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Asymmetrical changes in cerebral blood oxygenation induced by an active standing test in children with postural
Yayumi Kamiyama1, Yukihiko Fujita2, Tatsuo Fuchigami2
1Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan. kyayuyayu@yahoo.co.jp.
Insights
Near-infrared spectroscopy revealed asymmetric frontal cortex activity in children with postural tachycardia syndrome (POTS). Left frontal cortex oxygenated hemoglobin (oxy-Hb) decreased more, suggesting right-sided activation influences sympathetic nervous system activity.
Area of Science:
- Neuroscience
- Pediatrics
- Biomedical Engineering
Background:
- Orthostatic intolerance, including postural tachycardia syndrome (POTS), affects autonomic nervous system function in children.
- Near-infrared spectroscopy (NIRS) is a non-invasive tool for monitoring cerebral hemodynamics.
Purpose of the Study:
- To investigate the relationship between frontal cortex activity asymmetry and autonomic nervous system function in Japanese children with POTS.
- To compare changes in oxygenated hemoglobin (oxy-Hb) in the right and left frontal cortices during an active standing test.
Main Methods:
- Utilized near-infrared spectroscopy (NIRS) to measure oxygenated hemoglobin (oxy-Hb) levels.
- Enrolled 23 Japanese children (aged 7-16 years) diagnosed with postural tachycardia syndrome (POTS).
- Assessed changes in frontal cortex oxy-Hb during an active standing test.
Main Results:
- Oxygenated hemoglobin (oxy-Hb) levels decreased in the frontal cortex during the active standing test.
- Observed significant asymmetry in oxy-Hb changes between the right and left frontal cortices.
- A notably larger decrease in oxy-Hb was recorded in the left frontal cortex compared to the right.
Conclusions:
- Asymmetrical frontal cortex activity, specifically greater reduction in left frontal oxy-Hb, is associated with POTS in children.
- This asymmetry may indicate right frontal cortex activation, leading to sympathetic nervous system overactivity and tachycardia in POTS.
- NIRS can help elucidate the neurophysiological mechanisms underlying POTS in pediatric populations.
Abstract:
Near-infrared spectroscopy enables recognition of various brain conditions based on certain factors, such as oxygenated hemoglobin (oxy-Hb). Since July 2012, we have been trying to determine the mechanisms of autonomic function in Japanese children with orthostatic intolerance (also called orthostatic dysregulation) in Nihon University Itabashi Hospital in Tokyo, Japan. A total of 23 children aged 7-16 years diagnosed with postural tachycardia syndrome (POTS), a subtype of orthostatic dysregulation, were enrolled in the study. We evaluated the relation between asymmetry in frontal cortex activity and the automatic nervous system and compared oxy-Hb changes in the right and left frontal cortices during an active standing test. We observed that during active standing oxy-Hb decreased in the frontal cortex. The oxy-Hb changes were asymmetrical, with a significantly larger decrease in the left frontal cortex than in the right frontal cortex, suggesting that tachycardia during active standing in POTS patients might be caused by activation of the right frontal cortex, which induces sympathetic nervous system activity.
