[Cognitive evoked potentials in uncomplicated hypertensive patients]. / Potenciales evocados cognitivos en pacientes con hipertensión arterial no complicada.

INTRODUCTION: One of the most frequent complications of vascular encephalopathies is the onset of cognitive disorders that lead the patient to a progressive decay of his abilities and useful life. Being high blood pressure (HBP) one of the most important causes of brain vascular disorders, we studied some aspects of cognition in HBP patients without neurological manifestations and with normal scores in Mini Mental State Examination. PATIENTS AND METHODS: There were studied 84 uncomplicated hypertensive patients, with a normal neurological physical examination and a group of 35 functionally healthy subjects. The patients were divided into three groups: slight high blood pressure (SLHBP, n = 24 age, 49 +/- 4) with diastolic blood pressure (DBP) between 90 and 100 mmHg, moderate high blood pressure (MHBP, n = 40, age 51 +/- 6) with DBP between 101 and 114 mmHg, and severe high blood pressure (SHBP, n = 20, age 49 +/- 8) with DBP of 115 mmHg or higher. All subjects underwent visual and auditory P300 evoked potentials. RESULTS: Visual and auditory P300 wave showed global latency delay, and amplitude decrease and absence of response in different leads, especially in frontal regions, higher in SHBP patients. This absence of response was more evident in auditory P300 in all patient groups. CONCLUSION: It is remarkable that neurologically asymptomatic HBP patients have P300 alterations with regional focalization, possibly due to a functional disorder related to hemodynamic changes in the central nervous system.

Potenciales evocados cognitivos en pacientes con hipertensión arterial no complicada / Cognitive evoked potentials in uncomplicated hypertensive patients

Introducción. Una de las complicaciones más frecuentes de las encefalopatías vasculares es la aparición de trastornos cognitivos que llevan al paciente a un progresivo deterioro de sus capacidades y vida útil. La hipertensión arterial (HTA) es una de las causas más frecuentes de alteraciones vasculares cerebrales, por lo que estudiamos las características de la onda P300 en etapas de la HTA en las que no había alteraciones clínicas neurológicas y con resultados normales en el Mini Mental State Examination. Pacientes y métodos. Se estudiaron 84 pacientes hipertensos sin complicaciones, con examen físico neurológico normal, y un grupo de 35 sujetos funcionalmente sanos. Los pacientes se clasificaron en hipertensión arterial ligera (HTAL, n 24, edad 49 4), con una tensión arterial diastólica (TAD) entre 90 y 100 mmHg, hipertensión arterial moderada (HTAM, n 40, edad 51 6), con TAD entre 101 y 114 mmHg; hipertensión arterial grave (HTAG, n 20, edad 49 8), con TAD igual o mayor a 115 mmHg. A todos los sujetos se les registraron los potenciales evocados cognitivos P300 visuales y auditivos. Resultados. La onda P300 (visual y auditiva) presentó retraso de latencia y disminución de amplitud de forma global, y ausencia de respuesta en diferentes derivaciones con predominio frontal, mayor en pacientes con HTAG. Esta ausencia de repuesta fue más notable para la P300 auditiva en todos los grupos de pacientes. Conclusión. Se aprecia que los pacientes hipertensos neurológicamente asintomáticos presentan alteraciones en la P300 con focalización regional, posiblemente por un trastorno funcional desarrollado en relación con cambios hemodinámicos en el sistema nervioso central

Introduction. One of the most frequent complications of vascular encephalopathies is the onset of cognitive disorders that lead the patient to a progressive decay of his abilities and useful life. Being high blood pressure (HBP) one of the most important causes of brain vascular disorders, we studied some aspects of cognition in HBP patients without neurological manifestations and with normal scores in Mini Mental State Examination. Patients and methods. There were studied 84 uncomplicated hypertensive patients, with a normal neurological physical examination and a group of 35 functionally healthy subjects. The patients were divided into three groups: slight high blood pressure (SLHBP, n = 24 age, 49 ± 4) with diastolic blood pressure (DBP) between 90 and 100 mmHg, moderate high blood pressure (MHBP, n = 40, age 51 ± 6) with DBP between 101 and 114 mmHg, and severe high blood pressure (SHBP, n = 20, age 49 ± 8) with DBP of 115 mmHg or higher. All subjects underwent visual and auditory P300 evoked potentials. Results. Visual and auditory P300 wave showed global latency delay, and amplitude decrease and absence of response in different leads, especially in frontal regions, higher in SHBP patients. This absence of response was more evident in auditory P300 in all patient groups. Conclusion. It is remarkable that neurologically asymptomatic HBP patients have P300 alterations with regional focalization, possibly due to a functional disorder related to hemodynamic changes in the central nervous system

[Early functional disorders of the brain in uncomplicated hypertensive patients]. / Alteraciones funcionales cerebrales tempranas en pacientes con hipertensión arterial no complicada.

OBJECTIVE: To detect the presence of changes in brain electrical activity that might be used as early markers in patients with risk factors for developing vascular encephalopathy. PATIENTS AND METHODS: There were studied 84 uncomplicated hypertensive patients, with a normal neurological physical examination and mean age of 49 years compared to 35 functionally healthy subjects. The patients were divided into three groups: slight high blood pressure (SLHBP, n = 24) with diastolic blood pressure (DBP) between 90 and 100 mmHg, moderate high blood pressure (MHBP, n = 40) with DBP between 101 and 114 mmHg, and severe high blood pressure (SHBP, n = 20) with TAD of 115 mmHg or higher. All subjects underwent digital electroencephalogram (dEEG) with quantitative analysis (QEEG). RESULTS: The patients showed focal, especially frontal paroxysms, and diffuse polymorphic theta activity in these areas, mainly those with SLHBP. Posterior alpha rhythm disorganization, inter-hemispheric asymmetries and frontal monomorphic activity were more often found in SHBP patients. In QEEG was observed an increase in absolute and relative power of slow activities, and a decrease in power of alpha and beta activities. All these findings were more frequent in the left hemisphere. CONCLUSION: The hemodynamic characteristics of the Central Nervous System and the changes caused by HBP alter the functional organization of the brain cortex, especially in frontal and midline regions, irrigated by the anterior cerebral artery.

Alteraciones funcionales cerebrales tempranas en pacientes con hipertensión arterial no complicada / Early functional disorders of the brain in uncomplicated hypertensive patients

Objetivo. Detectar la presencia de cambios en la actividad eléctrica cerebral que puedan utilizarse como marcadores biológicos tempranos en pacientes con factores de riesgo para desarrollar encefalopatías vasculares. Pacientes y métodos. Se estudiaron 84 pacientes hipertensos sin complicaciones, con examen físico neurológico normal, y una edad media de 49 años, y un grupo de 35 sujetos funcionalmente sanos. Los pacientes se clasificaron en hipertensión arterial ligera (HTAL, n 24), con una tensión arterial diastólica (TAD) entre 90 y 100 mmHg; hipertensión arterial moderada (HTAM, n 40), con TAD entre 101 y 114 mmHg, e hipertensión arterial grave (HTAG, n 20), con TAD igual o mayor a 115 mmHg. A todos los sujetos se les realizó un electroencefalograma digital (EEGd) con análisis cuantitativo (QEEG). Resultados. Los pacientes presentaron paroxismos focales predominantemente frontales y actividad θ polimorfa difusa en esas áreas, principalmente los que tenían HTAL. La desorganización del ritmo posterior, las asimetrías interhemisféricas y la actividad θ monomorfa frontal fue mayor en los pacientes con HTAG. En el QEEG predominó el incremento de energía absoluta y relativa de la actividad lenta y la disminución de la energía de las actividades θy . Las alteraciones fueron más frecuentes en el hemisferio izquierdo. Conclusión. Las características hemodinámicas propias del sistema nervioso central y los cambios producidos por la HTA alteran la organización funcional de la corteza cerebral, principalmente en las regiones frontales y la línea media lo que corresponde a las áreas de irrigación de la arteria cerebral anterior

Objective. To detect the presence of changes in brain electrical activity that might be used as early markers in patients with risk factors for developing vascular encephalopathy. Patients and methods. There were studied 84 uncomplicated hypertensive patients, with a normal neurological physical examination and mean age of 49 years compared to 35 functionally healthy subjects. The patients were divided into three groups: slight high blood pressure (SLHBP, n = 24) with diastolic blood pressure (DBP) between 90 and 100 mmHg, moderate high blood pressure (MHBP, n = 40) with DBP between 101 and 114 mmHg, and severe high blood pressure (SHBP, n = 20) with TAD of 115 mmHg or higher. All subjects underwent digital electroencephalogram (dEEG) with quantitative analysis (QEEG). Results. The patients showed focal, especially frontal paroxysms, and diffuse polymorphic theta activity in these areas, mainly those with SLHBP. Posterior alpha rhythm disorganization, inter-hemispheric asymmetries and frontal monomorphic activity were more often found in SHBP patients. In QEEG was observed an increase in absolute and relative power of slow activities, and a decrease in power of alpha and beta activities. All these findings were more frequent in the left hemisphere. Conclusion. The hemodynamic characteristics of the Central Nervous System and the changes caused by HBP alter the functional organization of the brain cortex, especially in frontal and midline regions, irrigated by the anterior cerebral artery