MÜSLÜMANOĞLU, Lütfiye istanbul Üniversitesi - istanbul Tıp Fakültesi - Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, turkey , AKI, Semih istanbul Üniversitesi - istanbul Tıp Fakültesi - Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, turkey , TÜRKDOĞAN, Dilsad Marmara Üniversitesi - Nöroloji Enstitüsü - Pediyatrik Nöroloji ve Nörofizyoloji Bölümü, turkey , KESĠKTAS, Nur istanbul Üniversitesi - istanbul Tıp Fakültesi - Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, turkey , AKYÜZ, Gülseren Marmara Üniversitesi - Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, turkey

AUTONOMIC FUNCTIONS IN PATIENTS WITH STROKE: A COMPARISON WITH LOCATION OF VASCULAR INSULT

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Objective: We aimed to investigate sympathetic and parasympathetic nervous system functions in patients with stroke and to correlate with localization of vascular insults.Materials and methods: Sympathetic skin response (SSR) of both upper extremity and RR interval variation (RRIV) during rest and deep breathing were recorded in 56 patients with stroke and 42 healthy volunteers. Results: The mean latency of SSR of either side in patients with stroke (both in affected side and unaffected side) significantly prolonged as compared to those in controls (p 0.05). Mean amplitudes of the responses of either extremity in patients with stroke (0.8±0.6 mV in affected side, 0.9±0.8 mV in unaffected side) were significantly smaller than in controls (1.4±0.9 mV) (p 0.001, p 0.01). RRIV during rest in patients compared to controls were 30.97± 27.99 versus 16.5±5.1 and during deep breathing were 34.2±25.2 versus 19.9±8.6 (p 0.05). Based on the localization of infarcts, lesions were classified as hemispheric (n=46) and brain stem (n=10). Patients with hemispheric lesions had significantly increased latencies (p 0.05) and depressed amplitudes (p 0.001), increased RRIV at rest (p 0.001) and during hyperventilation (p 0.001) as compared to controls. RRIV during rest and during deep breath were both higher in the right-sided cortical lesions than left sided cortical lesions (p 0.05, p 0.01). Increased SSR latencies from affected hands and decreased amplitudes from non-affected hands of brain stem lesions recorded than controls’ (p 0.05). Conclusion: As a result, vascular insults of cerebrum, mainly right-sided cortical structures affect sympathetic and parasympathetic functions. Brain stem vascular lesions were characterized by involvement of sympathetic reflex activity.

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Stroke , sympathetic skin response , autonomic system

Journal Of Istanbul Faculty Of Medicine

73