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

Abstract

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.