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İNMELİ HASTALARDA OTONOMİK FONKSİYONLAR: VASKÜLER TUTULUMUN YERİ İLE KARŞILAŞTIRMA

AUTONOMIC FUNCTIONS IN PATIENTS WITH STROKE: A COMPARISON WITH LOCATION OF VASCULAR INSULT

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: We aimed to investigate sympathetic and parasympathetic nervous system functions in patients with stroke and to correlate with localization of vascular insults. Materials and methods: Sympathetic skin response (SSR) of both upper extremity and RR interval variation (RRIV) during rest and deep breathing were recorded in 56 patients with stroke and 42 healthy volunteers. Results: The mean latency of SSR of either side in patients with stroke (both in affected side and unaffected side) significantly prolonged as compared to those in controls (p<0.05). Mean amplitudes of the responses of either extremity in patients with stroke (0.8±0.6 mV in affected side, 0.9±0.8 mV in unaffected side) were significantly smaller than in controls (1.4±0.9 mV) (p<0.001, p<0.01). RRIV during rest in patients compared to controls were 30.97± 27.99 versus 16.5±5.1 and during deep breathing were 34.2±25.2 versus 19.9±8.6 (p<0.05). Based on the localization of infarcts, lesions were classified as hemispheric (n=46) and brain stem (n=10). Patients with hemispheric lesions had significantly increased latencies (p<0.05) and depressed amplitudes (p<0.001), increased RRIV at rest (p<0.001) and during hyperventilation (p<0.001) as compared to controls. RRIV during rest and during deep breath were both higher in the right-sided cortical lesions than left sided cortical lesions (p<0.05, p<0.01). Increased SSR latencies from affected hands and decreased amplitudes from non-affected hands of brain stem lesions recorded than controls’ (p<0.05). Conclusion: As a result, vascular insults of cerebrum, mainly right-sided cortical structures affect sympathetic and parasympathetic functions. Brain stem vascular lesions were characterized by involvement of sympathetic reflex activity.
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Abstract (Original Language): 
Amaç: ÇalıĢmamızın amacı; inmeli hastaların sempatik ve parasempatik sistem fonksiyonlarını araĢtırmak ve vasküler tutulumun yeri ile iliĢkisini incelemekti. Gereç ve yöntem: Her iki üst ekstremitenin sempatik deri yanıtı (SSR) ve RR interval varyasyonları (RRIV) inmeli 56 hasta ve 42 sağlıklı gönüllüde istirahat ve derin nefes sırasında kayıt edildi. Bulgular: Ġnmeli hastaların her iki (etkilenen ve etkilenmeyen) tarafının ortalama SSR latansları kontrollerinki ile karĢılaĢtırıldığında anlamlı olarak uzamıĢtı (p<0,05). Ġnmeli hastaların her iki ekstremitesinden elde edilen ortalama amplitüdler (0,8±0,6 mV etkilenen, 0,9±0,8 mV etkilenmeyen) kontrollerden anlamlı olarak daha küçüktü (1,4 ±0,9 mV) (p<0,001, p<0,01). Hastalarda istirahatte RRIV’ler kontrollerle karĢılaĢtırıldığında 30,97± 27,99 karĢı 16,5±5,1 ve derin nefes alma ile 34,2±25,2 karĢı 19,9±8,6 idi (p<0,05). Ġnfarkt lokalizasyonuna göre lezyonlar hemisferik (n=46) ve beyin sapı olarak sınıflandı (n=10). Hemisferik lezyonlu hastaların kontroller ile karĢılaĢtırıldığında anlamlı olarak artmıĢ latansları vardı (p<0,05) ve amplitüdleri düĢüktü (p<0,001), istirahat (p<0,001) ve hiperventilasyon sırasında (p<0,001) RRIV artmıĢtı. Ġstirahat ve derin nefes ile RRIV’nin her ikisi sağ taraf kortikal lezyonlarında sol taraf kortikal lezyonlarından daha yüksekti (p<0,05, p<0,01). Beyin sapı lezyonlarının etkilenen ellerinden artmıĢ SSR latansları ve etkilenmeyen ellerinden azalmıĢ amplitüdleri kontrollere göre kayıt edilmiĢtir (p<0,05). Sonuç: Sonuç olarak beyin damar tutulumlarında esas olarak sağ taraf kortikal lezyonları sempatik ve parasempatik fonksiyonları etkilendi. Beyin sapı vasküler lezyonları sadece sempatik refleks aktivitenin tutulumu ile karakterize idi.
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69-73
  • English

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Autonomic functions in patients with stroke
İstanbul Tıp Fakültesi Dergisi Cilt / Volume: 73 • Sayı / Number: 3 • Yıl/Year: 2010
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İnmeli hastalarda otonomik fonksiyonlar
İstanbul Tıp Fakültesi Dergisi Cilt / Volume: 73• Sayı / Number: 3 • Yıl/Year: 2010
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