Abstract
Cerebral autoregulation (CA) is the ability of brain to maintain cerebral blood flow (CBF) at constant level despite blood pressure changes. Autonomic neuropathy (AN) is a common complication in diabetes and might affect CA. To evaluate the relation between AN and CA in diabetics, higher order crossings (HOC) analysis of mean arterial blood pressure (MABP) and mean cerebral blood flow velocity (MCBFV) signals have been performed in 43 diabetics (25 mild AN and 18 severe AN) and 11 age-matched healthy control subjects. HOC was used to count the number of zero-crossings to evaluate the degree of oscillating. HOC values of MABP and MCBFV converge to the same constant limit with increasing filter order in healthy subjects. In diabetics, the process and limit of converge of HOC values of MABP and MCBFV were significantly different during tilt (linear index CUMUDIFF HOC, Healthy: 8.31±3.23, diabetics (severe AN): 10.63±2.77, p < 0.05). HOC difference between MABP and MCBFV reveals disturbance in CA. The linear index derived from HOC can be useful to evaluate autonomic neuropathy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Freeman R. (2005) Autonomic peripheral neuropathy. Lancet 365: 1259–1270.
Statistical data: ten leading causes of death in Taiwan 2006. Department of Health, Taiwan at http://www.doh.gov.tw/statistic/data
Toyry JP, Niskanen LK, Lansimies EA, Partanen KP, Unsitupa MI et al. (1996) Autonomic neuropathy predicts the development of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke 27: 1316–1318.
Kothari V, Stevens RJ, Adler AI et al. (2002) UKPDS 60: risk of stroke in type 2 diabetes estimated by the UK prospective diabetes study risk engine. Stroke 33: 1776–1781, 2002.
Mankovsky BN, Piolot R, Mankovsky OL, Ziegler D et al. (2003) Impairment of cerebral autoregulation in diabetic patients with cardiovascular autonomic neuropathy and orthostatic hypotension. Diabet Med 20: 119–126.
Aaslid R., Lindegaard KF, Sorteberg W, Nornes H et al. (1989) Cerebral autoregulation dynamics in humans. Stroke 20: 45–52.
Jordan J, Shannon JR, Diedrich A, Black B, Costa F, Robertson D, Biaggioni I et al. (2000) Interaction of carbon dioxide and sympathetic nervous system activity in the regulation of cerebral perfusion in humans. Hypertension: 36:383–388.
Tiecks FP, Lam AM, Aaslid DW, Newell DW et al. (1995) Comparison of static and dynamic cerebral autoregulation measurements. Stroke 26: 1014–1019.
Kong X, Qiu T. (1998) Injury detection and signal discrimination of EEG by higher order crossings. Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 20: 2016–2019.
Hadjileontiadis LJ. (2003) Discrimination analysis of discontinuous breath sounds using higher-order crossings. Med Biol Eng Comput 41: 445–455.
Chen YH. (1999) The Analysis of Autonomic Nervous System Using Higher Order Crossings of Heart Rate Variability, Master Thesis, Institute of Automatic Control Engineering, Feng Chia University, Taiwan.
Kedem B. (1994) Time Series Analysis by Higher Order Crossings. Piscataway: IEEE Press.
Marthol H, Zikeli U, Brown CM, Tutaj M, Hilz MJ et al. (2007) Cardiovascular and cerebrovascular responses to lower body negative pressure in type 2 diabetic patients. J Neurol Sci 252: 99–105.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Yeh, S.J., Chiu, C.C., Liau, B.Y. (2008). Assessment of Severity in Diabetic Autonomic Neuropathy Using Cumulative Linear Index of Higher Order Crossings. In: Abu Osman, N.A., Ibrahim, F., Wan Abas, W.A.B., Abdul Rahman, H.S., Ting, HN. (eds) 4th Kuala Lumpur International Conference on Biomedical Engineering 2008. IFMBE Proceedings, vol 21. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69139-6_38
Download citation
DOI: https://doi.org/10.1007/978-3-540-69139-6_38
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-69138-9
Online ISBN: 978-3-540-69139-6
eBook Packages: EngineeringEngineering (R0)