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大血管闭塞缺血性脑卒中患者脑血流速度与脑电图的交叉耦合

发布日期【2019-03-13】 已浏览【】次
摘自:FRONTIERS
作者:Xiuyun Liu, Yuehua Pu, Dan Wu1, Zhe Zhang, Xiao Hu and Liping Liu

背景:
神经血管耦合能够快速适应脑血流(CBF)以支持神经元活动。 这种机制在缺血性卒中后的急性期是否受损仍然未知。 在这项研究中,我们应用相位-幅度交叉频率耦合(PAC)算法来研究包括脑血流速度(CBFV)和脑电图(EEG)的多模神经信号。

方法:
选取入住首都医科大学天坛医院神经重症监护室的急性缺血性卒中患者,持续监测8导联脑电图(F3-C3,T3-P3,P3-O1,F4-C4,T4-P4,P4-O2),无创动脉血压(ABP)、双侧大脑中动脉(MCA)或大脑后动脉(PCA)的血流速度,并进行回顾性分析。使用频带为0-0.05Hz和0.05-0.15Hz的CBFV相位,与5个频带(δ, θ, α, β, γ)的EEG振幅来计算PAC。全局的PAC则由每个患者6个EEG通道中的5个EEG频带的所有PAC的总和。交叉频率耦合(CFC)的半球不对称性通过左右PAC之间的差异进行计算。

结果:
16名患者(3名男性)符合标准并纳入本研究,年龄为60.9±7.9岁,平均ABP、平均左侧CBFV、平均右侧CBFV分别为90.2±31.2mmHg、57.3±20.6cm/s、68.4±20.9cm /s。CBFV和EEG之间的PAC在β和γ波段明显高于其他三个频段。枕部区域(P3-O1和P4-O2通道)显示出比其他区域更强的PAC。死亡组的全局PAC往往小于生存组(受试者工作特征曲线[AUROC]下的面积为0.81,p=0.57)。不利结果组的全局PAC较有利结果组更小(AUROC=0.65,p=0.23)。两个脑半球之间的PAC不对称性与中风患者的狭窄程度相关(p=0.01)。

结论:
我们发现,CVBF与β和γ频带的EEG通过相位振幅CFC关系相互作用,且在枕区PAC最强,并且CFC的半球不对称程度与狭窄程度相关。

Cross-Frequency Coupling Between Cerebral Blood Flow Velocity and EEG in Ischemic Stroke Patients With Large Vessel Occlusion
  Xiuyun Liu, Yuehua Pu, Dan Wu1, Zhe Zhang, Xiao Hu, and Liping Liu
Background: Neurovascular coupling enables a rapid adaptation of cerebral blood flow(CBF) to support neuronal activities. Whether this mechanism is compromised during the acute phase after ischemic stroke remains unknown. In this study, we applied a phase-amplitude cross-frequency coupling (PAC) algorithm to investigate multimodal neuro signals including CBF velocity (CBFV), and electroencephalography (EEG).
Methods: Acute ischemic stroke patients admitted to the Neurointensive Care Unit,
Tiantan Hospital, Capital Medical University (Beijing, China) with continuous monitoring of 8-lead EEG (F3-C3, T3-P3, P3-O1, F4-C4, T4-P4, P4-O2), non-invasive arterial blood pressure (ABP), and bilateral CBFV of the middle cerebral arteries or posterior cerebral arteries were retrospectively analyzed. PAC was calculated between the phase of CBFV in frequency bands (0–0.05 and 0.05–0.15Hz) and the EEG amplitude in five bands (d, ", a, b, g). The global PAC was calculated as the sum of all PACs across the six EEG channels and five EEG bands for each patient. The hemispherical asymmetry of cross-frequency coupling (CFC) was calculated as the difference between left and right PAC.
Results: Sixteen patients (3 males) met our inclusion criteria. Their age was 60.9 ± 7.9 years old. The mean ABP, mean left CBFV, and mean right CBFV were 90.2 ± 31.2 mmHg, 57.3 ± 20.6 cm/s, and 68.4 ± 20.9 cm/s, respectively. The PAC
between CBFV and EEG was significantly higher in b and g bands than in the other three bands. Occipital region (P3-O1 and P4-O2 channels) showed stronger PAC than the other regions. The deceased group tended to have smaller global PAC than the
survival group (the area under the receiver operating characteristic curve [AUROC] was 0.81, p = 0.57). The unfavorable outcome group showed smaller global PAC than the favorable group (AUROC = 0.65, p = 0.23). The PAC asymmetry between the two brain hemispheres correlates with the degree of stenosis in stroke patients (p = 0.01). Conclusion: We showed that CBFV interacts with EEG in b and g bands through a phase-amplitude CFC relationship, with the strongest PAC found in the occipital region and that the degree of hemispherical asymmetry of CFC correlates with the degree of stenosis.
Keywords: cerebral blood flow, EEG, cross frequency coupling, stroke, neurovascular coupling
fneur-10-00194.pdf