{Reference Type}: Journal Article
{Title}: Link between cerebral blood flow and autonomic function in survivors of internal carotid artery occlusion.
{Author}: Chang YT;Chang WN;Tsai NW;Huang CC;Wang HC;Kung CT;Su YJ;Lin WC;Chang HW;Cheng BC;Su CM;Chiang YF;Lu CH;
{Journal}: J Neurol Sci
{Volume}: 353
{Issue}: 1
{Year}: 2015
{Factor}: 4.553
{DOI}: 10.1016/j.jns.2015.04.035
{Abstract}: <B>OBJECTIVE: </B>Symptomatic internal carotid artery occlusion (ICAO) is an important cause of cerebral ischemia with poor long-term outcome. Reductions in baroreflex function is reported in carotid atherosclerosis and implicated in increased risk of recurrent cardiovascular events. A distributed network of forebrain regions can exert modulatory influences over the cardio-vagal and baroreflex functions. The successful clinical translation of these approaches offers insights into underlying modulatory mechanisms and to possible therapeutic strategy.<BR><B>METHODS: </B>This study enrolled 20 symptomatic ICAO survivors, 20 patients with small vessel disease (SVD) as risk control, and 20 healthy controls. All underwent a standardized evaluation of cardiovascular autonomic function testing that included baroreflex sensitivity (BRS), Valsalva ratio (VR), and heart rate response to deep breathing (HR_DB). The regional cerebral blood flow (rCBF) of the central autonomic network (CAN) was obtained from arterial spin-labeling magnetic resonance imaging. Parameters of autonomic function between symptomatic ICAO survivors with and those without recurrent cardiovascular events were compared.<BR><B>RESULTS: </B>Valsalva ratio and HR_DB levels were significantly higher in the control group, followed by the SVD and ICAO groups (p=0.009 and p=0.007, respectively). Spontaneous BRS and BRS during the early phase II of Valsalva maneuver levels were both significantly higher in the control group, followed by the SVD and ICAO groups (p<0.001 and p=0.042, respectively). The rCBF of CAN inversely correlated with spontaneous BRS.<BR><B>CONCLUSIONS: </B>Autonomic dysregulation, including reduced BRS and impaired cardio-vagal function in the convalescent stage ICAO, can persist for a long time. Reduced BRS is inversely correlated with CAN activity.