0081 Physiologic anatomy, use of Infra-Red Thermography in Hypersomnia

Abstract

Abstract Introduction In the words of Michel Salmon, " Between anatomy and physiology there is room for a functional anatomy and for a physiologic anatomy “. This concept was applied to analyze our (1) Sleep Research 21, 1992,341 (2) Sleep Research 22, 1993, 363, and (3) SLEEP 31, 2008, A219 publications on patients with Hypersomnia who had intracranial and extracranial blood flow evaluations. Methods For “Functional Anatomy”, Intracranial cerebral blood flow was done with Xenon 133 inhalation. For “Physiologic Anatomy”, Extracranial facial blood flow Imaging, Infra-Red thermography was done. 1992,3 and 2008 data was classified: Groups I, II and III. Group I had Intracranial and Extracranial blood flow study, 5% CO2 inhalation. Groups II had Extracranial flow study with 5 % CO2 and 100 % Oxygen inhalation. Groups III had Extracranial flow study 100 % Oxygen inhalation. Response interpretation: Normal response to 5% CO2, vasodilation. For 100% Oxygen / hyperoxia, vasoconstriction. Response is considered as normal or abnormal, if response is absent or paradoxical. Results Group I: All three patients 5% CO2 inhalation, intracranial Functional anatomy vasomotor response normal. Physiological Anatomy response abnormal. Group II, Physiological Anatomy study. 8 patients. CO2 response, 7/8 vasoconstriction, abnormal response. 100% Oxygen challenge, 4/8 had no vasoconstriction, abnormal response. Group III: Physiological anatomy. 7 patients tested with 100% Oxygen challenge. 6/7 abnormal response, (1 vasoconstriction, 4 no response, 2 vasodilation). Total of 18 patients in all groups, physiological anatomy/ Extracranial flow vasomotor response was abnormal in 16/18, (Group I = 3, Group II = 7, and Group III = 6) Conclusion In hypersomnia patients vasomotor testing, Functional Anatomy, intracranial flow vasomotion normal in 3/3 for hypercarbia inhalation. For Physiologic Anatomy, using Infra-Red Thermography to image extracranial facial blood flow (not coupled with metabolism) vasomotion was abnormal in 16/18 patients. 5% CO2 and 100% Oxygen inhalation used as contrast agents is well tolerated and facilitates imaging vasomotor dysfunction in the facial blood flow, trigeminal angiosomes, which can be correlated with hypersomnia. Association between trigeminal system and the hypocretin receptor 1 gene HCRTR1 gene has been reported. Support (If Any) None.