scholarly journals Decreased Nocturnal Heart Rate Variability and Potentially Related Brain Regions In Arteriosclerotic Cerebral Small Vessel Disease

2021 ◽  
Author(s):  
Miaoyi Zhang ◽  
Huan Yu ◽  
Weijun Tang ◽  
Ding Ding ◽  
Jie Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Sleep Disordered Breathing ◽  
Small Vessel Disease ◽  
Brain Regions ◽  
Cerebral Small Vessel Disease ◽  
Sleep Period ◽  
Vessel Disease ◽  
Cerebrovascular Risk

Abstract Background To assess heart rate variability(HRV) among patients with arteriosclerotic cerebral small vessel disease (CSVD) by comparing with control subjects, and to determine whether HRV parameters were related to structural alterations in brain regions involved in autonomic regulation among CSVD patients. MethodsWe consecutively recruited subjects aged between 50 and 80 years who visited the Sleep Center of Huashan Hospital from September 1, 2018 to August 31, 2019. Brain magnetic resonance imaging(MRI) was scanned before enrollment. 63 patients were assigned to the arteriosclerotic CSVD group and 46 to the control group. Polysomnography and synchronous analyses of HRV were performed. Multivariable binary logistic regression was used to identify the relationship between HRV parameters and CSVD. A number of 24 CSVD patients and 21 control participants further underwent three-dimensional brain volume scan, and the voxel based morphometry (VBM) analysis was used to identify gray matter atrophy.ResultsLower standard deviation of normal-to-normal intervals(SDNN, OR=0.943, 95% CI 0.903 to 0.985, P=0.009) and higher ratio of low to high frequency power (LF/HF, OR=4.372, 95% CI 1.033 to 18.508, P=0.045) during the sleep period were associated with CSVD, independent of traditional cerebrovascular risk factors and sleep disordered breathing. Based on VBM results, SDNN during the awake time (b=0.544, 95% CI 0.211 to 0.877, P=0.001) and the sleep period(b=0.532, 95% CI 0.202 to 0.862, P=0.001) were both positively related with gray matter thickness within the right inferior frontal gyrus only among CSVD patients.ConclusionsDecreased nocturnal HRV may be associated with arteriosclerotic CSVD independent of traditional cerebrovascular risk factors and sleep disordered breathing. The structural atrophy of some brain regions associated with cardiac autonomic regulation sheds light on the potential relationship.Trial registration Trial registration number: ChiCTR1800017902.Date of registration: 2018-08-20

scholarly journals Decreased nocturnal heart rate variability and potentially related brain regions in arteriosclerotic cerebral small vessel disease

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miaoyi Zhang ◽  
Huan Yu ◽  
Weijun Tang ◽  
Ding Ding ◽  
Jie Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sleep Disordered Breathing ◽  
Brain Volume ◽  
Small Vessel Disease ◽  
Three Dimensional ◽  
Brain Regions ◽  
Cerebral Small Vessel Disease ◽  
Sleep Period ◽  
Vessel Disease ◽  
Cerebrovascular Risk

Abstract Background To assess heart rate variability (HRV) among patients with arteriosclerotic cerebral small vessel disease (CSVD) by comparing with control subjects, and to determine whether HRV parameters were related to structural alterations in brain regions involved in autonomic regulation among CSVD patients. Methods We consecutively recruited subjects aged between 50 and 80 years who visited the Stroke Prevention Clinic of our hospital and have completed brain magnetic resonance imaging examination from September 1, 2018 to August 31, 2019. Polysomnography and synchronous analyses of HRV were then performed in all participants. Multivariable binary logistic regression was used to identify the relationship between HRV parameters and CSVD. Participants were invited to further undergo three-dimensional brain volume scan, and the voxel based morphometry (VBM) analysis was used to identify gray matter atrophy. Results Among 109 participants enrolled in this study, 63 were assigned to the arteriosclerotic CSVD group and 46 to the control group. Lower standard deviation of normal-to-normal intervals (SDNN, OR = 0.943, 95% CI 0.903 to 0.985, P = 0.009) and higher ratio of low to high frequency power (LF/HF, OR = 4.372, 95% CI 1.033 to 18.508, P = 0.045) during the sleep period were associated with CSVD, independent of traditional cerebrovascular risk factors and sleep disordered breathing. A number of 24 CSVD patients and 21 controls further underwent three-dimensional brain volume scan and VBM analysis. Based on VBM results, SDNN during the awake time (β = 0.544, 95% CI 0.211 to 0.877, P = 0.001) and the sleep period (β = 0.532, 95% CI 0.202 to 0.862, P = 0.001) were both positively related with gray matter volume within the right inferior frontal gyrus only among CSVD patients. Conclusions Decreased nocturnal HRV is associated with arteriosclerotic CSVD independent of traditional cerebrovascular risk factors and sleep disordered breathing. The structural atrophy of some brain regions associated with cardiac autonomic regulation sheds light on the potential relationship. Trial registration Trial registration number: ChiCTR1800017902. Date of registration: 20 Aug 2018.

scholarly journals Association among Parkinsonism-related motor complaints, cerebral small vessel disease, and cerebrovascular risk factors in a community-dwelling population

2019 ◽  
Author(s):  
Yang Guo ◽  
Cai-hong Ji ◽  
Fei Han ◽  
Jiang-tao Zhang ◽  
Fei-fei Zhai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Small Vessel Disease ◽  
Univariate Analysis ◽  
The Elderly ◽  
Cerebral Small Vessel Disease ◽  
Community Dwelling ◽  
Small Vessel ◽  
Vessel Disease ◽  
Cerebrovascular Risk Factors ◽  
Cerebrovascular Risk

Abstract Background Parkinsonism-related motor complaints are commonly seen in the elderly. Our study aimed to investigate the association among Parkinsonism-related motor complaints, cerebral small vessel disease and cerebrovascular risk factors in a community-dwelling population in a Chinese rural area.Methods Individuals who were 50 years old or older, were independently living, were well-functioning, and had no history of ischemic or hemorrhagic stroke, were included. Brain magnetic resonance imaging (MRI), quantified motor function assessment, and questionnaire screening for Parkinsonism-related motor complaints were performed. Clinical data including cerebrovascular risk factors were collected. In univariate analysis, Chi-square test and student t-test were used to compare dichotomous variables and continuous variables, respectively, between individuals with or without motor complaints. In multivariate analysis, binary Logistic regression models were generated to determine risk factors for Parkinsonism-related motor complaints. General linear models were used to compare motor parameters between individuals with or without motor complaints. Results In the final analysis, 854 people were included. Individuals with motor complaints had a longer time for finger taping (6.2s v.s. 5.6s, p = 0.006), and a longer time for 3m-walking(4.0s v.s. 3.6s, p = 0.034) than did those without motor complaints. Hypertension was associated with motor complaints (odds ratio, 1.82; 95% confidence interval [CI], [1.21, 2.73]; p = 0.004). Age was not associated with motor complaints; none of the neuroimaging markers of cerebral small vessel disease was associated with motor complaints. Conclusion Hypertension is associated with Parkinsonism-related motor complaints. Better management of hypertension may prevent mobility limitation in the elderly. The questionnaire that we used for Parkinsonism is not suitable for screening small vessel disease in a community-dwelling population.

scholarly journals Effect of Heart Rate Variability on the Association Between the Apnea-Hypopnea Index and Cerebral Small Vessel Disease

Stroke ◽  
2019 ◽  
Vol 50 (9) ◽  
pp. 2486-2491 ◽  
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Aldo F. Costa ◽  
Pablo R. Castillo
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Apnea Hypopnea Index ◽  
Vessel Disease

Abstract TP465: Autonomic Dysfunction and Potentially Related Brain Regions in Cerebral Small Vessel Disease

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Zhang Miaoyi ◽  
Yu Huan ◽  
Ding Ding ◽  
Tang Weijun ◽  
Jianhui Fu
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Autonomic Dysfunction ◽  
Grey Matter ◽  
Small Vessel Disease ◽  
Brain Regions ◽  
Cerebral Small Vessel Disease ◽  
Vessel Disease ◽  
Grey Matter Atrophy

Objects: To observe the fluctuations of nocturnal oxygen saturation, heart rate and blood pressure and whether there are autonomic dysfunction related brain regions in cerebral small vessel disease (CSVD). Methods: Consecutive patients with arteriosclerotic CSVD and community-dwelling elders without CSVD between 50 and 80 years old were enrolled. The parameters of oxygen saturation fluctuations and heart rate variability(HRV) were synchronously collected by polysomnography(PSG). 24-hour ambulatory blood pressure monitoring were also performed to assess the circadian rhythm and blood pressure variability(BPV). The differences in the above parameters were analyzed using appropriate statistical methods. Additionally, the voxel based morphometry (VBM) analysis was used to determine whether there were autonomic dysfunction associated structural alterations in CSVD. Results: 1. 51 patients were included in CSVD group and 37 in control group. After adjustment for gender, age, hypertension, stroke, BMI and apnea-hypopnea index(AHI), CSVD was independently associated to oxygen desaturation index (P=0.039).After adjusting age, gender, hypertension, stroke, AHI, and periodic limb movement index during sleep, significant difference of the standard deviation of normal-to-normal intervals(SDNN) during sleep period existed (P=0.030).The ratio of patients with reverse dipping patterns was higher in CSVD group after correcting age, gender, stroke, use of antihypertensive drugs, AHI and BP levels at the same periods. But no statistical differences in all BPV parameters were determined between two groups. 2. 19 CSVD patients and 16 community elders were finally included for VBM analysis. After adjustment for age, gender and AHI, grey matter atrophy in certain brain regions were more significant in CSVD group, especially in the right inferior orbitofrontal gyrus, superior medial frontal gyrus, insula, medial cingulate and bilateral medial temporal gyrus. Conclusion: CSVD patients have autonomic dysfunction which may be related with grey matter atrophy in part of autonomic network associated brain regions.

Abstract TP407: Effects of Remote Ischemic Conditioning on Cerebral Small Vessel Disease Outcomes

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yuan Wang ◽  
Haiqing Song ◽  
Kai Dong ◽  
Ran Meng ◽  
Shuying Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Flow Velocity ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Vascular Risk ◽  
Remote Ischemic Conditioning ◽  
Ischemic Conditioning ◽  
Vessel Disease

Objective: To evaluate the preliminary efficacy of remote ischemic conditioning (RIC) on patients with cerebral small vessel disease (SVD). Methods: Thirty patients diagnosed with symptomatic SVD within 30 days of onset were enrolled in this prospectively randomized controlled study for 1 year. All patients received routine medical treatment including treating vascular risk factors according to the guideline. Patients in the experimental group (n=14) were administered 5 cycles consisting of ischemia followed by reperfusion for 5 minutes on bilateral upper limbs twice daily for 1 year. Those in the control group (n=16) underwent sham ischemia-reperfusion cycles. Primary outcome was the change of cognitive function measured by mini-mental state examination (MMSE) and montreal cognitive assessment scale (MoCA), and secondary outcomes were changes of plasma biomarkers, cerebral hemodynamic parameters measured by vascular ultrasound and brain lesions measured by MRI FLAIR both at baseline and at the end of 1 year visit. Results: Compared with patients in the control group, patients in the RIC group had higher flow velocity (FV), and lower pulsatility index (PI), but without statistical difference. Patients in the RIC group had improvement in visuospatial and executive abilities (3.86±1.03 vs. 4.43±0.85, p=0.026), reduced plasma triglyceride (1.60±0.74 vs. 1.25±0.38, p=0.019), low density lipoprotein (2.89±0.81 vs. 2.26±0.67, p=0.003) and homocysteine (15.66±10.11 vs. 13.66±9.80 p=0.017). Similarly in the RIC group, the diastolic flow velocity (DFV) of middle cerebral artery (MCA) (right: 33.93±7.67 vs. 36.93±6.12, p=0.032; left: 33.93±7.67 vs. 36.93± 6.12, p=0.032) and the mean flow velocity (MFV) of left MCA (35.00±5.04 vs. 39.50±5.59, p=0.003) increased, and the PI of MCA (right: 1.11±0.19 vs. 1.02±0.14 p=0.030; left: 1.10±0.22 vs. 0.99±0.14, p=0.037) decreased. Conclusion: RIC appears to be potentially effective for improving cognition, enhancing cerebral perfusion, and modifying vascular risk factors in SVD patients. Further studies focusing on long-term neurological outcomes and potential mechanisms underlying RIC on SVD patients are needed.

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