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Dynamic cerebral autoregulation is heterogeneous in different subtypes of acute ischemic stroke

Zhen-Ni Guo1, Jia Liu2, Yingqi Xing3

  • 1Neuroscience Center, Department of Neurology, the First Norman Bethune Hospital of Jilin University, Chang Chun, China.

Plos One
|March 28, 2014
PubMed

Insights

Dynamic cerebral autoregulation (dCA) differs between stroke subtypes. Large-artery atherosclerosis stroke impairs dCA in the affected hemisphere, while small-artery occlusion stroke affects both hemispheres.

Area of Science:

  • Neurology
  • Cerebrovascular Medicine
  • Physiology

Background:

  • Stroke is classified into subtypes like large-artery atherosclerosis and small-artery occlusion.
  • These stroke subtypes may have distinct effects on dynamic cerebral autoregulation (dCA).
  • Understanding these differences is crucial for clinical management and outcomes.

Purpose of the Study:

  • To investigate and compare the patterns of dCA in patients with large-artery atherosclerosis stroke versus small-artery occlusion stroke.
  • To assess how these stroke subtypes differentially impact cerebral blood flow regulation.

Main Methods:

  • Enrolled 41 patients with acute middle cerebral artery (MCA) territory stroke (15 large-artery atherosclerosis, 26 small-artery occlusion) and 20 healthy controls.
  • Utilized non-invasive transcranial Doppler and finger plethysmography for continuous monitoring of cerebral blood flow velocity and blood pressure.
  • Applied transfer function analysis to calculate dCA parameters, including phase difference (PD) and slope of step response.

Main Results:

  • In large-artery atherosclerosis stroke, the affected hemisphere showed significantly reduced phase difference (PD) compared to the unaffected hemisphere and healthy controls.
  • In small-artery occlusion stroke, both hemispheres exhibited significantly lower PD compared to healthy controls, with no significant difference between the affected and unaffected sides.
  • Results for the slope of step response corroborated the findings observed for PD.

Conclusions:

  • Dynamic cerebral autoregulation is heterogeneous across different subtypes of acute ischemic stroke.
  • Variations in dCA patterns may stem from the distinct pathological changes in cerebral blood vessels associated with each stroke subtype.
Abstract

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