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Autonomic dysfunction in different subtypes of post-acute ischemic stroke
L Xiong1, H W Leung1, X Y Chen1
1Department of Medicine & Therapeutics, Chinese University of Hong Kong, Hong Kong, China.
Journal of the Neurological Sciences
|December 12, 2013
Summary
Post-stroke patients frequently experience autonomic dysfunction, particularly a parasympathetic cardiac deficit. Cardiovascular autonomic impairment is more severe in large-artery atherosclerosis stroke subtypes compared to small-vessel occlusion.
Area of Science:
- Neurology
- Cardiology
- Autonomic Neuroscience
Background:
- Central autonomic impairment is a common complication following ischemic stroke.
- The precise mechanisms underlying autonomic dysfunction post-stroke remain unclear.
- Investigating cardiovascular autonomic function across different ischemic stroke subtypes is crucial.
Purpose of the Study:
- To evaluate cardiovascular autonomic function in patients with different post-acute ischemic stroke subtypes.
- To compare autonomic function between large-artery atherosclerosis (LAA) and small-vessel occlusion (SVO) stroke patients.
- To identify specific patterns of autonomic impairment in relation to stroke etiology.
Main Methods:
- Recruited 77 ischemic stroke patients (50 LAA, 27 SVO) and 37 elderly controls.
- Administered Ewing's battery autonomic function tests.
- Performed power spectral analysis of heart rate variability (HRV).
Main Results:
- Stroke patients (LAA and SVO) exhibited significantly lower low-frequency power spectral density compared to controls.
- Autonomic dysfunction prevalence was higher in LAA (82.0%) and SVO (63.0%) groups versus controls (21.6%).
- LAA patients showed greater impairment in parasympathetic and sympathetic functions than SVO patients.
Conclusions:
- Post-acute ischemic stroke patients, regardless of subtype, demonstrate a parasympathetic cardiac deficit.
- Cardiovascular autonomic modulation, both parasympathetic and sympathetic, is more significantly impaired in LAA stroke patients.
- Findings highlight the impact of stroke etiology on autonomic nervous system recovery.
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