Abstract
Purpose
The dynamic variance of cerebral blood flow velocity (CBFV), monitored by transcranial
doppler (TCD), can reveal the integrated effects of cardio-cerebral vascular autoregulation.
We investigated the characteristics of CBFV curve during active standing in multiple
system atrophy (MSA), Parkinson's disease (PD) and healthy volunteers.
Methods
The CBFV curve of middle cerebral arteries was recorded using TCD in 22 patients with
probable MSA; 20 PD patients and 20 volunteers matched for age. All individuals started
in a supine posture, followed by abrupt standing for 2 min before returning to supine.
The features of CBFV curve were compared among the groups.
Results
In the healthy volunteers, the CBFV decreased following standing up but quickly rebounded
and reached the same or greater level as the supine baseline. Afterwards, the CBFV
decreased abruptly to a sustained level, lower than the supine baseline, forming a
spike wave that appeared in CBFV curve. This spike wave was present in 5/22 of MSA,
significantly less than PD patients (18/20) and volunteers (20/20) (P<0.001). The CBFV decrease after standing showed no significant difference between
MSA than PD (9±7 vs. 6±3 cm/s, P=0.163).
Conclusions
The different pattern of CBFV curves during active standing suggests MSA may possess
cardio-cerebral vascular modulation different from PD. The clinical value of the CBFV
curve in differentiating MSA from PD needs further investigation.
Keywords
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Article info
Publication history
Accepted:
September 3,
2008
Received in revised form:
September 2,
2008
Received:
June 22,
2008
Identification
Copyright
© 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
