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Background@#and Purpose By measuring a newly defined parameter, the carotid–cerebral pulse wave velocity (ccPWV), this study aimed to determine the association of intracranial artery calcification (IAC) with arterial stiffness as reflected by the pulse wave velocity between the carotid and middle cerebral arteries using transcranial Doppler sonography in patients with acute stroke. @*Methods@#We recruited 146 patients with ischemic stroke from our stroke center. Computed tomography of the head was used to assess the presence and severity of IAC. Arterial stiffness was evaluated using ccPWV. Data are presented as quartiles of ccPWV. A multivariable logistic regression model was used to assess the independent relationship between ccPWV and IAC. @*Results@#The IAC prevalence increased with the ccPWV quartile, being 54%, 76%, 83%, and 89% for quartiles 1, 2, 3, and 4, respectively (p<0.001) as did IAC scores, with median [interquartile range] values of 0 [0–2], 3 [2–4], 4 [2–5], and 5 [4–6], respectively (p<0.001). After additionally adjusting for age and hypertension, a significant correlation was only found between quartiles 3 and 4 of ccPWV and IAC scores. The odds ratio (95% confidence interval) for the IAC scores was 1.78 (1.28–2.50) (p=0.001) in quartile 4 of ccPWV and 1.45 (1.07–1.95) (p=0.015) in quartile 3 compared with quartile 1. @*Conclusions@#We found that in patients with acute ischemic stroke, ccPWV was positively related to the degree of IAC. Future longitudinal cohort studies may help to identify the potential role of IAC in the progression of cerebral arterial stiffness.
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Objective To investigate the correlation of lacune of presumed vascular origin and microalbu-minuria in elderly inpatients. Methods 237 elderly patients (184 males and 53 females) at Guangzhou First People's Hospitalwho aged from 70 to 94 years old with a median age of 83.92 ± 5.32 were included in this study. We collected data on age,gender,medical history,smoking history,renal function test,blood lipid test,C-reactive protein,microalbuminuria,cerebral MR. Logistic regression was conducted to analyze all the data. Based on the MR findings ,the patients were divided into two groups:a group with lacune of presumed vascular origin (132 patients)and a control group(105 patients). Results The group with lacune of presumed vascular origin had higher mean systolic blood pressure than the control group. Median MAU was higher in the groupwith lacune of presumed vascular origin.Single factor or multiple factors logistic regression showed that increased systolic blood pressure and positive rates of MAU and MAU were independent risk factors for lacune of presumed vascular origin and were also significantly associated with the severity of lacune of presumed vascular origin. Conclusion Microalbuminuria is significantly associated with lacune of presumed vascular origin in elderly patients.
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Objective To explore the clinical features,electroneurophysiology,neuroimaging and gene characteristics of one juvenile dentatorubral-pallidoluysian atrophy (DRPLA) pedigree with an onset of epilepsy.Methods The clinical data of the elder sister and younger brother in a family with juvenile DRPLA were collected.Furthermore,their clinical manifestations,electroneurophysiology results,neuroimaging characteristics and atrophin-1 gene CAG repeat numbers were detected and analyzed in detail.Results There were four patients in this family in total.The probands were two siblings,and they both had the onset manifestation of epilepsy.The younger brother had frequently epileptic seizure,marked cerebellar ataxia,involuntary movement and mental retardation.Compared with her younger brother,the sister had light symptoms such as mild memory deterioration without ataxia and involuntary movement,and she could undertake some simple work.The spike wave and sharp wave complex can be detected in electroencephalogram (EEG) examination,the cortical center segment lesions pathological changes were revealed in somatosensory evoked potentials (EP),and the latency period of P300 was prolonged in the both siblings.Magnetic resonance imaging (MRI) showed that the younger brother had marked atrophies in the cerebral cortex,brainstem and cerebellum.Furthermore,MRI showed that the elder sister had only mild atrophies in the cerebral cortex,brainstem and cerebellum,and that on the contrary some abnormally high signals were observed in cerebral cortex but not white matter.DRPLA gene detection revealed that the numbers of CAG repeats were 15/68 (the younger brother) and 15/64 (the elder sister),respectively.Conclusions Epilepsy,especially the myoclonus,is a common clinical manifestation for juvenile DRPLA,and many other types of epileptic seizures may arise with the development of DRPLA.DRPLA has diverse clinical heterogeneity.EEG,EP and brain MRI examination are great for DRPLA diagnosis and differential diagnosis,and the specific gene detection can be helpful for a definitive diagnosis.
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Objective To investigate the hemodynamic parameters to stabilize cerebral blood flow within limits of cerebral autoregualtion. Methods We assessed the flow velocity of middle cerebral artery using transcranial Doppler and recorded invasively the blood pressure simultaneously. We then analyzed the curves of cerebral blood flow autoregulation (CBFA) and calculated upper limit of autoregulation (ULA) and lower limit of autoregulation (LLA). The values of critical closing pressue (CCP) and resistance area product (RAP) were calculated according to previous theory. The relationship between CCP, RAP and MABP were analyzed. Results In the process of increasing or decreasing blood pressure, ULA and LLA of normal rats were 148.12 ± 7.49 mmHg or 62.96 ± 3.34 mmHg, respectively. When mean artery blood pressue (MABP) changed within limits of cerebral autoregulation, the cerebral blood flow velocity changed little (increasing:0.65± 0.27 cm/s/10mmHg MABP, decreasing:0.43±0.23cm/s/10 mmHg MABP), while CCP and RAP changed significantly (in?creasing: 4.60 ± 1.06 mmHg/10mmHg MABP and 0.11 ± 0.04/10 mmHg MABP, decreasing: 6.74 ± 0.59 mmHg/10 mmHg MABP and 0.09 ± 0.02/10mmHg MABP). After fixing change of blood flow velocity, CCP and RAP were correlated with MABP more remarkablely, although all blood flow velocity, CCP and RAP were significantly correlated with MABP. Conclusion Within limits of cerebral autoregulation, stable cerebral blood flow is mainly achieved by the change of CCP and RAP against blood pressure changing on normal rats, especially the increasing or de?creasing of CCP.
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Objective The anti-amyloidogenic effects of Curcumin had been clearly certified, Whether the anti-amyliodogenic effects were mediated through the modulation of BACE1 activity was addressed. Methods SwAPP-HEK293 cells were incubated for 24h without or with 5μM curcumin mix, Cur, DMC and BDMC respectively, then the cells were collected for the cell viability evaluation by using MTT analysis and for the BACE1 activity evaluation by theβ-Secretase Activity Fluorometric Assay Kit. Results The cell viability of swAPPHEK293 cells was unchanged after cur-cuminoids incubation; All of Curcumin mix, Cur, DMC and BDMC could decreased the BACE1 activity, Cur was the most active in suppressing BACE1 activity, and the inhibition strength of others in order was DMC>COM>BDMC. Con-clusion This paper indicate that the anti-amyloidogenic effects of curcumin mix,Cur ,DMC,BDMC may be through the in-hibition of BACE1 activity.
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cerebral small vessel disease refers to the small vessel lesion and the resulting changes in the cerebral tissue.Both the small vessels detected by cerebrovascular reserve and the lesion of cerebral small vessel disease are in the same segment,so we can take advantage of cerebrovascular reserve as means to inspect and evaluate the small vessel lesion itself.
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Objective To investigate the correlation between the measurement methods of carotidcerebral pulse wave velocity (ccPWV) and the traditional method of brachial-ankle pulse wave velocity (baPWV).Methods A total of 136 healthy volunteers were divided into a youth group (20-39 years),a middleaged group (40-59 years),and an elderly group (more than 60 years) according to their ages.While detecting baPWV,transcranial Doppler ultrasound was used to simultaneously monitor the ipsilateral common carotid artery and the terminal segment of internal carotid artery.The time differences of the beating points of their cardiac cycles and the distanceses of the skin surfaces between the 2 probes were measured and ccPWV was calculated.Results The systolic blood pressure,pulse pressure and mean arterial pressure in the elderly group were signifificantly higher than those in the middle-aged group and the young group.The ccPWVs in the youth,middle-aged and elderly groups were 418 ± 52 cm/s,489 ±54 cm/s,and 599 ± 58 cm/s,respectively.The elderly group was significantly faster than the middle-aged group (t =7.308,P ＜0.001),and the middle-aged group was significantly faster than the youth group (t=6.758,P＜0.001).A Pearson correlation analysis showed that ccPWV was significantly positively associated with the age (r=0.847,P＜0.001) and baPWV (r =0.548,P ＜0.001).The multiple linear regression analysis showed that ccPWV was significantly positively associated with the age and diastolic blood pressure (partial correlation coefficients were 0.742 and 0.293respectively,P ＜0.001 and ＜0.010 respectively).Conchlusions ccPWV is a new measurement method for cerebrovascular stiffneas,and it has a good correlation with the traditional measurement method.
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In recent years, much attention has been paid to arterial stiffness detection,but the relation between arterial stiffness and cerebrovascular disease has not been fully elucidated.This article reviews the detective methods of arterial stiffness and its relationship between the risk factors for cerebrovascular disease, ischemic stroke (including asymptomatic cerebral infarction) and cerebral hemorrhage.
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BACKGROUND: Critical closing pressure (CCP) is recently thought to play a key role in cerebral blood flow autoregulation as an effective downstream pressure of cerebral circulation and can objectively reflect the cerebrovascular tone, namely the vascular smooth muscle contraction and diastole, which is subjected to dynamic modulation.OBJECTIVE: To dynamically assess the hypertension-induced damage of the contraction function of cerebral microvascular smooth muscles and its correlation with morphological changes based on CCP evaluation.DESIGN: Randomized controlled experiment.SETTING: Institute of Neural Science of Second Hospital Affiliated to Guangzhou Medical College and Department of Neurology, First Hospital Affiliated to Sun Yet-san University.MATERIALS: The experiment was carried out at the Laboratory of Physiological Science of Sun Yet-san University between July 2002 and August 2003. Totally 160 health male SD rats were randomized into control group and hypertension group with 80 rats in each group. METHODS: Stroke-prone renovas cular hyp ortonsive rats were established in rats of the hypertension group by bilateral renal artery occlusion with two clips. The rats in the control group were not subjected to the occlusion with other treatments identical to those of the hypertension group. At the time points of 2, 4, 6, 8, 10, 12, 14 and 16 weeks after operation, respectively, 10 rats were randomly selected from each of the two groups for determination of arterial pressure and CCP. After the measurements the frontal-parietal lobe was obtained from the anaesthetized rats and cut into slices for quantitative analysis of the morphological changes in cerebral microvessels.different postoperative time points.mean arterial pressure in hypertension group obviously increased from the 6th postoperative week with significant difference from that of the control after operation to a level significantly higher than that of the control group at postoperative 14 and 16 weeks [(63.75±7.43) vs (37.28±3.68) mm Hg and (67.37±15.57) vs (38.39t7.41) mm Hg, respectively, P ＜ 0.05].significance from that of the control group at the 8th postoperative week (Paverage arterial pressure and cerebral arteriole tunica media (r=0.906 93,0.811 36, respectively, P ＜ 0.05). The changes in CCP was more obvious in the early and advanced stages of blood pressure elevation, but not so manifest during obvious blood pressure increment, displaying an inverted S-shaped curve of changes (R2=0.996 2, P ＜ 0.05).CONCLUSION: Contraction of the cerebrovascular smooth muscles is enhanced with the dynamic increment of arterial pressure after the development of hypertension. Vascular tone increase is more manifest during the early and advanced stages of hypertension.
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Objective To explore the value cerebral blood flow in prediction of motor recovery of stroke patients. Methods After evaluating the cerebral blood flow velocities of bilateral middle cerebral arteries with TCD during passive elbow movement, 68 patients with cerebral infarction were treated by rehabilitation therapy. The motor function of upper limbs was evaluated with Fugl Meyer before and after 6,12 weeks of treatment. The patients were divided into groups A and B according to the Fugl Meyer scales score of the paralytic upper limb at 12 weeks and the changes of cerebral blood velocities were compared between the two groups. Results The score of upper limb motor function were not different between group B and A before the treatment, but the score of group B was significantly higher than that of group A ( P
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Objective To establish a new practical method to assess the cerebral blood flow autoregulation. Methods We assessed the flow velociey of middle cerebral artery with transcranial Doppler and recorded invasively the blood presure simultaneonsly. Then on the basis of critical closing pressure (CCP), the lower limit of cerebral blood flow autoregulation and the blood flow resistance of arterioles were calculated.The data compared with the results generated by routine method. Results The lower limit of autoregulation working out by CCP was 70.88±24.05 mmHg, which was similar to the result measured by routine method. The lower limit of autoregulation and the arteriole resistance in RHR were significantly higher than those of normal controls, and highly relate to arterial blood pressure significantly, especially pulse pressure. Conclusions The physiology and pathology of cerebral blood flow can be evaluated conveniently and accurately by assessment of the lower limit of autoregulation and arterioles resistance with CCP.
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AIM:To study the effect of hypertensive arteriosclerosis on cerebral blood flow autoregulation (CBFA), and to introduce a new method to measure the lower limit. METHODS:The blood velocities and blood pressure was recorded simultaneously and the curves of CBFA were analyzed and classified into classical and non-classical pattern. The lower limit were determined by clinical closing pressure (CCP) and the curve CBFA. RESULTS:When the blood pressure was decreasing, the classical and non-classical pattern of the cerebral blood flow autoregulation were 25% and 75% respectively in normal SD rats, while they were 40.55% and 54.45% respectively in renovascular hypertensive rats (RHR). However, when the blood pressure was elevating, the classical and non-classical pattern were 76.47% and 23.53% respectively in SD rats, while they were all classical in RHR. Furthermore, in SD and RHR ras, the lower limits measured by CCP were well in accordance with that measured by CBFA. CONCLUSION:Hypertensive arteriosclerosis could influence the limits and the patterns of cerebral blood flow autoregulation. The lower limit of CBFA can be measured and analyzed by CCP.
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Objective To probe into the treatment effect of Sibelium to hypertensive cerebral vascular lesion and its mechanism.Methods After preparing the model of renovascular hypertensive rats (RHR), we observed the changes of the arterial blood pressure, the cerebral blood velocity, and the pathology of cerebral vascular with treatment of Sibelium. Results The arterial blood pressure of the rats taking medicine 2 to 4 weeks later was lower obviously than RHR of no taking medicine at the same stage, The pathological changes of basal cerebral arteries in the rats were milder than RHR of no taking medicine after treating 4 to 6 weeks. These effects may keep 2 to 4 weeks.Conclusion At early stage of hypertension,Sibelium can reduce the arterial blood pressure of RHR, and stop the progress of cerebral vascular lesion.
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Objective: To study the mechanism of electromyographic (EMG) biofeedback. Methods: The EMG and electroencephalographic (EEG) signals were recorded dynamically during the course of EMG biofeedback. Changes of EMG amplitude and frequency during EMG biofeedback were assessed with linear analysis. We also applied the nonlinear analysis, approximate entropy (ApEn) of EMG signals and Cross Approximate entropy (Cross-ApEn) between EMG and EEG signals, to assess regularities in EMG and correlation between EMG and EEG. Results: With the processing of EMG biofeedback, the maximum, minimum and mean amplitude of EMG signals decreased significantly (F=3.85~25.59,P
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AIM: To study the effect of hypertensive arteriosclerosis on cerebral blood flow autoregulation (CBFA), and to introduce a new method to measure the lower limit. METHODS: The blood velocities and blood pressure was recorded simultaneously and the curves of CBFA were analyzed and classified into classical and non-classical pattern. The lower limit were determined by clinical closing pressure (CCP) and the curve CBFA. RESULTS: When the blood pressure was decreasing, the classical and non-classical pattern of the cerebral blood flow autoregulation were 25% and 75% respectively in normal SD rats, while they were 40.55% and 54.45% respectively in renovascular hypertensive rats (RHR). However, when the blood pressure was elevating, the classical and non-classical pattern were 76.47% and 23.53% respectively in SD rats, while they were all classical in RHR. Furthermore, in SD and RHR ras, the lower limits measured by CCP were well in accordance with that measured by CBFA. CONCLUSION: Hypertensive arteriosclerosis could influence the limits and the patterns of cerebral blood flow autoregulation. The lower limit of CBFA can be measured and analyzed by CCP.