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首页> 外文期刊>Journal of neurology >Cerebral blood flow abnormalities in patients with neurally mediated syncope.
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Cerebral blood flow abnormalities in patients with neurally mediated syncope.

机译：神经介导的晕厥患者的脑血流异常。

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The aim of this study is to investigate regional cerebral blood flow (rCBF) in patients with syncope. We compared brain single photon emission computed tomography (SPECT) images of neurally mediated syncope patients with those of age/sex matched healthy volunteers. (99m)Tc-ethylcysteinate dimer (ECD) brain SPECT was performed in 35 patients (M/F = 17/18, mean 36.6 years) with syncope during the asymptomatic period, and in 35 healthy volunteers. For statistical parametric mapping (SPM) analysis, all SPECT images were spatially normalized to the standard SPECT template and then smoothed using a 14-mm full width at half maximum Gaussian kernel. The mean duration of syncope history was 4.9 years and the mean number of syncope episodes was 6.3. In all patients, syncope or presyncope episodes occurred during head-up tilt tests, and all were the vasodepressive type. SPM analysis of brain SPECT images showed significantly decreased rCBF in the right anterior insular cortex, left parahippocampal gyrus, bilateral fusiform gyri, bilateral middle and inferior temporal gyri, left lingual gyrus, bilateral precuneus and bilateral posterior lobes of the cerebellum in syncope patients at a false discovery rate corrected p < 0.05. There were no brain regions that showed increased rCBF in syncope patients. Furthermore, we found a negative correlation between the total number of syncopal episodes and the rCBF of the right prefrontal cortex, and between the duration of syncope history and the rCBF of the right cingulate gyrus at uncorrected p < 0.001. Decreases of rCBF in multiple brain regions may be responsible for autonomic dysregulation and improper processing of emotional stress in neurally mediated syncope patients, and frequent syncope episodes may lead to frontal dysfunction.
机译：这项研究的目的是调查晕厥患者的局部脑血流量（rCBF）。我们将神经介导的晕厥患者与年龄/性别相匹配的健康志愿者的大脑单光子发射计算机断层扫描（SPECT）图像进行了比较。在无症状期对35例（M / F = 17/18，平均36.6岁）晕厥患者进行了（99m）Tc-乙基半胱氨酸二聚体（ECD）脑SPECT检查，并对35名健康志愿者进行了检查。对于统计参数映射（SPM）分析，将所有SPECT图像在空间上均归一化为标准SPECT模板，然后使用14毫米全宽，一半最大高斯核进行平滑。晕厥病史的平均持续时间为4.9年，晕厥发作的平均次数为6.3。在所有患者中，在抬头向上倾斜测试期间均发生晕厥或晕厥前发作，均为血管降压型。脑SPECT图像的SPM分析显示，在a晕厥患者中，a晕厥患者的右前岛小叶皮层，左海马旁回，双侧梭状回，双边中下颞回，左舌回，双前突和小脑后后叶的rCBF显着降低错误发现率校正p <0.05。在晕厥患者中，没有大脑区域显示rCBF增加。此外，我们发现在未校正p <0.001时，晕厥发作的总数与右前额叶皮层的rCBF以及晕厥病史的持续时间与右扣带回的rCBF之间呈负相关。在神经介导的晕厥患者中，多个大脑区域的rCBF降低可能是自主神经调节异常和情绪应激处理不当的原因，频繁的晕厥发作可能导致额叶功能障碍。

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