Ogawa M, Fukuyama H, Harada K, Kimura J
Department of Neurology, Faculty of Medicine, Kyoto University, Japan.
J Neurol Sci. 1998 Jun 30;158(2):173-9. doi: 10.1016/s0022-510x(98)00117-8.
To investigate the role of the autonomic nervous system in cerebral blood flow (CBF) and metabolism, CBF and oxygen metabolism in patients with multiple system atrophy of the Shy-Drager syndrome type were examined. Seven patients with Shy-Drager syndrome were imaged using positron emission tomography and 15O-labeled gases. There was excellent local coupling between CBF and the cerebral metabolic rate of oxygen in the resting state. Elevation of blood pressure induced by leg raising increased CBF. The inhalation of CO2 also increased CBF in the Shy-Drager patients. These results showed that autoregulation is impaired in Shy-Drager syndrome, but local metabolic-flow coupling in the resting state and the CBF response to CO2 inhalation are spared. We conclude that the autonomic nervous system plays an important role in autoregulation, but not in local metabolic-flow coupling in the resting state. We suggest that metabolic mechanisms may mediate resting metabolic-flow coupling.
为研究自主神经系统在脑血流量（CBF）和代谢中的作用，对夏伊-德雷格综合征型多系统萎缩患者的CBF和氧代谢进行了检查。使用正电子发射断层扫描和15O标记气体对7例夏伊-德雷格综合征患者进行成像。在静息状态下，CBF与脑氧代谢率之间存在良好的局部耦合。抬腿引起的血压升高使CBF增加。吸入二氧化碳也使夏伊-德雷格患者的CBF增加。这些结果表明，夏伊-德雷格综合征患者的自动调节功能受损，但静息状态下的局部代谢-血流耦合以及对吸入二氧化碳的CBF反应未受影响。我们得出结论，自主神经系统在自动调节中起重要作用，但在静息状态下的局部代谢-血流耦合中不起作用。我们认为代谢机制可能介导静息代谢-血流耦合。
