Vegetative and cerebrovascular regulation in vestibular dysfunctions of ischemic origin

Abstract

Vestibular dysfunction (VD) is a common syndrome of ischemic brain damage that occurs with pronounced vegetative accompaniment, cerebrovascular regulation disorder. 62 patients with VD on the background of chronic brain ischemia in the compensated (I group n = 24) and subcompensated (II group n = 38) stages were examined (40.3 % men; 59.7 % women), age from 18 to 55 years, average age was 38.6 ± 1.6 years. In case of ischemic damage to the brain due to degenerative-dystrophic changes in the cerebral cortex, certain mechanisms of the development of VD with dizziness have been registered. Their presence in the clinical picture of vascular dyshemia correlates with the degree of damage, is ac- companied by pain, as well as associated complaints and symptoms. Vestibulo-atactic disorders, recorded using the integrative state of statolocomotor, were elevated compared to healthy subjects, and further increased depending on the degree of brain damage, especially against the background of prevailing vagotonia in most patients. Autonomic dysfunctions are an important aspect of the development of VD. The obtained data indicate that VD develops against the background of pathological autonomic characteristics with predominant parasympathetic orientation of vegetative tone, especially in the case of insufficiency of vegetative reactivity and pathological vegetative maintenance of activity. Such changes significantly (p < 0.05) increased in the presence of subcompensation of the chronic brain ischemia. Psychoemotional and cognitive disorders are comorbid according to the changed autonomic characteristics in VD on the background of chronic brain ischemia with initial patterns depending on the degree of brain damage. A characteristic hemodynamic feature in the groups with compensated and subcompensated chronic brain ischemia is the presence of reduced perfusion in main artery and vertebral artery. Significant changes in cerebral vascular reactivity along the myogenic circuit with a decrease in KrO2 and KrFNT indicators are a characteristic feature of the subcompensated stage of chronic brain ischemia. Hyperreactivity on rotational functional loads in both clinical groups has a high correlation with the presence of staircase and, to a lesser extent, isolated instability.