Abstract
In a pilot study on acute ischemic stroke (AIS) patients, unexpected periodic fluctuations in microvascular cerebral blood flow (CBF) had been observed. Motivated by the relative lack of information about the impact of the emergence of breathing disorders in association with stroke on cerebral hemodynamics, we hypothesized that these fluctuations are due to apneic and hypopneic events. A total of 28 patients were screened within the first week after stroke with a pulse oximeter. Five (18%) showed fluctuations of arterial blood oxygen saturation ( ) and were included in the study. Near-infrared diffuse correlation spectroscopy (DCS) was utilized bilaterally to measure the frontal lobe CBF alongside respiratory polygraphy. Biphasic CBF fluctuations were observed with a bilateral increase of and for the ipsilesional and contralesional hemispheres, respectively, and a decrease of and for the ipsilesional and contralesional hemispheres, respectively. The polygraph revealed that, in general, the fluctuations were associated with apneic and hypopneic events. This study motivates us to investigate whether the impact of altered respiratory patterns on cerebral hemodynamics can be detrimental in AIS patients.
Highlights
Most interventions during the early hours after ischemic stroke onset aim to maximize and stabilize cerebral blood perfusion to diminish the neurological damage and improve the long-term outcome.[1]
Some works support the idea that breathing disorders (BDs) are associated with poor recovery from stroke,[10,13,14,15,16] one study has reported that BDs in stroke patients are associated with early neurological worsening but not with long-term outcome at 6 months.[4]
The respiratory polygraphy confirmed the presence of altered breathing patterns; two presented periodic breathing [cases 1 and 3; clusters of breaths separated by intervals of apnea or hypopnea], two presented a predominance of obstructive and hypopneic events, and one presented central apneas
Summary
Most interventions during the early hours after ischemic stroke onset aim to maximize and stabilize cerebral blood perfusion to diminish the neurological damage and improve the long-term outcome.[1]. Different types of BDs with different physiological origins have been reported in association with stroke in 10% to 70% of the patients.[3,4,5,6,7,8,9,10,11,12] it is not yet clear if the presence of a BD is associated with the long-term outcome. Some works support the idea that BDs are associated with poor recovery from stroke,[10,13,14,15,16] one study has reported that BDs in stroke patients are associated with early neurological worsening but not with long-term outcome at 6 months.[4] The reason for the divergence of the results of these studies could be the physiological origin of BDs
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