Lesion configuration effect on stroke-related cardiac autonomic dysfunction.

Area of Science:

• Neuroscience
• Cardiology
• Autonomic Nervous System Research

Background:

• Autonomic nervous system (ANS) dysfunction is a frequent complication following stroke.
• The precise relationship between stroke lesion location and the manifestation of ANS malfunction remains poorly understood.

Purpose of the Study:

• To investigate the association between the anatomical location of a stroke and the resulting autonomic nervous system (ANS) malfunction.
• To specifically assess how stroke location influences cardiac rhythm control, measured by heart rate variability (HRV).

Main Methods:

• Utilized voxel-based lesion symptom mapping (VLSM) on CT scans of 25 subacute ischemic stroke patients.
• Recorded RR intervals using a heart rate monitor to analyze heart rate variability (HRV) parameters.
• Correlated lesion data with HRV metrics to identify brain regions significantly impacting cardiac autonomic function.

Main Results:

• Damage in the right hemisphere affected a wide range of cortical and subcortical structures influencing HRV.
• In the left hemisphere, only damage to specific subcortical areas significantly impacted HRV.
• Voxel-based lesion symptom mapping revealed distinct patterns of cerebral control for different HRV measures (SDNN and RMSSD).

Conclusions:

• Stroke location critically influences autonomic nervous system (ANS) control of cardiac rhythm.
• The right hemisphere appears more broadly involved in cardiac autonomic regulation post-stroke compared to the left.
• Different HRV parameters exhibit varying sensitivities to focal brain damage, highlighting complex neural control mechanisms.