Dynamic cerebral autoregulation is heterogeneous in different subtypes of acute ischemic stroke (1068.5)

Abstract

Dynamic cerebral autoregulation is heterogeneous in different subtypes of acute ischemic stroke Zhen‐Ni Guo1, Jia Liu2, Yingqi Xing1, Yi Yang1* 1Department of Neurology, the First Norman Bethune Hospital of Jilin University, Chang Chun, China; 2Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Zhen‐Ni Guo and Jia Liu contributed equally to the manuscript. * Correspondence author: Yi Yang1, M.D, PhD, #71 Xinmin Street, 130021, Changchun, China. Telephone: 86‐15843073217; E‐mail: doctor_yangyi@hotmail.com Dynamic cerebral autoregulation (dCA) is affected in acute ischemic stroke. Large‐artery atherosclerosis and small‐artery occlusion are considered as the most common subtypes. However, the underlying mechanisms might be heterogeneous, resulting in varied clinical conditions and outcomes. We therefore investigated the pattern of dCA in these two subtypes using transfer function analysis (TFA).Forty‐one patients with acute unilateral middle cerebral artery (MCA) territory stroke (15 with ipsilateral large‐artery atherosclerosis and 26 with small‐artery occlusion, according to TOAST classification) and 20 healthy volunteers were enrolled. Non‐invasive continuous CBFV and ABP were recorded simultaneously from each subject in supine position for 10 minutes using transcranial Doppler (TCD) on MCA bilaterally and servo‐controlled plethysmograph on the middle finger, respectively. TFA was applied to derive autoregulatory parameters, gain, phase, and slope of step response. The results showed that dCA is impaired ipsilaterally with the affected side in the large‐artery atherosclerosis group, whereas the impairment of dCA in the small‐artery occlusion group is bilateral.We thus concluded that dCA in different subtypes of acute ischemic stroke is heterogeneous, which might be attributed to the varied pathologic changes of vessels.