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Related Experiment Videos

Lateralization in autonomic dysfunction in ischemic stroke involving the insular cortex.

S Meyer1, M Strittmatter, C Fischer

  • 1Department of Neurology and Pediatrics, University of the Saarland, Germany.

Neuroreport
|April 13, 2004
PubMed
Summary

Ischemic stroke can cause autonomic nervous system dysfunction. This study found right-hemisphere insular cortex strokes most severely impact cardio-autonomic function, indicating lateralization of autonomic control.

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Area of Science:

  • Neuroscience
  • Cardiology
  • Autonomic Nervous System Research

Background:

  • Autonomic nervous system (ANS) dysfunction is a frequent complication following ischemic stroke.
  • Evidence suggests hemispheric lateralization in the central control of autonomic activity.
  • The insular cortex is recognized as a key component of the central autonomic network.

Purpose of the Study:

  • To evaluate cardio-autonomic dysfunction in patients with ischemic stroke affecting the insular cortex compared to non-insular cortex.
  • To investigate potential lateralization of autonomic activity controlled by the insular cortex.
  • To determine if stroke laterality influences the severity of autonomic dysfunction.

Main Methods:

  • Prospective assessment of sympathetic function using plasma norepinephrine and epinephrine levels.

Related Experiment Videos

  • Monitoring of systolic and diastolic blood pressure and heart rate in the initial 5 days post-stroke.
  • Comparison of autonomic parameters between patients with left-hemisphere (LH) and right-hemisphere (RH) middle cerebral artery (MCA) strokes, including insular and non-insular infarction groups.

    • Main Results:

    • Sympathetic activity and cardiovascular parameters were significantly elevated in patients with insular infarction compared to non-insular infarction.
    • Pathological activation of the sympathetic nervous system was most pronounced in right-hemisphere (RH) strokes involving the insular cortex.
    • A significant difference (p < 0.05) was observed in sympathetic activity between insular and non-insular infarction groups.

    Conclusions:

    • The findings indicate hemispheric lateralization in autonomic activity, predominantly mediated by the right-sided insular cortex.
    • Patients experiencing right-hemisphere (RH) stroke with insular cortex involvement are at the highest risk for developing significant cardio-autonomic dysfunction.
    • The insular cortex plays a critical, lateralized role in regulating cardiovascular autonomic function after ischemic stroke.