脑静脉窦血栓形成患者的动态脑自动调节功能受损：经颅多普勒和默读刺激评估。
Impaired Dynamic Cerebral Autoregulation in Patients With Cerebral Venous Sinus Thrombosis: Evaluation Using Transcranial Doppler and Silent Reading Stimulation.
机构信息
Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China.
出版信息
Ultrasound Med Biol. 2023 Oct;49(10):2221-2226. doi: 10.1016/j.ultrasmedbio.2023.07.009. Epub 2023 Aug 1.
OBJECTIVE
Cerebral venous sinus thrombosis (CVST) may impair dynamic cerebral autoregulation (dCA) of the middle cerebral artery (MCA). However, most studies have focused on dCA of the MCA; a few studies are based on the posterior cerebral artery (PCA) during silent reading and neurovascular coupling (NVC). This study explored the effects of CVST on dCA of the MCA and PCA during silent reading and NVC.
METHODS
From January 2021 to August 2022, 60 CVST patients and 30 controls were enrolled in this study. Non-invasive continuous beat-to-beat blood pressure, cerebral blood flow velocity and other associated information on the MCA and PCA during silent reading were collected using a transcranial Doppler. NVC assessment was performed by opening and closing the eyes periodically based on voice prompts, and eye-opening visual stimulation was achieved by silently reading Chinese tourism materials. Visual stimulation signals can selectively activate Brodmann's areas 17, 18, and 19 of the occipital when reading silently with open eyes, prompting them to release neurotransmitters and dilate PCA. dCA was determined by transfer function analysis.
RESULTS
In dCA of the PCA during silent reading, the CVST group's very low frequency phase was lower than that of the control group (p = 0.047). In NVC, the difference in the indexes of the cerebrovascular conductance and visually evoked flow response of the CVST group were lower than those of the control group (p = 0.017 and p = 0.019, respectively).
CONCLUSION
Compared with the control group, dCA and NVC of the PCA during silent reading were impaired in CVST patients.
目的
脑静脉窦血栓形成（CVST）可能会损害大脑中动脉（MCA）的动态脑自动调节（dCA）。然而，大多数研究都集中在 MCA 的 dCA 上；少数研究基于安静阅读和神经血管耦合（NVC）期间的后大脑动脉（PCA）。本研究探讨了 CVST 对安静阅读和 NVC 期间 MCA 和 PCA 的 dCA 的影响。
方法
本研究纳入了 2021 年 1 月至 2022 年 8 月的 60 例 CVST 患者和 30 例对照者。使用经颅多普勒超声仪采集安静阅读期间 MCA 和 PCA 的无创连续逐搏血压和脑血流速度等相关信息。通过周期性开闭眼睛根据语音提示进行 NVC 评估，通过安静阅读中文旅游材料实现睁眼视觉刺激。安静阅读时睁眼，视觉刺激信号可以选择性地激活枕叶的布罗德曼 17、18 和 19 区，促使它们释放神经递质并扩张 PCA。通过传递函数分析确定 dCA。
结果
在安静阅读期间的 PCA 的 dCA 中，CVST 组的极低频相位低于对照组（p=0.047）。在 NVC 中，CVST 组的脑血管传导和视觉诱发血流反应指标的差异低于对照组（p=0.017 和 p=0.019）。
结论
与对照组相比，CVST 患者安静阅读期间的 PCA 的 dCA 和 NVC 受损。
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