From the Stroke Program (D.L.B., R.H., M.C., L.D.L.), Sleep Disorders Center (R.D.C.), EMG Laboratory, Department of Neurology (J.W.), and School of Public Health (L.D.L.), University of Michigan, Ann Arbor; and EMG Laboratory (K.L.G.), Department of Neurology, SUNY Upstate, Syracuse, NY.
Neurology. 2014 Apr 1;82(13):1149-52. doi: 10.1212/WNL.0000000000000263. Epub 2014 Feb 28.
This cross-sectional study of acute ischemic stroke patients examined relationships between hypoglossal nerve conduction, sleep-disordered breathing (SDB), and its severity.
Patients within 7 days of stroke underwent nocturnal respiratory monitoring with the ApneaLink device and hypoglossal nerve conduction studies.
Eighteen of 52 subjects (35% [95% confidence interval: 22%, 49%]) had an abnormal hypoglossal amplitude and 23 (44% [95% confidence interval: 30%, 59%]) had an abnormal hypoglossal latency. No differences were identified in hypoglossal nerve latency or amplitude between those with (n = 26) and without (n = 26) significant SDB, defined by an apnea-hypopnea index ≥ 15. However, hypoglossal nerve conduction latency was associated (linear regression p < 0.05) with SDB severity as reflected by the apnea-hypopnea index.
Acute ischemic stroke patients have a high prevalence of hypoglossal nerve dysfunction. Further studies are needed to explore whether hypoglossal nerve dysfunction may be a cause or consequence of SDB in stroke patients and whether this association can provide further insight into the pathophysiology of SDB in this population.
本研究通过对急性缺血性脑卒中患者进行横断面研究,探讨舌下神经传导、睡眠呼吸障碍(SDB)及其严重程度之间的关系。
在脑卒中发生后 7 天内,对患者进行夜间呼吸监测,并使用 ApneaLink 设备进行舌下神经传导研究。
52 名受试者中有 18 名(35%[95%置信区间:22%,49%])存在异常的舌下神经振幅,23 名(44%[95%置信区间:30%,59%])存在异常的舌下神经潜伏期。在存在(n = 26)和不存在(n = 26)显著 SDB(定义为呼吸暂停低通气指数≥15)的患者中,舌下神经潜伏期或振幅没有差异。然而,舌下神经传导潜伏期与 SDB 严重程度呈相关(线性回归 p<0.05),反映为呼吸暂停低通气指数。
急性缺血性脑卒中患者存在较高的舌下神经功能障碍发生率。需要进一步研究探讨舌下神经功能障碍是否可能是脑卒中患者 SDB 的原因或后果,以及这种关联是否能为该人群 SDB 的病理生理学提供进一步的认识。