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Stroke Res Treat. 2010 Nov 8;2011:692595. doi: 10.4061/2011/692595.

Neckties and cerebrovascular reactivity in young healthy males: a pilot randomised crossover trial.

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



A necktie may elevate intracranial pressure through compression of venous return. We hypothesised that a tight necktie would deleteriously alter cerebrovascular reactivity.


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.


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).


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.

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