Guo Zhen-Ni, Xing Yingqi, Wang Shuang, Ma Hongyin, Liu Jia, Yang Yi
Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Chang Chun, China.
Center for Neurovascular ultrasound, the First Hospital of Jilin University, Chang Chun, China.
Sci Rep. 2015 Oct 15;5:15269. doi: 10.1038/srep15269.
Cerebral small vessel disease is a major cause of stroke and vascular dementia; however, the pathogenesis is largely unclear. In this study, we investigated the characteristics of the impairment of dynamic cerebral autoregulation (dCA) in lacunar infarction patients. Seventy-one lacunar infarction patients were enrolled in the study, including 46 unilateral middle cerebral artery (MCA) territory stroke patients and 25 unilateral posterior cerebral artery (PCA) territory stroke patients. Each group of patients was randomly divided into two subgroups. Group 1 underwent dCA assessments in the bilateral MCAs, and Group 2 underwent dCA assessments in the bilateral PCAs. All patients were followed up for 6 months. Transfer function analysis was applied to derive the autoregulatory parameters of gain and phase difference. In the unilateral MCA territory stroke patients, impairments of dCA were observed in both the MCAs and PCAs, and the same results were observed in the unilateral PCA territory stroke patients. These impairments remained unchanged during the 6-month follow-up. In lacunar infarction, which is most prevalent type of cerebral small vessel disease, though patients with unilateral MCA territory/PCA territory stroke, the impairments of dCA were global and sustained. This finding suggests that the physiological changes associated with lacunar infarction were diffuse.
脑小血管病是中风和血管性痴呆的主要原因；然而，其发病机制在很大程度上尚不清楚。在本研究中，我们调查了腔隙性梗死患者动态脑自动调节（dCA）受损的特征。71例腔隙性梗死患者纳入研究，包括46例单侧大脑中动脉（MCA）区域卒中患者和25例单侧大脑后动脉（PCA）区域卒中患者。每组患者随机分为两个亚组。第1组在双侧MCA进行dCA评估，第2组在双侧PCA进行dCA评估。所有患者随访6个月。应用传递函数分析得出增益和相位差的自动调节参数。在单侧MCA区域卒中患者中，MCA和PCA均观察到dCA受损，单侧PCA区域卒中患者也观察到相同结果。这些损伤在6个月的随访期间保持不变。在脑小血管病最常见的类型腔隙性梗死中，尽管是单侧MCA区域/PCA区域卒中患者，dCA的损伤是全身性且持续的。这一发现表明与腔隙性梗死相关的生理变化是弥漫性的。
