Spontaneous Low Frequency Oscillations in Acute Ischemic Stroke - A Near Infrared Spectroscopy (NIRS) Study
Spontaneous Low Frequency Oscillations in Acute Ischemic Stroke - A Near Infrared Spectroscopy (NIRS) Study
复制标题
急性缺血性中风中的自发低频振荡 - 近红外光谱 (NIRS) 研究
DOI：
10.4172/2155-9562.1000241
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
M. Ashina
中科院分区：
文献类型：
--
作者：
Dorte Phillip;H. Schytz;H. Iversen;J. Selb;D. Boas;M. Ashina
背景和目的：连续波近红外光谱(NIRS)是一种无创的床边光学方法，用于检测大脑皮层最外层的氧合和脱氧血红蛋白的变化。在0.09-0.11赫兹范围内的皮层氧合血红蛋白低频振荡(LFO)受到大脑自动调节(CA)变化的影响，而大脑自动调节(CA)在中风后会改变。在接受或不接受重组组织型纤溶酶原激活剂溶栓治疗的卒中患者中，我们在床边检测氧合Hb LFO作为CA亚急性期的标志物。方法：我们招募了29名有缺血性中风症状的卒中病房入院患者。29例中有11例接受了溶栓治疗。NIRS检查是在卒中发病后2天(中位时间)进行的。在头部两侧放置近红外光管，源-探测器距离为3 cm。利用传递函数分析方法，对0.09-0.11赫兹范围内的氧合血红蛋白振荡的半球间相移和幅度比进行了评估。结果：入院时NIHSS评分与氧合Hb参数呈显著正相关(P=0.028)，入院时卒中严重程度与大脑半球相移呈正相关。接受溶栓治疗的患者氧合血红蛋白的绝对半球间相移明显小于未溶栓治疗的患者(3°vs 23°，P=0.005)。结论：卒中严重程度与皮质CA受损程度相关，接受溶栓治疗的卒中患者CA受损程度可能较轻。NIRS检测亚急性期卒中患者大脑半球间皮质氧合Hb-LFO的变化，可能是探讨卒中单元床边变化的一种可行的方法。
Background and purpose: Continuous wave near infrared spectroscopy (NIRS) is a non-invasive bed-side optical method to detect changes in oxygenated (oxyHb) and deoxygenated hemoglobin (deoxyHb) in the outermost layers of the cerebral cortex. Cortical oxyHb low frequency oscillations (LFOs) in the 0.09-0.11 Hz range are affected by changes in cerebral autoregulation (CA), which is altered following stroke. We examined oxyHb LFOs at bed-side as a marker of CA in the subacute phase in stroke patients with or without recombinant tissue plasminogen activator thrombolytic therapy. Methods: We recruited 29 patients admitted to the stroke unit with symptoms of ischemic stroke. 11/29 patients received thrombolytic therapy. NIRS examination was conducted 2 days (median time) from stroke onset. NIRS optodes were placed on each side of the head with a 3 cm source-detector distance. Using transfer function analysis, inter-hemispheric phase shift and amplitude ratio of the oxyHb oscillations in the 0.09-0.11 Hz range were assessed. Results: The correlation between NIHSS scores at admission and oxyHb parameters revealed a significant positive correlation between stroke severity at admission and inter-hemispheric phase shift (P=0.028). The oxyHb absolute inter-hemispheric phase shift was significantly less in patients receiving thrombolytic therapy compared to non-thrombolytic therapy patients (3 ° vs. 23 ° , P=0.005). Conclusions: Stroke severity correlates with the degree of impaired cortical CA and stroke patients receiving thrombolytic therapy might have less severely impaired CA. NIRS detects alteration in cortical oxyHb LFOs between hemispheres in stroke patients in the subacute phase and may be a feasible method to explore changes at bed-side in a stroke unit.