CARDIOVASCULAR EFFECTS OF HUMAN INSULAR CORTEX STIMULATION
CARDIOVASCULAR EFFECTS OF HUMAN INSULAR CORTEX STIMULATION
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DOI：
10.1212/wnl.42.9.1727
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发表时间：
1992-09-01
期刊：
影响因子：
9.9
通讯作者：
HACHINSKI, VC
中科院分区：
文献类型：
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作者：
OPPENHEIMER, SM;GELB, A;HACHINSKI, VC
最近的调查表明，在大鼠的左岛叶皮质内的心脏代表的网站。此外，病变研究的结果表明，交感心血管效应的左侧岛屿优势。目前还不清楚人类岛叶皮层中是否存在类似的表达。5例癫痫患者在颞叶切除术前接受了术中岛叶刺激以控制癫痫发作。刺激左侧岛叶皮质，心动过缓和降压反应比心动过速和升压反应更常见（P < 0.005）。右侧岛叶皮质则相反。我们相信这是第一次证明在人类岛叶刺激过程中引起的心血管变化，以及皮层部位这种反应的偏侧化。与大鼠不同，人类的交感神经效应似乎存在右侧优势。这些发现可能与预测人类中风的自主神经效应和解释突发意外癫痫死亡有关。
Recent investigations indicate a site of cardiac representation within the left insular cortex of the rat. Moreover, the results of lesion studies suggest left-sided insular dominance for sympathetic cardiovascular effects. It is unclear whether similar representation exists within the human insular cortex. Five epileptic patients underwent intraoperative insular stimulation prior to temporal lobectomy for seizure control. On stimulation of the left insular cortex, bradycardia and depressor responses were more frequently produced than tachycardia and pressor effects (p < 0.005). The converse applied for the right insular cortex. We believe this to be the first demonstration of cardiovascular changes elicitable during insular stimulation in humans, and of lateralization of such responses for a cortical site. In humans, unlike the rat, there appears to be right-sided dominance for sympathetic effects. These findings may be of relevance in predicting the autonomic effects of stroke in humans and in the explanation of sudden unexpected epileptic death.