011), Article ID 692595, 4 pages
Clinical Study

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

Institute of Cardiovascular and Medical Sciences, College of Medical and Life Sciences, University of Glasgow, Glasgow G11 6NT, UK

Received 11 August 2010; Revised 14 October 2010; Accepted 20 October 2010

Academic Editor: Halvor Naess

Copyright © 2011 Mark Rafferty et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.