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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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  • English

REFERENCES

References: 

1.
Akyuz G, Sozuer DT, Turan B, Canbolat N, Yılmaz I, Us O, Kayhan O. Normative data of sympathetic skin response and RR interval variation in Turkish children. Brain Dev. 21: 99-102, 1999.
2.
Aramaki S, Kira Y, Hirasawa Y. A study of the normal values and habituation phenomenon of sympathetic skin response. Am J Phys Med Rehabil.76:2-7, 1997.
3.
Barron SA, Rogovski Z, Hemli J. Autonomic consequences of cerebral hemisphere infarction. Stroke. 25:113-116, 1994.
4.
Cheung RTF, Hachinski V. The insula and cerebrogenic sudden death. Arch Neurol 57: 1685-1688, 2000.
5.
Colivicchi F, Bassi A, Santini M, Caltagirone C. Cardiac autonomic derangement and arrhytmias in right sided stroke with insular involvement. Stroke 2004;35: 2094-2098.
6.
Colivicchi F, Bassi A, Santini M, Caltagirone C: Prognostic implications of right sided insular damage, cardiac autonomic derangement and arrhytmias after acute ischemic stroke. Stroke 2005; 36: 1710-1715.
7.
Erciyas AH, Topalkara K, Topaktas S, Akyuz A, Dener S. Supression of cardiac parasympathetic functions in patients with right hemispheric stroke. Eur J Neurol 6: 685-690, 1999.
8.
Hachinski VC, Wilson JX, Smith KE, Cechetto DF: Effect of age on autonomic and cardiac responses in a rat stroke model. Arch Neurol 49: 690-696, 1992.
9.
Karatas GK, Meray J. Sympathetic skin responses in stroke patients. J Rheum Med Rehabil 2002; 13: 41-4.
10.
Korpelainen JT, Sotaniemi KA, Huikuri HV, Myllyla VV: Circadian rhythm of heart rate variability is reversibly abolished in ischemic stroke. Stroke 28:2150-2154,1997.
11.
Korpelainen JT, Sotaniemi KA, Myllalä V.V. Ipsilateral hypohidrosis in brain stem infarction. Stroke 24: 100-104, 1993.
12.
Korpelainen JT, Sotaniemi KA, Supminen K, Tolonen U, Myllyla VV. Cardiovascular anatomic reflexes in brain infarction. Stroke 25:787-792, 1994.
13.
Korpelainen JT, Tolonen U, Sotaniemi KA, Myllyla VV: Suppressed sympathetic skin response in brain infarction. Stroke 24: 1389-1392, 1993.
14.
Laowattana S, Zeger SL. Lima JAC, Goodman SN, Wittstein LS, Oppenheimer SM. Left insular stroke is associated with adverse cardiac outcome. Neurology 66:477-483, 2006.
15.
Linden D, Berlit P. Sympathetic skin responses (SSRs) in monofocal brain lesions: topographical aspects of central sympathetic pathways. Acta Neurol Scand 91: 372-376, 1995.
16.
Mc Leod JG: Evaluation of the autonomic nervous system. In: Aminoff MJ (ed.) Electrodiagnosis in Clinical Neurology. New York, Churchill Livingstone. 421-432, 1992.
17.
Meyer S, Strittmatter M, Fischer C, Georg T, Schmitz B. Lateralization in autonomic in ischemic stroke involving the insular cortex. Neuroreport 15:357-361, 2004.
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
18.
Muslumanoglu L, Akyuz G, Aki S, Karsıdag S, Us O. Evaluation of autonomic nervous system functions in post-stroke patients. Am J Phys Med Rehabil 81:721-725, 2002.
19.
Oppenheimer SM, Cechetto DF, Hachinski VC. Cerebrogenic cardiac arrhythmias. Arch Neurol 47: 513-519, 1990.
20.
Perez-Trepichio AD,Williams JL, Block CH, Jones SC. Cardiovascular changes during focal cerebral ischemia in rats . Stroke 24: 691-696, 1993.
21.
Pitts R, Larrabee MG, Bronk DW. An analysis of hypothalamic cardiovascular control. Am J Physiol 134:359-383, 1941.
22.
Rossini PM, Opsomer RJ, Boccasena P. Sudomotor skin responses following nerve and brain stimulation. Electroenceph Clin Neurophysiol 89: 442-446, 1993.
23.
Roth EJ, Harvey RL: Rehabilitation of stroke syndromes. In: Braddom RL (ed.): Physical Medicine & Rehabilitation. Philadelphia, W.B. Saunders Company 1117-1163, 2000.
24.
Shahani BT, Day TJ, Cros D, Kahlil N, Kneebone CS. Interval variation and the sympathetic skin response in the assessment of autonomic function in peripheral neuropathy. Arch Neurol 47:659-664, 1990.
25.
Uncini A, Muzio AD, Lugaresi A, Gambi D. Sympathetic skin response in hemispheric lesions. Neurophysiol Clin 22:475-481, 1992.
26.
Zimmermann KP, Monga TN, Darouiche RO, Lawrence SA. Post-stroke autonomic nervous system function: Palmar sympathetic skin responses thirty or more days after cerebrovascular accident. Arch Phys Med Rehabil 76: 250-256, 1995.

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