Neural Activation of the Brain With Hemodynamic Insufficiency

Little is known about how ischemia affects hemodynamic responses to neural activation in the brain. We compare the effects of a motor activation task and a cerebral vasodilating agent, acetazolamide (ACZ), on regional cerebral blood flow (rCBF) in primary sensorimotor cortex (PSM) in six patients wi...

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Bibliographic Details
Published in:Journal of cerebral blood flow and metabolism 1998-09, Vol.18 (9), p.960-967
Main Authors: Inao, Suguru, Tadokoro, Masanori, Nishino, Masanari, Mizutani, Nobuhiko, Terada, Koichi, Bundo, Masahiko, Kuchiwaki, Hiroji, Yoshida, Jun
Format: Article
Language:English
Subjects:
Acetazolamide - pharmacology
Aged
Biological and medical sciences
Brain Ischemia - physiopathology
Brain Mapping
Cerebrovascular Circulation - physiology
Female
Hemodynamics - physiology
Humans
Male
Medical sciences
Middle Aged
Neurology
Somatosensory Cortex - blood supply
Somatosensory Cortex - drug effects
Vascular diseases and vascular malformations of the nervous system
Vasodilator Agents - pharmacology
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Summary:Little is known about how ischemia affects hemodynamic responses to neural activation in the brain. We compare the effects of a motor activation task and a cerebral vasodilating agent, acetazolamide (ACZ), on regional cerebral blood flow (rCBF) in primary sensorimotor cortex (PSM) in six patients with major cerebral artery steno-occlusive lesions without paresis of the upper extremities. Quantitative rCBF was measured in all patients using H215 O autoradiographic method and positron emission tomography. The CBF was determined at rest, during a bimanual motor activation task, and 10 minutes after ACZ administration. With bimanual motor activation, rCBF increased significantly in both PSM compared with at rest (P < 0.01 on lesion side, and P < 0.02 on contralateral side). However, rCBF did not increase after ACZ injection in the PSM on the lesion side, whereas rCBF increased significantly in the contralateral PSM after ACZ injection compared with the level at rest. This result suggests that despite a decreased hemodynamic reserve, there is a nearly normal flow response to neural activation, indicating that the mechanism of vasodilation responsible for perfusion change is different for acetazolamide and neural activation. The relations among neural activation, hemodynamic status, and cerebral metabolism in the ischemic stroke patients are discussed.
ISSN:0271-678X
1559-7016
DOI:10.1097/00004647-199809000-00005