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Cerebral Autoregulation During Active Standing Test in Juvenile Patients with Instantaneous Orthostatic Hypotension

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Oxygen Transport to Tissue XLI

Abstract

Instantaneous orthostatic hypotension (INOH) is one of the main types of orthostatic dysregulation in children and adolescents. In patients with INOH arterial pressure drops considerably after active standing and is slow to recover. We investigated changes in cerebral oxygenation in the bilateral prefrontal cortex during an active standing test in juvenile INOH patients to evaluate changes in cerebral oxygen metabolism. We enrolled 82 INOH patients (mean age 13.8 ± 2.2 years, 52 mild and 30 severe patients) at Nihon University Itabashi Hospital from October 2013 to April 2018. We measured cerebral oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin levels in the bilateral prefrontal cortex using near-infrared spectroscopy during an active standing test. In severe INOH patients, cerebral oxygenation of the right prefrontal cortex remained constant when blood pressure dropped; however, de-oxy-Hb significantly increased. These findings confirm that there is asymmetrical autoregulation between the right and left prefrontal cortex.

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References

  1. Tanaka H, Fujita Y, Takenaka Y et al (2009) Japanese clinical guidelines for juvenile orthostatic dysregulation version 1. Pediatr Int 51:169–179

    Article  Google Scholar 

  2. Lassen NA (1956) Cerebral blood flow and oxygen consumption in man. Physiol Rev 39:183–238

    Article  Google Scholar 

  3. Kim YT, Tanaka H, Takaya R et al (2009) Quantitative study on cerebral blood volume determined by a near-infrared spectroscopy during postural change in children. Acta Paediatr 98:466–471

    Article  CAS  Google Scholar 

  4. Endo A, Fujita Y, Fuchigami T et al (2014) Changes in cerebral blood oxygenation induced by active standing test in children with POTS and NMS. Adv Exp Med Biol 812:253–261

    Article  Google Scholar 

  5. Tanaka H, Matsushima R, Tamai H et al (2002) Impaired postural cerebral hemodynamics in young patients with chronic fatigue with and without orthostatic intolerance. J Pediatr 140:412–417

    Article  Google Scholar 

  6. Kamiyama Y, Fujita Y, Fuchigami T et al (2014) Asymmetrical changes in cerebral blood oxygenation induced by an active standing test in children with postural tachycardia syndrome. Adv Exp Med Biol 812:271–278

    Article  Google Scholar 

  7. Holzschuh M, Woertgen C, Metz C et al (1997) Comparison of changes in cerebral blood flow and cerebral oxygen saturation measured by near infrared spectroscopy (NIRS) after acetazolamide. Acta Neurochir 139:58–62

    Article  CAS  Google Scholar 

  8. Sakatani K, Xie Y, Lichty W et al (1998) Language-activated cerebral blood oxygenation and hemodynamic changes of the left prefrontal cortex in poststroke aphasic patients: a near-infrared spectroscopy study. Stroke 29:1299–1304

    Article  CAS  Google Scholar 

  9. Wei L, Chen H, Wu GR (2018) Structural covariance of the prefrontal-amygdala pathways associated with heart rate variability. Front Hum Neurosci 12:1–11

    Article  Google Scholar 

  10. Sakatani K (2012) Optical diagnosis of mental stress: review. Adv Exp Med Biol 737:89–95

    Article  CAS  Google Scholar 

  11. Foster PS, Hubbard T, Yung RC et al (2013) Cerebral asymmetry in the control of cardiovascular functioning: evidence from lateral vibrotactile stimulation. Laterality 18:108–119

    Article  Google Scholar 

  12. Tanaka H, Yamaguchi H, Matushima R et al (1999) Instantaneous orthostatic hypotension in children and adolescents: a new entity of orthostatic intolerance. Pediatr Res 46:691–696

    Article  CAS  Google Scholar 

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Correspondence to Yukihiko Fujita .

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Ishii, W. et al. (2020). Cerebral Autoregulation During Active Standing Test in Juvenile Patients with Instantaneous Orthostatic Hypotension. In: Ryu, PD., LaManna, J., Harrison, D., Lee, SS. (eds) Oxygen Transport to Tissue XLI. Advances in Experimental Medicine and Biology, vol 1232. Springer, Cham. https://doi.org/10.1007/978-3-030-34461-0_11

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