Compromised dynamic cerebral autoregulation in patients with a right-to-left shunt: a potential mechanism of migraine and cryptogenic stroke.
Compromised dynamic cerebral autoregulation in patients with a right-to-left shunt: a potential mechanism of migraine and cryptogenic stroke.
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DOI：
10.1371/journal.pone.0104849
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Yang Y
中科院分区：
文献类型：
--
作者：
Guo ZN;Xing Y;Liu J;Wang S;Yan S;Jin H;Yang Y
右向左分流(RLS)与偏头痛和隐源性卒中之间的关系尚不清楚。在这项研究中，我们调查了RLS是否与动态脑自动调节(DCA)功能受损有关，DCA可能在偏头痛和隐源性中风中发挥作用。66名偏头痛患者参加了这项研究，其中包括36名非RLS患者和30名RLS患者。分别用经颅多普勒和伺服控制的血流量计同时记录患者的无创连续脑血流速度和动脉血压。通过传递函数分析，得到了增益、相位差、自调节指数等自调节参数。偏头痛合并呼吸窘迫综合征组的平均PD为50.6±22.9度，显著低于非偏头痛组的67.2±18.2度(P<；0.001)。大侧凸组的PD(45.4±2 2.6度)明显低于小侧凸组(64.9±17.1°，P<0.0 1)和非侧凸组(P<0.0 1)，而小侧凸组的PD与非侧凸组相近。永久性组PD(48.8±19.9度)与潜伏期组(52.6±26.1度)相近，均显著低于非RLS组(P<；0.05)。自动调节指数的结果与PD的结果相似。DCA在有较大RLS的偏头痛患者中受损，这可能代表了RLS、偏头痛和隐源性中风之间的潜在机制。
The relationship between right-to-left shunts (RLS) and migraine and cryptogenic stroke is not well understood. In this study, we investigated whether RLS are associated with impairment of dynamic cerebral autoregulation (dCA), which may play a role in migraine and cryptogenic stroke. Sixty-six migraineurs were enrolled in the study, including 36 non-RLS patients and 30 RLS patients. Non-invasive continuous cerebral blood flow velocity and arterial blood pressure were recorded simultaneously from each patient by using transcranial Doppler and servo-controlled plethysmograph, respectively. Transfer function analysis was applied to derive autoregulatory parameters of gain, phase difference (PD), and autoregulation index. The PD in migraineurs with RLS was 50.6±22.9 degrees, which was significantly lower than that observed in the non-RLS group (67.2±18.2 degrees, P<0.001). The PD in the large RLS group (45.4±22.6 degrees) was significantly lower than that of the small RLS group (64.9±17.1 degrees, P<0.01) and non-RLS group (P<0.001); however, the PD in the small RLS group was similar to that of the non-RLS group. The PD in the permanent group (48.8±19.9 degrees) was similar to that of the latent group (52.6±26.1 degrees), and both were significantly lower than that of the non-RLS group (P<0.05). The autoregulation index results were similar to the PD findings. dCA is impaired in migraineurs with large RLS, and this may represent a potential mechanism linking RLS, migraine, and cryptogenic stroke.
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影响因子：
8.3
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