Journal of Human Sport and Exercise

Effects of the exercise in the cerebral blood flow and metabolism: A review

Ángel Gabriel Lucas-Cuevas, Jose Ignacio Priego Quesada, Pedro Pérez-Soriano, Salvador Llana-Belloch



In recent years it has been shown that cerebral blood flow is affected by intense exercise, what may even lead to a reduction in the cognitive capacity. This statement is contrary to the traditional belief that cerebral blood flood remains constant and unaltered even when exercise is performed. During physical exercise of moderate intensity, cerebral blood flow increases in the cerebral areas responsible for movement. Moreover, recent studies have observed that cerebral blood flow decreases during high-intensity exercise as a consequence of a local hyperventilation and vasoconstriction of the areas with lower cerebral activity. Traditionally, the glucose has been considered as the main and unique source of energy for the brain. However, new studies are suggesting that as the intensity of exercise increases, the glucose uptake decreases in favour of an increase in the lactate uptake. Finally, Hyperthermia may also play a major role in the cerebral regulation system, since it can provoke central fatigue as well as hypoglycaemia.


Brain; Blood circulation; Oxygen consumption; Hyperthermia; Glucose uptake; Lactate


Ahlborg, G., & Wahren, J. (1972). Brain substrate utilization during prolonged exercise. Scand J Clin Lab Invest, 29(4), 397–402.

Ainslie, P. N., Barach, A., Murrell, C., Hamlin, M., Hellemans, J., & Ogoh, S. (2007). Alterations in cerebral autoregulation and cerebral blood flow velocity during acute hypoxia: rest and exercise. Am J Physiol Heart Circ Physiol, 292(2), H976–H983.

Attwell, D., Buchan, A. M., Charpak, S., Lauritzen, M., MacVicar, B. A., & Newman, E. A. (2010). Glial and neuronal control of brain blood flow. Nature, 468(7321), 232–243.

Bolduc, V., Thorin-Trescases, N., & Thorin, E. (2013). Endothelium-dependent control of cerebrovascular functions through age: exercise for healthy cerebrovascular aging. Am J Physiol Heart Circ Physiol, 305(5), H620–633.

Brisswalter, J., Arcelin, R., Audiffren, M., & Delignieres, D. (1997). Influence of physical exercise on simple reaction time: Effect of physical fitness. Percept Mot Skills, 85(3), 1019–1027.

Brothers, R. M., Wingo, J. E., Hubing, K. A., & Crandall, C. G. (2009). The effects of reduced end-tidal carbon dioxide tension on cerebral blood flow during heat stress. J Physiol, 587(15), 3921–3927.

Dalsgaard, M. K., Nybo, L., Cai, Y., & Secher, N. H. (2003). Cerebral metabolism is influenced by muscle ischaemia during exercise in humans. Exp Physiol, 88(2), 297–302.

Dalsgaard, M. K., Quistorff, B., Danielsen, E. R., Selmer, C., Vogelsang, T., & Secher, N. H. (2004). A reduced cerebral metabolic ratio in exercise reflects metabolism and not accumulation of lactate within the human brain. J Physiol, 554(2), 571–578.

Delp, M. D., Armstrong, R. B., Godfrey, D. A., Laughlin, M. H., Ross, C. D., & Wilkerson, M. K. (2001). Exercise increases blood flow to locomotor, vestibular, cardiorespiratory and visual regions of the brain in miniature swine. J Physiol, 533(3), 849–859.

Dempsey, J. A., Hanson, P. G., & Henderson, K. S. (1984). Exercise-induced arterial hypoxaemia in healthy human subjects at sea level. J Physiol, 355(1), 161–175.

Dienel, G. A., Wang, R. Y., & Cruz, N. F. (2002). Generalized sensory stimulation of conscious rats increases labeling of oxidative pathways of glucose metabolism when the brain glucose–oxygen uptake ratio rises. J Cereb Blood Flow Metab, 22(12), 1490–1502.

Fan, J.-L., Cotter, J. D., Lucas, R. A., Thomas, K., Wilson, L., & Ainslie, P. N. (2008). Human cardiorespiratory and cerebrovascular function during severe passive hyperthermia: effects of mild hypohydration. J Appl Physiol, 105(2), 433–445.

Faraci, F. M. (2011). The Robert M. Berne Distinguished Lecture: Protecting against vascular disease in brain. Am J Physiol Heart Circ Physiol, 300(5), H1566.

Fox, P. T., & Raichle, M. E. (1986). Focal physiological uncoupling of cerebral blood flow and oxidative metabolism during somatosensory stimulation in human subjects. Proc Natl Acad Sci U S A, 83(4), 1140–1144.

Hedlund, S., Nylin, G., & Regnström, O. (2008). The behaviour of the cerebral circulation during muscular exercise. Acta Physiol Scand, 54(3-4), 316–324.

Ide, K., Horn, A., & Secher, N. H. (1999). Cerebral metabolic response to submaximal exercise. J Appl Physiol, 87(5), 1604–1608.

Ide, K., Schmalbruch, I. K., Quistorff, B., Horn, A., & Secher, N. H. (2004). Lactate, glucose and O2 uptake in human brain during recovery from maximal exercise. J Physiol, 522(1), 159–164.

Ide, K., & Secher, N. H. (2000). Cerebral blood flow and metabolism during exercise. Prog Neurobiol, 61(4), 397–414.

Jorgensen, L. G., Perko, G., & Secher, N. H. (1992). Regional cerebral artery mean flow velocity and blood flow during dynamic exercise in humans. J Appl Physiol, 73(5), 1825–1830.

Kemppainen, J., Aalto, S., Fujimoto, T., Kalliokoski, K. K., Laangsjö, J., Oikonen, V., … Knuuti, J. (2005). High intensity exercise decreases global brain glucose uptake in humans. J Physiol, 568(1), 323–332.

Kety, S. S., & Schmidt, C. F. (1948). The nitrous oxide method for the quantitative determination of cerebral blood flow in man: theory, procedure and normal values. J Clin Invest, 27(4), 476.

King, P., Kong, M. F., Parkin, H., MacDonald, I. A., Barber, C., & Tattersall, R. B. (1998). Intravenous lactate prevents cerebral dysfunction during hypoglycaemia in insulin-dependent diabetes mellitus. Clin Sci (Lond), 94(2), 157.

Kleinschmidt, A., Obrig, H., Requardt, M., Merboldt, K. D., Dirnagl, U., Villringer, A., & Frahm, J. (1996). Simultaneous recording of cerebral blood oxygenation changes during human brain activation by magnetic resonance imaging and near-infrared spectroscopy. J Cereb Blood Flow Metab, 16(5), 817–826.

Larrabee, M. G. (1995). Lactate metabolism and its effects on glucose metabolism in an excised neural tissue. J Neurochem, 64(4), 1734–1741.

Lassen, N. A. (1959). Cerebral blood flow and oxygen consumption in man. Physiol Rev, 39(2), 183–238.

Lassen, N. A. (1974). Control of cerebral circulation in health and disease. Circulation Research, 34(6), 749–760.

Linkis, P., Jorgensen, L. G., Olesen, H. L., Madsen, P. L., Lassen, N. A., & Secher, N. H. (1995). Dynamic exercise enhances regional cerebral artery mean flow velocity. J Appl Physiol, 78(1), 12–16.

Madsen, P. L., Hasselbalch, S. G., Hagemann, L. P., Olsen, K. S., Bülow, J., Holm, S., … Lassen, N. A. (1995). Persistent resetting of the cerebral oxygen/glucose uptake ratio by brain activation: evidence obtained with the Kety–Schmidt technique. J Cereb Blood Flow Metab, 15(3), 485–491.

Madsen, P. L., Sperling, B. K., Warming, T., Schmidt, J. F., Secher, N. H., Wildschiodtz, G., … Lassen, N. A. (1993). Middle cerebral artery blood velocity and cerebral blood flow and O2 uptake during dynamic exercise. J Appl Physiol, 74(1), 245–250.

Marsden, K. R., Haykowsky, M. J., Smirl, J. D., Jones, H., Nelson, M. D., Altamirano-Diaz, L. A., … Willie, C. K. (2012). Aging blunts hyperventilation-induced hypocapnia and reduction in cerebral blood flow velocity during maximal exercise. Age, 34(3), 725–735.

Nelson, M. D., Haykowsky, M. J., Stickland, M. K., Altamirano-Diaz, L. A., Willie, C. K., Smith, K. J., … Ainslie, P. N. (2011). Reductions in cerebral blood flow during passive heat stress in humans: partitioning the mechanisms. J Physiol, 589(16), 4053–4064.

Nielsen, H. B., Madsen, P., Svendsen, L. B., Roach, R. C., & Secher, N. H. (1998). The influence of PaO2, pH and SaO2 on maximal oxygen uptake. Acta Physiol Scand, 164(1), 89–87.

Nybo, L., Møller, K., Volianitis, S., Nielsen, B., & Secher, N. H. (2002). Effects of hyperthermia on cerebral blood flow and metabolism during prolonged exercise in humans. J Appl Physiol, 93(1), 58–64.

Nybo, L., & Nielsen, B. (2001a). Hyperthermia and central fatigue during prolonged exercise in humans. J Appl Physiol, 91(3), 1055–1060.

Nybo, L., & Nielsen, B. (2001b). Middle cerebral artery blood velocity is reduced with hyperthermia during prolonged exercise in humans. J Physiol, 534(1), 279–286.

Nybo, L., & Secher, N. H. (2004). Cerebral perturbations provoked by prolonged exercise. Prog Neurobiol, 72(4), 223–261.

Ogoh, S., & Ainslie, P. N. (2009). Cerebral blood flow during exercise: mechanisms of regulation. J Appl Physiol, 107(5), 1370–1380.

Ogoh, S., Dalsgaard, M. K., Yoshiga, C. C., Dawson, E. A., Keller, D. M., Raven, P. B., & Secher, N. H. (2005). Dynamic cerebral autoregulation during exhaustive exercise in humans. Am J Physiol Heart Circ Physiol, 288(3), H1461–H1467.

Paulson, O. B., Strandgaard, S., & Edvinsson, L. (1990). Cerebral autoregulation. Cerebrovasc Brain Metab Rev, 2(2), 161–192.

Pellerin, L. (2005). How astrocytes feed hungry neurons. Mol Neurobiol, 32(1), 59–72.

Poca, M. A., Sahuquillo, J., Monforte, R., & Vilalta, A. (2005). Métodos globales de monitorización de la hemodinámica cerebral en el paciente neurocrítico: fundamentos, controversias y actualizaciones en las técnicas de oximetría yugular. Neurocirugía, 16(4), 301–322.

Querido, J. S., & Sheel, A. W. (2007). Regulation of cerebral blood flow during exercise. Sports Med, 37(9), 765–782.

Quistorff, B., Secher, N. H., & Lieshout, J. J. V. (2008). Lactate fuels the human brain during exercise. FASEB J, 22(10), 3443–3449.

Sato, K., & Sadamoto, T. (2010). Different blood flow responses to dynamic exercise between internal carotid and vertebral arteries in women. J Appl Physiol, 109(3), 864–869.

Scheinberg, P., Blackburn, L. I., Rich, M., & Saslaw, M. (1954). Effects of vigorous physical exercise on cerebral circulation and metabolism. Am J Med, 16(4), 549–554.

Schurr, A., Miller, J. J., Payne, R. S., & Rigor, B. M. (1999). An Increase in Lactate Output by Brain Tissue Serves to Meet the Energy Needs of Glutamate-Activated Neurons. J Neurosci, 19(1), 34–39.

Secher, N. H., Seifert, T., & Lieshout, J. J. V. (2008). Cerebral blood flow and metabolism during exercise: implications for fatigue. J Appl Physiol, 104(1), 306–314.

Seifert, T., & Secher, N. H. (2011). Sympathetic influence on cerebral blood flow and metabolism during exercise in humans. Prog Neurobiol, 95(3), 406–426.

Smith, D., Pernet, A., Hallett, W. A., Bingham, E., Marsden, P. K., & Amiel, S. A. (2003). Lactate: A Preferred Fuel for Human Brain Metabolism In Vivo. J Cereb Blood Flow Metab, 23(6), 658–664.

Smith, K. J., Wong, L. E., Eves, N. D., Koelwyn, G. J., Smirl, J. D., Willie, C. K., & Ainslie, P. N. (2012). Regional cerebral blood flow distribution during exercise: Influence of oxygen. Respir Physiol Neurobiol, 184(1), 97–105.

Veneman, T., Mitrakou, A., Mokan, M., Cryer, P., & Gerich, J. (1994). Effect of hyperketonemia and hyperlacticacidemia on symptoms, cognitive dysfunction, and counterregulatory hormone responses during hypoglycemia in normal humans. Diabetes, 43(11), 1311–1317.

Vissing, J., Andersen, M., & Diemer, N. H. (1996). Exercise-induced changes in local cerebral glucose utilization in the rat. J Cereb Blood Flow Metab, 16(4), 729–736.

Williamson, J. W., McColl, R., Mathews, D., Ginsburg, M., & Mitchell, J. H. (1999). Activation of the insular cortex is affected by the intensity of exercise. J Appl Physiol, 87(3), 1213–1219.

Willie, C. K., Cowan, E. C., Ainslie, P. N., Taylor, C. E., Smith, K. J., Sin, P. Y. W., & Tzeng, Y. C. (2011). Neurovascular coupling and distribution of cerebral blood flow during exercise. J Neurosci Methods, 198(2), 270–273.

Willie, C. K., & Smith, K. J. (2011). Fuelling the exercising brain: a regulatory quagmire for lactate metabolism. J Physiol, 589(4), 779–780.

Zobl, E. G., Talmers, F. N., Christensen, R. C., & Baer, L. J. (1965). Effect of exercise on the cerebral circulation and metabolism. J Appl Physiol, 20(6), 1289–1293.


Copyright (c) 2015 Journal of Human Sport and Exercise

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.