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Circadian rhythm abnormalities of acute cerebral infarction correlate with poor prognosis in the chronic phase
90
Abstracts
ated by administration of atropine and propranolol (Nishijo et al., 1997). However, the neural mechanisms of the acupuncture-induced bradycardiac response are not yet fully understood. In the present study we aimed to clarify the involvement of the cardiac sympathetic and parasympathetic nerves as efferent pathways in the acupunctureinduced reflexive bradycardia in anesthetized rats. Secondly, we examined the contribution of skin and muscle as afferent pathways. Male Wistar rats were anesthetized with pentobarbital and artificially ventilated. An acupuncture needle (diameter 340 μm) was inserted into the skin and underlying muscles of a hindlimb (Tsusanli, S36) to a depth of about 5 mm. Once inserted, the needle was twisted left and right with the fingers at about 2 Hz for 1 min. Heart rate began decreasing after the onset of stimulation with peak reduction (by about 20 beats/min) occurring at the end of the stimulation period, after which it gradually returned to pre-stimulation control levels. Acupuncture-like stimulation applied to the muscles alone induced a similar decrease in heart rate. However, stimulation to the skin alone was ineffective. The bradycardiac response to acupuncture-like stimulation was not influenced by severance of the bilateral vagus nerves, but was abolished by bilateral stellectomy. The cardiac sympathetic efferent activity decreased in parallel with the reflex bradycardia following acupuncture-like stimulation. At the end of stimulation, the nerve activity decreased to about 80% of pre-stimulation control values. From these results it was concluded that the reflex decrease in the efferent discharge activity of the cardiac sympathetic nerve following acupuncture-like stimulation is responsible for the bradycardia response, while the efferent discharge activity of the cardiac parasympathetic (vagus) nerve does not seem to contribute to the reflex decrease in heart rate in anesthetized rats. The afferent pathway seems to be composed of hindlimb muscle afferent nerves. doi:10.1016/j.autneu.2007.06.146
I-P-033 Circadian rhythm abnormalities of acute cerebral infarction correlate with poor prognosis in the chronic phase Hidehiro Takekawa, Yasuhisa Daimon, Atsuko Ebata, Tomoyuki Miyamoto, Hideaki Tanaka, Masayuki Miyamoto, Koichi Hirata Department of Neurology, Dokkyo Medical University, Tochigi, Japan
with acute stroke. The aim of this study was to determine circadian rhythm abnormalities of rectal temperature and wrist motor activity in patients with acute ischemic stroke and their relationship with functional prognosis in the chronic phase. Materials and methods We investigated 184 patients with cerebral infarction who had been observed within the first 48 h after onset of symptoms. The exclusion criteria were impossible classification of ischemic stroke, a modified Rankin Scale (mRS) score before hospitalization of more than 3, development of infectious disease within 7 days of stroke onset, positive antinuclear antibody, and an exothermic disorder caused by collagen disease. Fifty patients (age, 68.4 ± 11.9 years, ± SD) were included in this study. RT and WMA in the nonparalyzed wrist were recorded with a Mini-Logger 2000 for 48 h during the acute phase (within 7 days of stroke onset). Time-series data of rectal temperature and wrist motor activity were assayed by MEM spectral analysis. The MEM power spectra of RT and WMA were classified into three types: group normal; power spectra showing prominent circadian rhythms for both RT and WMA, group separate; the power spectrum showed prominent circadian rhythm for either RT or WMA; and group aberration; power spectra showing prominent other rhythm for both RT and WMA. Functional prognosis (degree of handicap) was assessed at 3 months after stroke onset by the modified Rankin Scale. Results In the acute stroke phase, 16 (32.0%), 20 (40.0%), and 14 (28.0%) patients were classified as normal, separate and aberrant groups, respectively, based on the MEM of RT and WMA power spectra. With regard to the ischemic stroke type, the aberrant group consisted mainly of patients with cardioembolism. However, there were no differences between the normal and separate groups, normal and aberration groups with regard to the stroke type composition. There was a significant relationship between age and mRS score at the chronic phase ( p b 0.05). The mean mRS scores at 3 months after stroke onset were 1.1 (1.0), 1.4 (1.5), and 5.4 (0.8) for the normal, separate and aberrant groups, respectively. Conclusion
Background
Our findings suggest the biological rhythms of RT and WMA during the acute stroke phase might be a possible prognostic indicator of their chronic phase.
Rectal temperature (RT) and wrist motor activity (WMA) rhythms in healthy persons predominately show circadian rhythm, but little is known about these rhythms in patients
doi:10.1016/j.autneu.2007.06.147
Abstracts
ated by administration of atropine and propranolol (Nishijo et al., 1997). However, the neural mechanisms of the acupuncture-induced bradycardiac response are not yet fully understood. In the present study we aimed to clarify the involvement of the cardiac sympathetic and parasympathetic nerves as efferent pathways in the acupunctureinduced reflexive bradycardia in anesthetized rats. Secondly, we examined the contribution of skin and muscle as afferent pathways. Male Wistar rats were anesthetized with pentobarbital and artificially ventilated. An acupuncture needle (diameter 340 μm) was inserted into the skin and underlying muscles of a hindlimb (Tsusanli, S36) to a depth of about 5 mm. Once inserted, the needle was twisted left and right with the fingers at about 2 Hz for 1 min. Heart rate began decreasing after the onset of stimulation with peak reduction (by about 20 beats/min) occurring at the end of the stimulation period, after which it gradually returned to pre-stimulation control levels. Acupuncture-like stimulation applied to the muscles alone induced a similar decrease in heart rate. However, stimulation to the skin alone was ineffective. The bradycardiac response to acupuncture-like stimulation was not influenced by severance of the bilateral vagus nerves, but was abolished by bilateral stellectomy. The cardiac sympathetic efferent activity decreased in parallel with the reflex bradycardia following acupuncture-like stimulation. At the end of stimulation, the nerve activity decreased to about 80% of pre-stimulation control values. From these results it was concluded that the reflex decrease in the efferent discharge activity of the cardiac sympathetic nerve following acupuncture-like stimulation is responsible for the bradycardia response, while the efferent discharge activity of the cardiac parasympathetic (vagus) nerve does not seem to contribute to the reflex decrease in heart rate in anesthetized rats. The afferent pathway seems to be composed of hindlimb muscle afferent nerves. doi:10.1016/j.autneu.2007.06.146
I-P-033 Circadian rhythm abnormalities of acute cerebral infarction correlate with poor prognosis in the chronic phase Hidehiro Takekawa, Yasuhisa Daimon, Atsuko Ebata, Tomoyuki Miyamoto, Hideaki Tanaka, Masayuki Miyamoto, Koichi Hirata Department of Neurology, Dokkyo Medical University, Tochigi, Japan
with acute stroke. The aim of this study was to determine circadian rhythm abnormalities of rectal temperature and wrist motor activity in patients with acute ischemic stroke and their relationship with functional prognosis in the chronic phase. Materials and methods We investigated 184 patients with cerebral infarction who had been observed within the first 48 h after onset of symptoms. The exclusion criteria were impossible classification of ischemic stroke, a modified Rankin Scale (mRS) score before hospitalization of more than 3, development of infectious disease within 7 days of stroke onset, positive antinuclear antibody, and an exothermic disorder caused by collagen disease. Fifty patients (age, 68.4 ± 11.9 years, ± SD) were included in this study. RT and WMA in the nonparalyzed wrist were recorded with a Mini-Logger 2000 for 48 h during the acute phase (within 7 days of stroke onset). Time-series data of rectal temperature and wrist motor activity were assayed by MEM spectral analysis. The MEM power spectra of RT and WMA were classified into three types: group normal; power spectra showing prominent circadian rhythms for both RT and WMA, group separate; the power spectrum showed prominent circadian rhythm for either RT or WMA; and group aberration; power spectra showing prominent other rhythm for both RT and WMA. Functional prognosis (degree of handicap) was assessed at 3 months after stroke onset by the modified Rankin Scale. Results In the acute stroke phase, 16 (32.0%), 20 (40.0%), and 14 (28.0%) patients were classified as normal, separate and aberrant groups, respectively, based on the MEM of RT and WMA power spectra. With regard to the ischemic stroke type, the aberrant group consisted mainly of patients with cardioembolism. However, there were no differences between the normal and separate groups, normal and aberration groups with regard to the stroke type composition. There was a significant relationship between age and mRS score at the chronic phase ( p b 0.05). The mean mRS scores at 3 months after stroke onset were 1.1 (1.0), 1.4 (1.5), and 5.4 (0.8) for the normal, separate and aberrant groups, respectively. Conclusion
Background
Our findings suggest the biological rhythms of RT and WMA during the acute stroke phase might be a possible prognostic indicator of their chronic phase.
Rectal temperature (RT) and wrist motor activity (WMA) rhythms in healthy persons predominately show circadian rhythm, but little is known about these rhythms in patients
doi:10.1016/j.autneu.2007.06.147