Asymmetrical Changes in Cerebral Blood Oxygenation Induced by an Active Standing Test in Children with Postural Tachycardia Syndrome

  • Yayumi Kamiyama
  • Yukihiko Fujita
  • Tatsuo Fuchigami
  • Hiroshi Kamiyama
  • Shori Takahashi
  • Kaoru Sakatani
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 812)


Near-infrared spectroscopy enables recognition of various brain conditions based on certain factors, such as oxygenated hemoglobin (oxy-Hb). Since July 2012, we have been trying to determine the mechanisms of autonomic function in Japanese children with orthostatic intolerance (also called orthostatic dysregulation) in Nihon University Itabashi Hospital in Tokyo, Japan. A total of 23 children aged 7–16 years diagnosed with postural tachycardia syndrome (POTS), a subtype of orthostatic dysregulation, were enrolled in the study. We evaluated the relation between asymmetry in frontal cortex activity and the automatic nervous system and compared oxy-Hb changes in the right and left frontal cortices during an active standing test. We observed that during active standing oxy-Hb decreased in the frontal cortex. The oxy-Hb changes were asymmetrical, with a significantly larger decrease in the left frontal cortex than in the right frontal cortex, suggesting that tachycardia during active standing in POTS patients might be caused by activation of the right frontal cortex, which induces sympathetic nervous system activity.


Cerebral blood oxygenation Near-infrared spectroscopy Autonomic function Orthostatic intolerance 



This research was partly supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (B23300247), and grants from Alpha Electron Co., Ltd (Fukushima, Japan) and Iing Co., Ltd (Tokyo, Japan).


  1. 1.
    Okuni M (1962) Orthostatic dysregulation in childhood with special reference to the standing electrocardiogram. Jpn Circ J 27:200–204CrossRefGoogle Scholar
  2. 2.
    Novak V, Novak P, Spies JM, Low PA (1998) Autoregulation of cerebral blood flow in orthostatic hypotension. Stroke 29:104–111CrossRefPubMedGoogle Scholar
  3. 3.
    Miyakawa M (1989) Cerebral blood flow in orthostatic dysregulation. Auton Nerv Syst 26:25–30Google Scholar
  4. 4.
    Kim YT, Tanaka H, Takaya R, Kajiura M, Tamai H, Arita M (2009) Quantitative study on cerebral blood volume determined by a near-infrared spectroscopy during postural change in children. Acta Pediatr 98:466–471CrossRefGoogle Scholar
  5. 5.
    Tanaka H, Fujita Y, Takenaka Y, Kajiwara S, Masutani S, Ishizaki Y, Matsushima R, Shiokawa H, Shiota M, Ishitani N, Kajiura M, Honda K, Task Force of Clinical Guidelines for Child Orthostatic Dysregulation, Japanese Society of Psychosomatic Pediatrics (2008) Japanese clinical guidelines for juvenile orthostatic dysregulation version 1. Pediatr Int 51:169–179Google Scholar
  6. 6.
    Mehagnoul-Schipper DJ, Colier WN, Jansen RW (2001) Reproducibility of orthostatic changes in cerebral oxygenation in healthy subjects aged 70 years or older. Clin Physiol 21:77–84CrossRefPubMedGoogle Scholar
  7. 7.
    Everdell NL, Airantzis D, Kolvya C, Suzuki T, Elwell CE (2013) A portable wireless near-infrared spatially resolved spectroscopy system for use on brain and muscle. Med Eng Phys 35:1692–1697CrossRefPubMedGoogle Scholar
  8. 8.
    Bozkurt A, Rosen A, Rosen H, Onaral B (2005) A portable near-infrared spectroscopy system for bedside monitoring of newborn brain. Biomed Eng Online 4:29CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Sakatani K (2012) Optical diagnosis of mental stress: review. Adv Exp Med Biol 737:89–95CrossRefPubMedGoogle Scholar
  10. 10.
    Tanida M, Katsuyama M, Sakatani K (2007) Relation between mental stress-induced prefrontal cortex activity and skin conditions: a near infrared spectroscopy study. Brain Res 1184:210–216CrossRefPubMedGoogle Scholar
  11. 11.
    Tanida M, Sakatani K, Takano R, Tagai K (2007) Relation between asymmetry of prefrontal cortex activities and the autonomic nervous system during a mental arithmetic task: near infrared spectroscopy study. Neurosci Lett 369:69–74CrossRefGoogle Scholar
  12. 12.
    Zamrini EY, Meador KJ, Loring DW, Nichols FT, Lee GP, Figueroa RE, Thompson WO (1990) Unilateral cerebral inactivation produces differential left/right heart rate responses. Neurology 40:1408–1411CrossRefPubMedGoogle Scholar
  13. 13.
    Weisz J, Emri M, Fent J, Lengyel Z, Marian T, Horvath G, Bogner P, Tron L, Adam G (2001) Right prefrontal activation produced by arterial baroreceptor stimulation: a PET study. Neuroreport 12:3233–3238CrossRefPubMedGoogle Scholar
  14. 14.
    Wittling W, Block A, Genzel S, Schweiger E (1998) Hemisphere asymmetry in parasympathetic control of the heart. Neuropsychologia 36:461–468CrossRefPubMedGoogle Scholar
  15. 15.
    Oppenheimer SM, Gelb A, Girvin JP, Hachinski VC (1992) Cardiovascular effects of human insular cortex stimulation. Neurology 42:1727–1732CrossRefPubMedGoogle Scholar
  16. 16.
    Terborg C, Birkner T, Schack B, Weiller C, Röther J (2003) Noninvasive monitoring of cerebral oxygenation during vasomotor reactivity tests by a new near-infrared spectroscopy device. Cerebrovasc Dis 16:36–41CrossRefPubMedGoogle Scholar
  17. 17.
    Tachtsidis I, Leung TS, Chopra A, Koh PH, Reid CB, Elwell CE (2009) False positives in functional near-infrared topography. Adv Exp Med Biol 645:307–315CrossRefPubMedGoogle Scholar
  18. 18.
    Hughson RL, Edwards MR, O'Leary DD, Shoemaker JK (2001) Critical analysis of cerebrovascular autoregulation during repeated head-up tilt. Stroke 32:2403–2408CrossRefPubMedGoogle Scholar
  19. 19.
    Bjurstedt H, Hesser CM, Liljestrand G, Matell G (1962) Effects of posture on alveolar-arterial CO2 and O2 differences and on alveolar dead space in man. Acta Physiol Scand 54:65–82CrossRefPubMedGoogle Scholar
  20. 20.
    Scholkmann F, Gerber U, Wolf M, Wolf U (2013) End-tidal CO2: an important parameter for a correct interpretation in functional brain studies using speech tasks. Neuroimage 66:71–79CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2014

Authors and Affiliations

  • Yayumi Kamiyama
    • 1
  • Yukihiko Fujita
    • 1
  • Tatsuo Fuchigami
    • 1
  • Hiroshi Kamiyama
    • 1
  • Shori Takahashi
    • 1
  • Kaoru Sakatani
    • 2
    • 3
  1. 1.Department of Pediatrics and Child HealthNihon University School of MedicineItabashi-kuJapan
  2. 2.Department of Pediatrics and Child HealthNihon University School of MedicineItabashi-kuJapan
  3. 3.Nihon University College of Engineering30-1 Oyaguchi-KamichoItabashi-kuJapan

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